REESE  LIBRARY 


UNIVERSITY  OF  CALIFORNIA.    | 


\r  PlOLOGt 
C/i7S-S  NO^  iBRARY 
G 


A    TEXT-BOOK 


OP 


Veterinary  Obstetrics: 

INCLUDING    THE   DISEASES   AND    ACCIDENTS   INCIDENTAL  TO 

PREGNANCY,  PARTURITION,  AND  EARLY  AGE  IN 

THE  DOMESTICATED  ANIMALS 


CUitl]  vLttio  i)unbrcb  anb  (ru3L-ntri-sii-  iHlustnUions 


GKORGE  FLEMING,  C.B.,  LL.D  (Glas.),  F.KC.V.S. 

PHISCIPAI.  VkTEHIXAKY   SciUiEON   OF  THE   HltlTISH    AH.MY  (ReTIIIED) 

HUNOHAUY    tOUEICN    .MKMHEll  Of  THE   ACAUEMIE   HOYALE    DE    MEItECINE     HEIXiigiTE: 

rOKEION   tMiKKESl'OXDINU   MEMBER  OE  THE  SOCIETE   KOYALE   DE  MEDECIXE 

PL'BLiyCE  UE  IIELGIQL'E;   FOllEIGN  ASSOCIATE  OF  THE  SOCIETE  CEXTHALE 

VETEKINAIKE  DE  M^DECINE  DE  FRANCE;  HONORARY  FOREIUN  MEMBER 

OF      THE      SO<IETE      XATIOXALE      D'AQRICULTURK      DE      FRANCE; 

HONORARY      I.IKE     MEMUbR     OF     THE     ROYAL     AORICULTURAI- 

SOCIETY  (IK  ENGI.AXD,  ETC. 


SECOND  EDITION,  REVISED 


V 


Nkw  York 

WILLIAM    li.    JENKLNS 

VETERINARY   PUBLISHER   AND   BOOKSELLER 

851  AND  853  Sixth  Avenue 


I'JOl 


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PREFATORY  NOTK  TO  THE  SECOND  EDITION. 


In  preparing  a  second  edition  of  this  work,  it  has  been  subjected  to 
some  alteration  and  considerable  revision,  in  order  to  make  it  more 
correct  and,  while  introducing  much  new  matter,  to  keep  it  within 
reasonable  dimensions.  The  illustrative  cases  given  in  the  first  edition 
have  been  almost  entirely  omitted,  and  for  several  reasons,  the  chief  of 
which  was  that  to  I'etain  them  and  add  others  that  have  since  been 
reported  would  greatly  increase  the  bulk  of  the  volume,  while  perhaps 
contributing  little  to  its  usefulness. 

It  is  scai'cely  necessary  to  state  that  everything  has  been  done  to 
make  this  edition  as  complete  and  acceptable  as  its  predecessor ;  the 
best  authorities  on  the  different  subjects  included  in  tlie  work  have 
been  consulted  and  utilised  in  bringing  the  information  up  to  date,  and 
more  woodcuts  have  been  added  ;  so  that  the  book  might  continue  to 
be  considered  as  at  least  equal  to  the  best  of  those  which  have  appeared 
on  this  important  branch  of  veterinary  science. 


GEORGE  FLEMING. 


HiGicF.K  Lkigh,  Combe  Martin,  North  Dkvox, 
Xovember,  1895. 


9409G 


V 


/ 


PvEFACi:  TU  THE  FIRST  EDITION. 


Wmkn  we  consider  the  vast  and  yearly  increasing  amount  of  animal 
wealth  we  possess,  the  great  skill,  attention,  and  expense  bestowed  on 
the  perfecting  of  the  most  important  of  the  domesticated  creatures, 
which  are  daily  becoming  more  essential  factors  in  our  progressive 
civilization,  it  is  somewhat  remarkable,  and  rather  discreditable, 
though  not  altogether  inexplicable,  that  nothing  in  the  way  of  a  work 
devoted  to  the  parturition  of  animals,  and  to  the  diseases  and  accidents 
incidental  to  that  period,  has  yet  appeared  in  the  English  language. 
For  very  many  years  the  Anglo-Saxon  race  has  devoted  itself  most 
assiduously  and  praiseworthily,  and  with  the  greatest  measure  of 
success,  to  the  multiplication  and  full  development  of  those  (jualities 
which  more  particularly  enhance  tlie  value  and  utility  of  these  animals. 
This  has  entailed  unwearied  etYorts,  the  closest  and  shrewdest  observa- 
tion, and  all  the  judgment  and  practical  and  scientific  knowledge  which 
generations  of  men  could  afford. 

It  might  therefore  be  considered  that  everything  relating  to  the 
reproduction  and  reai'ing  of  these  creatures  must,  from  a  materialistic 
point  of  view  alone,  be  of  great  moment  not  only  to  breeders  and  stock- 
raisers,  but  to  the  entire  community.  Great  loss  may  be,  and  far  too 
often  is,  quickly  sustained  among  animals  during  the  pregnant  or 
parturient  period,  and  this  loss  may  not  only  prove  very  serious  to 
individuals,  but  make  itself  gravely  felt  by  the  general  public.  A 
treatise  which  might  aid,  to  however  small  an  extent,  in  pointing  out 
how  these  losses  may  be  averted  or  remedied,  nmst  surely,  then,  prove 
a  welcome  boon  to  those  who  are  engaged  in  breeding  and  raising 
animals,  as  well  as  to  all  who  are  interested — and  few  are  not — in  their 
nmltiplication  and  welfare.  At  the  conunencement  of  this  century  a 
book  was  i)ublished,  entitled,  "  A  Practical  Treatise  on  the  Parturition 
of  the  Cow,  or  the  Extraction  of  the  Calf ;  and  also  on  the  Diseases  of 
Neat  Cattle  in  General."  The  author  was  Edward  Skellet,  "  Professor 
of  that  part  of  the  Veterinary  Art ";  but  that  and  otiier  parts  of  this  art 
were  certainly  in  a  very  crude,  meagre,  and  elementary  condition  in  the 
days  when  Skellet  ventured  to  touch  upon  them  ;  and  yet  his  book  may 
be  said  to  be  the  only  attempt  which  has  been  made  in  this  direction  in 
England.  Papers  on  Obstetricy—soine  of  them  of  much  value — have 
appeared  from  time  to  time  in  professional  journals  ;  but  while  in  other 
countries  many  treatises  have  been  produced,  no  one  in  tliis  country 
has  undertaken  the  task  of  supplying  what  has,  for  very  many  years, 
been  an  urgent  want — a  text-book  of  Obstetricy  worthy  of  modern 
Veterinary  Science.  The  necessity  for  such  a  guide  has  been  felt  more 
particularly  by  the  Veterinary  practitioner  at  the  commencement  of  his 
career ;  for  only  too  frequently  he  has  had  to  rely  entirely  upon  his  own 
resources,  and  to  painfully  acqmre,  at  the  expense  of  his  employers,  that 


vi  PREFACE  TO  THE  FIRST  EDITION. 

knowledge  of  the  subject  which  was  either  very  imperfectly  or  not  at  all 
taught  at  the  Veterinary  Schools,  and  could  not  be  found  elsewhere. 
To  deliver  one  of  the  larger  domesticated  animals  in  a  case  of  difficult 
parturition  requires  special  knowledge  and  aptitudes  ;  and  even  those 
practitioners  who  are  fortunate  in  possessing  these  will  be  the  first  to 
confess  that  to  attempt  delivery  in  many  cases  is  really  a  work  of  the 
Danaides. 

To  the  members  of  the  Veterinary  profession,  therefore,  no  apology 
can  be  necessary  in  offering  for  their  acceptance  the  present  book. 
Eveiy  endeavour  has  been  made  to  make  it  a  standard  work,  represen- 
tative of  the  most  advanced  views  relating  to  this  department  of 
Veterinary  Medicine.  Animated  by  the  desire  to  present  my  colleagues 
in  English-speaking  countries  with  a  text-book  at  least  equal  to  the  best 
of  the  many  which  have  been  published  on  the  Continent — a  list  of 
which  is  appended — every  likely  source  of  information  has  been  made 
available,  and  no  labour  or  pains  have  been  spared  to  render  my  onerous 
and  very  difficult  task  as  complete  and  as  useful  as  possible.  A  glance 
at  the  references  and  illustrative  cases  will  testify  to  the  correctness  of 
this  statement. 

It  has  often  been  a  matter  for  regret  by  the  accoucheur  of  women, 
that  the  parturient  period  of  animals  was  one  upon  which  they  could 
obtain  but  little,  if  any,  information ;  and  its  relations  and  importance 
with  regard  to  this  and  the  puerperal  period  in  the  human  species  has 
frequently  been  insisted  upon.  I  trust  that  this  cause  for  regret  may  be 
at  least  partially  removed,  and  that  the  text-book  may  prove  of  some 
service  to  those  medical  men  who  are  anxiously  striving  to  advance 
human  obstetricy,  and  a  knowledge  of  those  pathological  processes 
around  which  there  is  still  doubt  and  uncertainty. 

My  best  thanks  are  due  to  Professor  Saint-Cyr,  of  the  Lyons  Veteri- 
nary School,  for  allowing  me  to  use  many  of  the  drawings  which  illus- 
trate his  excellent  treatise  on  the  same  subject,  and  to  w^hich  I  have 
often  referred  with  much  advantage.  I  am  also  greatly  indebted  to 
Mr.  W.  A.  Cartwa-ight,  of  Whitchurch,  Salop,  for  his  kindness  in  look- 
ing over  the  proof-sheets  containing  the  more  practical  portion  of  the 
subject ;  his  long  experience  and  skilful  practice,  combined  with  careful 
reading  and  study,  rendered  his  assistance  particularly  valuable  in  this 
respect. 

In  this  first  attempt  to  deal  with  a  very  serious  task,  omissions  and 
defects  will  doubtless  be  discovered.  But  in  the  circumstances  in  which 
I  was  placed  they  were  unavoidable,  and  perhaps,  after  all,  they  will 
not  interfere  with  the  utility  of  the  work.  Now  that  certain  principles 
in  animal  obstetrics  have  been  laid  down,  and  a  commencement  has 
been  made  to  establish  the  practice  of  the  Veterinary  Obstetrist  on  a 
sound  scientific  basis,  it  is  to  be  hoped  that  rapid  progress  will  be  made 
in  rendering  it  more  perfect.  Humanity  is  perhaps  as  deeply  concerned 
in  this  direction  as  in  many  others,  and  it  must  always  be  an  important 
object  with  the  Veterinary  Surgeon  to  spare  animals  pain,  and  to  abridge 
their  sufferings  as  much  as  possible. 

GEOEGE  FLEMING, 
Second  Life  Guards. 
Regent  s  Park  Barracks, 
November,  1877. 


CHRONOLOGICAL  LIST  OF  WORKS 

OX    VETERINARY    OBSTETRICS    PUBLISHED 

UP  TO  THE  PRESENT  TIME. 


Franxe. 

Iiai7iarcl.     Traite  Complet  de  la  Parturition  des  Femelles  des  Animaux 

Domestiques.     Paris,  1845. 
Saint-Cyr.     Traito  d'Obstetrique  Veterinaire.     Paris,  1875. 
Saint-Cyr  and  Violet.     Second  Edition  of  the  above.     Paris,  1888. 

Germany. 

Jorg.  Anleitung  zu  einer  Eationellen  Geburtshiilfe  der  Landwirthschaft- 
lichen  Thiere.  Leipsic,  1818.  This  is  ahiiost  a  complete  reproduc- 
tion of  the  English  work  by  Skellet,  at  least  so  far  as  the  Plates  are 
concerned. 

Binz.  Theoretisch-praktische  Geburtshiilfe  filr  die  Haussaugethiere. 
I^eiburg,  1830. 

Gilnthcr.  Handbuch  der  Praktischen  Yeteriniirgeburtshiilfe,  nebst 
einem  Anhange  iiber  die  Wahl  der  Zuchtpferde.     Hanover,  1830. 

Thomas.  Kenntnisse,  Erfahrungen  und  Hulfsleistungen  bei  den  Gebur- 
ten  der  Pferde.     Glogau,  1832. 

Sey/lert.     Die  Geburtshiilfe  bei  den  Kiihen,  1838. 

ZHlcr.  Kurzgefastzter,  jedoch  moglichst  griindlicher  Unterricht  iiber 
die  Geburtshiilfe  der  Gniszeren  Landwirthschaftlichen  Ilausthiere. 
Schleusingen,  1838. 

Dietcrichs.  Handbuch  der  Praktischen  Geburtshiilfe  bei  den  Groszeren 
Hausthieren.     Berlin,  18-15. 

Jiaumeister-IiiicfT.  Die  Thieriirztliche  Geburtshiilfe.  Fifth  edition, 
Stuttgart,  1869  ;  sixth  edition,  Berlin,  1878. 

Ziirn.     Handbuch  der  Tliieriirztlichen  Geburtshiilfe.     Leipsic,  1863. 

Keh  rcr.  Beitriige  zur  vergleichenden  und  experimentellen  Geburtskunde. 
Giessen,  1864. 

Thovias.  Versuch  einer  Anweisung  zur  Geburtshiilfe  der  Pferde.  Mar- 
burg, 1866. 

Harms.  Lehrbuch  der  Thieriirztlichen  Geburtshiilfe.  Hanover,  1867  ; 
second  edition,  1884. 

Franck.  Handbuch  der  Thieriirztlichen  Geburtshiilfe.  Berlin,  1876; 
second  edition,  edited  by  Ph.  Goring,  Berlin,  1887. 

Belgium. 

Dclwart.     De   la   Parturition   des  Principales  Femelles  Domestiques. 

Brussels,  1839. 
Dencubounj.     Traite    Pratique    d'Obstetrique    Veterinaire.      Brussels, 

1880. 


viii  LIST  OF  WORKS  ON  VETEniNARY  OBSTETRICS. 

Holland. 

Eberkard  and  Guntlicr.  Veiiiandeliug  over  het  Verlossen  der  Koeyen. 
Amsterdam,  1793. 

Sweden. 

Sjostedt.  Handbok  i  Forlossnings  Konsten  for  Veteriniirer  och  uppfo- 
dare  af  Husdjur.     Stockholm,  1875. 

Austria. 

Hcnkcl.  Die  Geburtshiilfe  bei  den  Kiihen.  Second  edition,  Vienna, 
1840. 

POL.AND. 

Seifert  and  Tennchcr.     Lehrbuch   der  Pferdeiirztlichen   Geburtshiilfe. 

Prague,  1820. 
Kaldcrt.     Praktische  Anleitung  zu  einer  naturgemjiszen  Geburtshiilfe 

der  laudwirthschaftlichen  Hausthiere.     Prague,  1830. 

Italy. 

Gattaneo.     Manuale  di  Obstetricia  Yeterinaria.     Milan,  1845. 
LanziUofti-Buonsanti.     Manuale   di   Obstetricia    Veterinaria.     Milan, 

1871. 
Boschetti  and  Bassi.     Trattato  di  Ostetrica  Veterinaria.     Turin,  1889. 

A  translation  of  Fleming's  Text-Book,  with  additional  remarks  by 

Professor  Bassi. 

England. 

Skellet.  A  Practical  Treatise  on  the  Parturition  of  the  Cow,  or  the  Ex- 
traction of  the  Calf ;  and  also  on  the  Diseases  of  Neat  Cattle  in 
General.     London,  1807. 

Fleviing.  Text-book  of  Veterinary  Obstetrics  :  including  the  Diseases 
and  Accidents  incidental  to  Pregnancy,  Parturition,  and  Early  Age 
in  the  Domesticated  Animals.  First  edition,  London,  1878  ;  second 
edition,  1896. 


T  A  J!  L  E  OV    I  L  L  U  S  T 11 A  T  1 0  N  S. 


no. 

1.  Pelvis  of  the  Mare     ...  - 

2.  Pelvis  of  the  Cow      -  -  -  - 

3.  Pelvis  of  the  Sheep   -  -  -  - 

4.  Lateral  Ligaments  of  the  Sacrum  and  Pelvis 
0.  Ligaments  of  the  Lumbar  Vertebra),  Sacrum 

and  Pelvis,  seen  from  below 
G.  Longitudinal  Section  of  a  Mare's  Pelvis 

7.  Diagram  of  the  Mare's  Pelvic  Axis  - 

8.  Inlet  of  the  Pelvis  of  the  Mare  :  Wide  Pelvis 

9.  Inlet  of  the  Pelvis  of  the  Mare  :  Narrow 

Pelvis     ----- 

10.  Longitudinal  Section  of  the  Cow's  Pelvis    - 

11.  Inlet  of  the  Cow's  Pelvis  :  Narrow  Pelvis  - 

12.  Inlet  of  the  Cow's  Pelvis  :  Wide  Pelvis 

13.  Bones  of  Pelvis  of  Mare 

14.  Bones  of  Pelvis  of  Horsf 

!.">.  ^Tedian  Section  of  the  Pelvis  of  the  Horse  - 
I  t'l.  Median  Section  of  the  Pelvis  of  the  Mare  - 
17.  The  Generative  Organs  of  the  Mare  in  nitu 

15.  Section  of  Udder  of  Cow 

19.  Lobale  of  Mammffl    -  -  -  - 

20.  Section  of  the  Cow's  Teat     - 

21.  Generative  Organs  of  the  Mare  :  isolated    - 

22.  Nerves  of  Mare's  Uterus 

23.  Utricular  Gland  of  a  Pregnant  Goat 

24.  Utricular  Gland  of  a  Pregnant  Cow 

25.  Horizontal  Section  of  Uterine  Glands 

2t>.  Uteru.",  Oviducts,  and  Ovaria  of  the  Sheep  - 

27.  Ovary  opened  vertically         -  .  . 

28.  Portion  of  the  Ovary  of  a  Pig 

29.  Graafian  Vesicle  in  Mare's  Ovary 

30.  Ovulam  of  the  Mare 

31.  Formation  of  the  Ovisac  in  the  Bitch's  Ovary 

32.  Graafian  Vesicle  and  Ovum  - 

33.  Escape  of  Ovum  from  Ovisac 

34.  Successive  Stages  in  Formation  of  Corpus 

Lnteum  in  Graafian  Follicle  of  Sow     - 
3').  Impregnating  Tube  -  -  .  - 


I'Aor. 

Bauinehler 

and  Riirjf 

3 

Ibid. 

- 

- 

C) 

Ibul 

- 

7 

Leyh 

- 

8 

Ibid. 

- 

. 

10 

Saiid-Cijr 

- 

- 

13 

Ibid. 

- 

- 

14 

Ibid. 

- 

l.'j 

Ibid. 

- 

If, 

Ibid. 

- 

17 

Ibid. 

- 

- 

18 

Ibid. 

- 

- 

18 

Ibid. 

- 

20 

Ibid. 

20 

Franrk 

22 

Ibid. 

- 

22 

Sain(-C'i/r 

- 

- 

28 

Fninck 

- 

- 

34 

Virchow 

- 

- 

35 

Gnibiiurt 

- 

35 

Chauvcav 

- 

- 

37 

Franch 

- 

42 

Ibid. 

- 

- 

43 

Ibid. 

- 

- 

43 

Ibid. 

- 

- 

44 

Oiroi 

4.') 

y^tint-Ci/y 

- 

- 

50 

Ibid. 

- 

- 

5(» 

Franch 

- 

- 

50 

Ibid. 

- 

- 

50 

liisrhnf 

- 

- 

52 

Barry 

- 

53 

Thomson 

- 

- 

53 

Pour he t 

54 

Luford 

G7 

TABLE  OF  ILLUSTRATIONS. 


36.  Section  of  Impregnating  Tube 

37.  Dilator  of  the  Cervix 

38.  Ovum  from  Oviduct  of  Rabbit 

39.  A  more  advanced  Ovum 

40.  Ovum  from  Uterine  half  of  Oviduct 

41.  Ovum  from  Uterine  end  of  Oviduct 

42.  Blastoderm  and  Primitive  Trace 

43.  Ovum  Twenty  to  Twentj-five  Days  Old 

44.  Ovum  about  a  Month  Old     - 

45.  Chorion  of  Mare  at  Mid-term 

46.  Foetal  Membranes  of  the  Cow  at  Mid-term - 

47.  Foetal  Membranes  of  the  Goat  at  Full  Time 

48.  Foetus  and  Foetal  Membranes  of  Cat 

49.  Foetus  of  Mare  and  its  Envelopes     - 

50.  Plan  of  Foetal  Envelopes  in  Mare    - 

51.  Portion  of  Chorion  with  Placentulas  :  Cow- 

52.  Accessory  Placentulse  in  a  Cow's  Uterus 

53.  Accessory  Placentulte  on  the  Cow's  Uterus  - 

54.  Foetal  Portion  of  Placenta  Prsevia   - 

55.  Maternal  and  Foetal  Cotyledons  of  the  Cow 

56.  Cotyledon  of  a  Cow's  Uterus 

57.  Foetal  Circulation  in  a  Transition  State 

58.  Foetal  Circulation  :  Advanced  Period 

59.  Male  Foetus  of  the  Mare 
Genito-uriuary  Organs  of  a  Foetal  Sheep     - 
Female  Organs  of  a  Foetal  Deer 
Female  Foetus  of  the  Cow     - 

63,  Genital  Organs  of  a  Hermaphrodite  Goat    - 

64.  Vertical  Section  through  a  Portion  of  the 

Uterine  Cotyledon  of  a  Cow     - 
The   Gravid  Uterus  of  a  Multiparous  and 

Uniparous  Animal 
Twin  Pregnancy :  Cow         .  _  . 

A  Mole  ----- 

Hydatid  Cyst  or  Mole  :  Human 
Cow  in  the  Act  o£  Parturition  :  Standing 

Position  -  .  .  . 

Mare  in  the  Act  of  Parturition  :  Recumbent 

Position  -  -  .  _ 

71.  Normal  Position  of  the  Foetus  in  the  Mare 

at  Parturition  :  First  Stage 

72.  Normal  Position  of  the  Foetus  in  the  Mare 

at  Parturition  :  Second  Stage  - 

73.  Normal  Position  of  the  Foetus  in  the  Mare  : 

Third  Stage       -  .  -  - 

74.  Diameters  of  the  Pelvis 
lb.  Lumbo-sacral  Position 

76,  Right  Cephalo-ilial  Position  in   the  Dorso- 
lumbar  Presentation 


60, 
61, 
62, 


65, 

66, 
67. 
68. 
69. 

70. 


Ibid. 

■      67 

Ibid. 

-       67 

Bischoff 

-       69 

Ihkl. 

-       69 

Ibid. 

-       70 

Ihkl. 

-       70 

Saint-Cyr 

-      71 

Ihkl. 

-       73 

Ihkl. 

-      74 

Colin 

-       75 

Ibid. 

-       76 

Ibid. 

-       77 

Buffon 

-       78 

Chauveau 

-       79 

Saint-  Cyr 

-       82 

Gurlt 

-       87 

Franch 

-      88 

Ibid. 

-      88 

Ibid. 

-       89 

Colin 

-       90 

Pettigreio 

-      91 

Saint-  Cyr 

-     104 

Colin 

-     106 

Franch 

-     Ill 

Midler 

-     112 

Ihkl. 

-     114 

Fr  ancle 

-     114 

Leuchart 

-     115 

Franch 


129 


Thomson 

-     133 

Saint-Cyr 

-     165 

Zundel 

-     178 

Boivin 

-     179 

Original 

-     236 

Baumeister    - 

-     237 

Franch 

-     240 

Ibid. 

-     241 

Saint-Cyr 

-     243 

Saint-Cyr 

-     244 

Ibid. 

-    245 

Franch 


246 


TABLK  OF  ILLCSrJLlTIoXS. 


77.  Cephalo-sacral  Position  in  the  Dorso-lumbar 

Presentation       .  -  -  - 

78.  Cei)halo-sacnil  Position  in  the  Dorso-lumbar 

Presentation      .  -  .  - 

7'.\  Left  Cephahi-ilial  Position  in  the  Sterno- 
abdominal  Presentation 

80.  Mammarj'  Gland  during  Lactation 

81.  Completely  Deformed  Pelvis  :  Mare 

82.  Pelvic  Exostosis       -  .  -  - 

83.  Fracture  of  the  Pelvis 

84.  Uterine  Hernia  :  ^Lare 

85.  Uterine  Hernia  :  Cow 

86.  Incomplete  Torsion  of  the  Uterus  - 

87.  Multiple  Torsion  of  the  Uterus 

88.  Diagram  of  Uterine  Torsion 

89.  Left  Uterine  Torsion 

90.  Right  Uterine  Torsion 

91.  Right  Uterine  Torsion  :  ^Iani[)ulation 

92.  Left  Uterine  Torsion  :  Manipulation 

93.  Left  Uterine  Torsion  hi  situ 

94.  Darreau's  Retroversor 

95.  Barnes'  Uterine  Dilator 

96.  Skull  of  a  Hydrocephalic  Calf 

97.  Skull  of  a  Hydrocephalic  Calf 

98.  Skull  of  a  Hydrocephalic  Foal 

99.  Calf  affected  with  Hydrocephalus  - 

100.  Extraordinary  Development  of  theCranium 

of  a  Hydrocephalic  Calf 
li'l.  Anasarcous  Foetal  Calf 
IH-J.  Anasarcous  Fojtal  Calf 
l<t;5.  Deformed  Head  and  Xeck  of  a  Foal 
104.  Ectromelian  Monstrosity  :  Horse  - 
in.').  Ectromelian  Monstrosity  :  (ioat     - 
I'M').  Symelian  Monstrosity  :  Pig 
107.  Celosomian  Monstrosity  :  Calf 
ILH.  Ectopia  Cordis  .... 

In'.t.  Pseudencephalian  ^lonstrosity 
lli>.  Cyclopean  Monstrosity  :  Ram 
ill.  Cyclopean  Monstrosity  :  Ass 
\\'2.  Acephalian  Monstrosity       -  .  . 

II.?.  Schistocephalus  Fissislabrus 
1 14.  Camylorrhacchis  Contorta  - 
11").  Monomphalian  Monstrosity 
110.  Skull  of  Syncephalian  Monstrosity 

117.  Monocephalian  ^lonstrosity 

118.  Sysomian  Monstrosity 

119.  Monosomian  Monstrosity  :  Calf 
12i>.  Polymelian  Monstrosity  :  Calf 

rJl.  Double  Parasitic  Monstrosity  :  Cow 


Saint -Ci/r 

■ 

247 

/hi,/. 

- 

248 

FranrL 

. 

•248 

Virchow 

- 

272 

Saint- Ci/r 

. 

290 

Ihid 

- 

291 

Ibid. 

. 

292 

Ibid. 

- 

298 

Zundel 

- 

299 

Ibid. 

. 

313 

Gurlt 

- 

314 

Saiiit-Cyr 

- 

322 

G'lrlt 

- 

323 

Ibid. 

- 

323 

Saint-Cyr 

- 

324 

Ibid. 

- 

324 

Rosnif/nol 

- 

327 

Dorreau 

- 

333 

Origi)iol 

- 

359 

S<iint-Ci/r 

- 

382 

Ru  eff" —  lia  u  m  eister    - 

383 

Saint-Ciji' 

- 

383 

Rueff—Bi 

umeister    - 

384 

(h-ifjinal 

. 

385 

Fvanck 

- 

388 

Ibid. 

- 

388 

Ibid. 

- 

392 

Zundel 

- 

402 

Rufff — Buumeister    - 

4(12 

Ibid. 

- 

403 

Ibid. 

- 

403 

Ilering 

- 

404 

Ibid. 

- 

404 

Ibid. 

- 

405 

Gurlt 

- 

405 

Ibid. 

- 

406 

Rueff—Baumeister    • 

406 

Ibid. 

- 

407 

Ibid. 

. 

408 

Franck 

- 

408 

Ilurff— Buumeister    - 

409 

Rurf-Bftu 

nifister 

41)9 

Original 

• 

410 

Rueff—Baumeister    - 

410 

Zundel 

. 

411 

xii  TABLE  OF  ILLUSTRATIONS. 

FIG. 

122.  Sysomian  Monstrosity         -  .  .  Saint-Cyr 

123.  Celosomian  Monstrosity :  Lamb     -  -  Youatt 

124.  Twin  Foetuses  in  Different  Presentations  -  Saint-Cyr 

125.  Anterior  Presentation  :    Deviation  of  the 

Hind -limbs  in  the  Pelvis  -  -     Ihid. 

126.  Anterior  Presentation  :   Hind-limb   Devia- 

tion        -  -  .  .  .     Franch 

127.  Anterior  Presentation  :  Fore-limb  crossed 

over  the  Neck    -  -  .  -     Saint-Cyr 

128.  Anterior  Presentation  :  Fore-limbs  flexed 

at  the  Knees      -  -  .  .     Ih'id. 

129.  Anterior    Presentation  :     Extending    the 

Fore-limb  ....     Franck 

130.  Anterior    Presentation  :     One    Fore-limb 

completely  retained        -  -  -     Saint-Cyr 

131.  Anterior  Presentation  :    Both  Fore-limbs 

completely  retained       -  .  .     Ihid. 

132.  Anterior  Presentation  :  Downward  Devia- 

tion of  the  Head  -  -  -     Ihid. 

133.  Anterior   Presentation  :    Extreme    Down- 

ward Deviation  of  the  Head     -  -     Ihid. 

134.  Anterior  Presentation  :  Lateral  Deviation 

of  the  Head  towards  the  vShoulder        -     Ihid. 

135.  Anterior  Presentation  :  Lateral  Deviation 

of  the  Head  towards  the  Abdomen       -     Ibid. 

136.  Anterior   Presentation  :    Deviation  of  the 

Head  Upwards  and  Backwards  -     Ihid. 

137.  Anterior  Presentation  :    Deviation  of  the 

Head  Upwards  and  Laterally   -  -  Ibid. 

138.  Lumbo-Sacral  Position        -  -  -  Ibid. 

139.  Hock  Presentation  :  Calf    -  -  -  Franch 

140.  Diagrams  of  the  Hind-limbs  in  Hock  Pre- 

sentation            -             .             .  .  Ihid. 

141.  Hock  Presentation  :  Hock  Corded  -  Saint-Cyr 

142.  Thigh  and  Croup  Presentation       -  -  Ihid. 

143.  Thigh   and    Croup    Presentation  :  Thigh 

Corded  -  ...  -     Ibid. 

144.  Thigh    and    Croup    Presentation  :     Body 

Corded  -----     Franch 

145.  Transverse  Presentation  :  Right  Cephalo- 

ilial  Position — Side  View  -  -     Saint-Cyr 

146.  Transverse  Presentation  :  Right  Cephalo- 

ilial  Position — Upper  View       -  -     Franck 

147.  Transverse  Presentation  :  Vertical  or  Ce- 

phalo-sacral  Position     -  -  -     Saint-Cyr 

148.  Sterno-abdominal  Presentation,  Head  and 

Feet  Engaged  :  Foal     -  -  -     Franck 

149.  Sterno-abdominal  Presentation,  Head  Re- 

tained :  Calf      -  -  -  -     Saint-Cyr 


PAGE 

417 

-  419 

-  423 

-  430 

-  431 

-  435 

-  437 

-  438 

-  440 

-  441 

-  444 

-  446 

-  449 

-  450 

-  454 

-  454 

-  456 

-  462 

-  462 

-  466 

-  467 

-  469 

-  470 

-  474 

-  474 

-  477 

-  479 

-  480 


TAliLK  OF  ILLUSTRATIOXS. 


FIG. 

150.  Solid  Repeller,  with  a  Removable  Spike    - 

151.  Simple-joiated  Repeller 

152.  Jointed  Repeller  :  Open 

153.  Jointed  Repeller  :  Closed  - 

154.  Traction  Cord  and  Band,  and  the  Manner 

of  Applying  tbem 

155.  Schaack's  Traction  Cord 

156.  Binz's  Simple  Head-collar  - 

157.  RuefJ's  Head-collar,  No.  1  - 

158.  Rueffs  Head-Collar,  No.  2  - 
151'.  Binz's  Forceps- band 

1()0.  Schaack's  Forceps-halter 

161.  Manner  of  Placing  Schaack's  Halter 

16-'.  Schaack's  Halter  Placed  on  a  Calf's  Head  - 

103.  Halter  with  a  Single  Traction  Cord 

104.  Halter  with  Two  Traction  Cords   - 

1G5.  Defays'  Wire-extractor  with  the  Torsion 
Rods       .  -  .  -  - 

IGG.  Defays'  AVire  Extractor  Applied     - 
lf)7.  Breulet's  Tube  and  Noose  - 
1(")S.  Breulefs  Noose  Fixed  on  the  Foetus 
1G1>.  Cartwright's  Porte-cord 

170.  Darreau's  Porte-cord 

171.  Giinther's  Curved   Porte-cord   and    Blunt 

Crotchet  .  .  .  . 

172.  Darreau's  Curved  Porte -cord 

173.  Darreau's  Repeller  .  -  -  - 

174.  Binz's  Porte-cord     -  .  -  - 
17.'>.  Short  Blunt  Crotchet 

17t').  Blunt  Finger  Crotchet 

177.  Short    Sharp    Crotchet,    with    Broad    or 

Flanged  Point  -  -  -  - 

178.  Short  Sharp  Crotchet,  with  Round  Point  - 

179.  Long  Blunt  Crotchet 

180.  Long  Pointed  Crotchet 

181.  Long  Pointed  Crotchet,  Darreau's  Pattern 

182.  Long  Pointed  Crotchet,  Darreau's  Pattern 

183.  Schaack's  Crotchet  -  -  -  - 
1S4.  Simple  Short  Crotchet-forceps 

1H5.  Long  Simple  Crotchet-forceps 
18G.  Giinther's  Long  Crotchet-force p"*    - 

187.  Jointed  Crotchet-forceps     - 

188.  Nelson's  Blunt  Crotchet- forceps     - 

189.  Nelson's  Serrated  Crotchet-forceps 

190.  Tallich's  Short  Bent  Crotchet-forcep.s 
101.  Andre's  Crotchet-forceps     - 

192.  Bitch  Forceps  .... 

193.  Weber's  Forceps      .  -  .  . 

194.  Defays'  Forceps       .... 


OrKjinal 
IbUK 
Rainard 
Ibid. 

Baumeister     - 

Saint-Cj/r 

Bauineisler    • 

Rueff 

Ibid. 

Baitmeiiiter — Rueff 

Saint- Cyr 

Ibid. 

Ibid. 

Detroye 

Ibid. 


xui 

PAfiK 

489 
489 
489 
489 

500 
500 
502 
502 
502 
503 
504 
504 
505 
506 
50G 

507 
508 
508 
508 
509 
509 

509 
5U9 
510 
511 
511 
511 

512 
612 
513 
513 
513 
513 
516 
518 
518 
519 
519 
519 
519 
520 
620 
522 
.522 
522 


XIV 

no. 

195. 
196, 
197. 
198. 
199. 
200. 
201. 
202. 
203. 
204. 
205. 
206. 
207. 
208. 
209. 
210. 
211. 
212. 
213. 
214. 
216. 
216. 
217. 
218. 
219. 
220. 
221. 
222. 
223. 
224. 

225. 
226. 


TABLE  OF  ILLUSTRATIONS. 


Diagram  of  the  Pelvic  Axis 
Obstetric  Pulleys     -  -  .  - 

Baron's  Obstetric  Machine  - 
Straight  Embryotom  -  -  . 

Curved  Embryotom 

Gunther's  Embryotom  :  Improved  Pattei-n 
Colin's  Scalpel  Embryotom 
Unsworth's  Spring  Embryotom 
Gunther's  Long-handled  Embryotom 
Cartwright's  Subcutaneous  Spatula 
Carsten  Harm's  Spatula 
Ungefrohrn's  Spatula 

Cartwright's  Bone-chisel     -  .  - 

Cartwright's  Bone-saw         .  -  . 

Swedish  Chain-saw  -  -  .  - 

Pad  Pessary  .... 

Ring  Pessary  .  .  .  . 

Cup  and  Ball  Pessary 
Zundel's  Labial  Sutures 
The  Loop  of  Delwart's  Truss 
Delwart's  Truss  Applied 
Renault's  Truss        .  .  .  . 

Leather  Truss  -  -  .  . 

Lund's  Truss  L-on  -  .  -  . 

Lund's  Truss  Applied 
Parturient  Apoplexy  :  Cow 
Teat-syphon  .... 

Ring  Teat-syphon    ...  - 

Liithi's  Perforating  Sound  -  -  . 

Armatage's  Truss  Applied  for  Umbilical 
Hernia   -  -  -  .  . 

Umbilical  Clam       -  -  .  . 

Armatage's  Iron  Umbilical  Clam    - 


Saint- Cyr 
Ihkl. 
Ibid. 
Orifjmal 


Saint-Cijv 

Ihkl. 

Ibkl. 

Zunclel 

Franclc 

Saint- Cyr 

Ibid. 

Franch 

Saint-Cyr 
A  rniatage 
Original 


Artiiatage 

Ibid. 

Ihkl. 


PAGE 

524 
528 
530 
535 
535 
536 
536 
536 
537 
537 
537 
538 
538 
538 
538 
588 
589 
589 
593 
593 
594 
595 
596 
597 
598 
638 
691 
691 
699 

708 
712 
712 


TABLE  OF  CONTENTS. 


Prefatory  Note  to  Second  Editiox  - 

PuKKAiK  to  First  Edition    - 

Lisr  ok  Works  on  Veterinary  C)i!stetkics 

Imroduction 


PAOE 

ill 

V 

vii 
XX  xi 


PAET  FIRST. 

EUTOKIA,  OR   TOKOLOGY. 

BOOK  I.— OBSTETRICAL  ANATOMY    - 
CHAPTER  I.— THE  PELVIS 

Section  I. — Bones  or  the  Pelvis 

1.  Os  Innominatum 

Ilium 

Ischium 

Pubis 

2.  Sacrum 

3.  Coccyx 
Differences  in  the  Bones  of  the  Pelvis  of  other  Animals  than 

the  Mare 
Coxo        .... 
Sheep  and  Goat 
Bitch  and  Cat         ■ 
P\g         .... 

Section  II.— Articulations  or  the  Pelvis 

1.  Sacro-lumbar  Articulation 

2,  3.  Sacroiliac  Articulations 

4.  Ischio-pubic  Symphysis   - 

5.  Sacrococcygeal  Articulations 
Differences  in  the  Pelvic  Articulations  of  other  Animal.' 

than  the  ]Mare   - 
Cow        ...  - 

Sheep  and  Goat 
Bitch  tnid  Cat 

Sacro-sciatic  Ligament 
Section  III.— The  Pelvis  and  its  Cavity 
Jfare       .... 

External  Surface 

Internal  Surface 


2 
2 

3 
4 
4 
5 
6 

6 
6 

7 
7 
8 

8 
8 
it 
9 
[) 

IC 
10 
11 
11 
11 

12 
12 
12 
13 


TABLE  OF  CONTENTS. 

PAGE 

Anterior  Opening  or  Inlet                 -  -  -  14 

Posterior  Opening  or  Outlet             -  -  -  16 

Differences  in  other  Animals  than  the  Mare  -  -  17 

Coio        -                -                -                -  -  -  17 

Sheep  and  Goat     -                 -                 -  -  -  19 

Pig 19 

Bitch  and  Cat         -                 -                 -  -  -  19 

Differences  in  the  Pelvis  according  to  Sex  -  -  19 

Section  IY. — Capacity  of  the  Pelvis,  or  Pelvimetry     -  21 

CHAPTER  II.— FEMALE  GENERATIVE  ORGANS  -  27 

Section  I. — External  Organs  of  Generation  -  -  27 

The  Vulva              -                 -                 -  -  -  27 

Differences  in  other  Animals  than  the  Mare  -  -  30 

Coio        ■                 -                 -                 -  -  -  30 

Sheep      ■                 -                 -                 -  -  -  31 

Pig        -               -               -               -  -  -  31 

Bitch  and  Cat         -                 -                -  -  -  31 

Section  II. — The  Mamm^        -               -  -  -  32 

Differences  in  other  Animals  than  the  Mare  -  -  34 

Cow        -                -                -                -  -  -  34 

Sheep  and  Goat      -                -                -  -  -  35 

Pig         -                -                -                -  -  -  36 

Bitch      -                -                -                -  -  -  36 

CHAPTER  III.— INTERNAL  ORGANS  OF  GENERATION  36 

Section  I. — The  V..gina          -               -  -  -  36 

Differences  in  other  Animals  than  the  Mare  -  -  38 

Coio,  Sheep,  and  Goat            -                -  -  -  38 

Pig         -                -                -                -  -  -  38 

Bitch  and  Cat         -                -                -  -  -  39 

Section  II. — The  Uterus       -               -  -  -  39 

Differences  in  other  Animals  than  the  Mare  -  -  42 

Coio        -                -                 -                 -  -  -  42 

Sheep  and  Goat     -                -                '-  -  -  46 

Pig         -                -                -                -  -  -  46 

Bitch  and  Cat         -                 -                 -  -  -  46 

Development              -                 -                 -  -  -  46 

Section  III. — Fallopian  Tubes,  or  Oviducts  -  -  47 

Differences  in  other  Animals  than  the  Mare  -  -  48 

Cow,  Sheep,  and  Goat            -                -  -  -  48 

Pig         -                 -                -                -  -  -  48 

Bitch      -                -                ■                -  -  -  48 

Section  IV. — The  Ovaries      -               -  -  -  48 

Differences  in  other  Animals  than  the  Mare  -  -  51 

Cow,  Sheep,  and  Goat            -                 -  -  -  51 

Pig         -                -                -                -  -  -  51 

Bitch  and  Cat         -                -                -  -  -  51 

Development             -                 -                 -  -  -  51 


TABLE  OF  CONTENTS.  xvii 

BOOK  I r.— OBSTETRICAL  PHYSIOLOGY 
KEPKODUCTION      - 


53 


CHAPTER  I.— GENERATION                      -  -                -       57 

Section  I. — Puhkrty                                -  -                -      57 

Section  II.— CEstrum  or  Menstruation  -                      5'J 

Section  III. — M.vti'r.xtion  of  the  Graaki.vn  Vesicles           (J;-} 

CUAPTER  II.— FECUNDATION  -04 

CHAPTER  III. -STERILITY  -       65 

CHAPTER  lA'.-CHANGES  IN  THE  OVUM  -                -       08 

Section  I.  — Development  of  the  Embryo  -                      71 

Section  II. — Api-endaoes  of  the  Foctus  -                     li) 

Chorion     -                                                    -  -                 -lb 

Differences  in  other  Animals  than  the  Mare  -                 -       77 

Ruminants               -  -       77 

Pig         -                 -                                  -  -       78 

Bitch  and  Cat         -                 -                 -  ■                        78 

Amnion     -                -                                 -  -       79 

Liquor  Amnii            -                 -                 -  -                 -       80 

Differences  in  other  Animals  than  the  Mare  -       81 

Ruminants               -                 -                 -  -                  -       81 

Pig        ■              ■                             -  -              -      81 

Rilrh  and  Cat         ■                 -                  -  -                  -       81 

AUantois    -                 -                 -                 -  .                 -       81 

Differences  in  other  Animals  than  the  Mare  84 

RuininantH                -                    -                    -  .                    -        84 

Pi;,           ■                                       .                   .  .                   -        84 

Bitrh  and  Cat         -                  -                  -  -                  -       84 

Umbilical  Vesicle      -                -                -  -                -84 

Differences  in  other  Animals  than  the  Mare  -       85 

Rtimiiianl:(  and  Pif/                                    -  -        85 

The  Placenta  -       85 

Differences  in  other  Animals  than  the  Mare  -                        86 

Cow        -  -86 

Sheej)  and  Goat      -                 -                 .  .                 .       yo 

Pig         -                                -                -  -                -       92 

.  Bitch  and  Cat         ■  -       92 

Functions  -  -93 

Umbilical  Cord         ....       ii;{ 

Differences  in  other  Animals  than  the  Mare  94 

Ruminants               -                                   -  -94 

Pig         •                 ■                 -                 -  -                 -       95 

Bitrh  and  Cat         -                 ■                 ■  ■                 -       95 

Section  III. — Development  of  the  F<etus  -               -      96 

The  Nervous  System                                  -  -97 

The  Organs  of  Sense  -98 

The  Skin  and  its  Appendages  -                 -  -                      100 

The  Locomotor}-  Apparatus     -                 .  .                 .     101 


TABLE  OF  CONTEXTS. 

PAGE 

The  Circulatory  System           .                 .                 .                 .  104 

The  Respiratory  Apparatus     .                 -                 .                 -  107 

The  Digestive  Apparatus         -                 -                 -                 -  108 

The  Genito-urinary  Organs      .                 -                 -                 -  HO 

Sectiox  IV. — Periods  of  Development              -                -  115 

Sectiox  Y. — Physiological  Phenomena  in  the  Fcetus  -  118 

Nervous  Functions  -----  119 

Absorption                 .                 .                 .                 -                 .  120 

Nutrition  -                 -                 -                 -                 -                 -  121 

Circulation                 .                 .                 .                 .                 -  122 

Secretion  ------  124 

Section  YI. — "Weight  and  Dimensions  of  the  Fcetus  at 

Birth                -                .               .               .               .  125 

CHAPTER  v.— PREGNANCY      -                -                -                -  127 

Section    I.  —  Modifications    in    the     Uterus    during 

Pregnancy       -               -               -               -               -  128 

Yolume      -                 -                 -                 -                 -                 -  128 

Structure  -                 -                 -                 -                 -                 -  128 

Sensibility                  .                 .                 .                 -                 .  131 

Form          -                 -                 -                 -                 -                 -  132 

Situation  -----                 -  134 

Direction  ------  134 

Influence  on  and  Alterations  in  the  Position  of  Neighbour- 
ing Organs          -                 -                  -                  -                  -  135 

Section  II. — Position  of  the  Fcetus  in  the  Uterus       -  137 

Section  III. — Signs  of  Pregnancy       -               -               -  138 

Rational  Signs          -----  1.33 

Material  Signs           -                 -                 -                 -                 -  140 

Sensible  Signs           .                 .                 .                 -                 .  143 

Section  IY. — Duration  of  Pregnancy                -               -  148 

Mare      -                -                 -                 -                 -                 -  149 

Cow         ------  151 

Sheep  and  Goat      -----  152 

Pig         -                -                -                 -                 -                 -  153 

Bitch      -                -                -                -                -                -  153 

Cat          -                 -                 -                 -                 -                 -  153 

Section    Y.  —  Uniparous,    Gemelliparous,   and    Multi- 

PAROUS  Pregnancy         -               -                -                -  153 

Mare       ------  154 

Cow        ------  155 

Sheep      ------  158 

Goat      -                -                -                -                -                -  160 

Free-Martins          -                -                -                -                -  161 

Diagnosis  of  Multiple  Pregnancy            -                 -                 -  163 

Position  of  the  Foetuses  in  Multiple  Pregnancy    -                 -  164 

CHAPTER  YI.— HYGIENE  OF  PREGNANT  ANIMALS     -  166 


TABLE  OF  CONTENTS. 

BOOK  III.— PATHOLOGY  OF  PEEGNANCY  - 

CHAPTER  I.— ANOMALIES  IX  PREGNANCY 
Section  I. — Supkuk(Ktath>n 
Section  IT.— Extka  iTKiiixE  Pkkcjnancv 

Symptoms,  Course,  and  Terminations    - 

Diagnosis  and  Treatment 
Skction  hi. — SiTiuors  or  Pseudo-pkeunancy    - 

Moles         ..... 

Uterine  Cysts  .... 

Hydrops  Uteri  or  Hydrometra 

CHAPTER     II.- DISEASES     INCIDENTAL     TO     PREG 
NANCY 

Section    I.  —  Inflcknce    of    Pre(;nancy    on    Ordinary 

DlSE.\SES  .... 

Section  II. — Diseases  incidental  to  Pregnancy 
Pica  ..... 

Rickets  and  Osteomalacia 

Constipation  .... 

Vomiting  .  .  -  .  - 

Colic  -  .  .  -  . 

CEdema     .  .  -  -  . 

Hydramnios  or  Hydrops  Amnii 

Symptoms  .... 

Diagnosis 

Results  - 

Etiology 

Treatment 
Paraplegia 

Treatment 
Cramp 
Eclampsia - 
Cerebral  Congestion 
Hysteria    - 
Amaurosis 
Cough 

Albuminuria' 
Mammitis 
Red  Colostrum 

CHAPTER  III.— ACCIDENTS  OF  PREGNANCY 

Ante-partum  Prolapsus  of  the  Vagina    ■ 

Treatment 
Hernia  of  the  Uterus  (Hysterocele) 
Ante-partum  Rupture  of  the  Uterus 

Causes    .  -  -  - 

Symptoms 

Treatment 
Metrorrhagia 


XIX 

I'AUK 

KV.t 

ir.o 
nn 

177 
178 
178 
180 
180 

181 

181 
182 
183 
183 
184 
184 
184 
184 
185 
185 
185 
186 
186 
186 
187 
188 
188 
189 
18'.t 
189 
190 
190 
190 
190 
190 

I'.tl 
I'.M 
19-J 
193 
1'I4 
196 
196 
196 
197 


3CX  TABLE  OF  CONTENTS. 

PAGE 

Abnormal  Retention  of  the  Foetus         -                -  -  198 

Symptoms  and  Terminations               ...  i99 

Causes   -                -                -                -                -  -  202 

Treatment              -                 -                 -                -  -  202 

Abortion  -                 -                 -                 -                 -  -  204 

Sporadic  Abortion                  ....  205 

Causes                 -                 -                -                 -  -  205 

Symptoms          .                 .                .                .  -  209 

Results               -                 -                 -                 -  -  211 

Pathological  Anatomy      -                 -                 -  -  211 

Diagnosis            _                .                 .                .  -  212 

Treatment          .                 .                 -                 .  .  214 

Epizootic,  Enzootic,  or  Infectious  Abortion       -  -  216 

Causes                .                .                -                .  -  217 

Symptoms          ...                 -  -  222 

Pathological  Anatomy      -                 -                -  -  223 

Treatment         -                 -                 -                 -  -  224 

BOOK  IV.— NOKMAL  PARTUEITION  -             -  -  227 

CHAPTER  I.— PHYSIOLOGY  OF  PARTURITION  -  227 

Section  I. — Causes  of  Parturition      -               -  -  228 

Section  II. — The  Expelling  Powers  -               -  -  229 

Section  III. — Signs  and  Course  of  Parturition  -  232 

CHAPTER  II.— PRESENTATIONS  OF  THE  FOETUS  AND 

MECHANISM  OF  PARTURITION  -                -  -  239 

Section  I.— Presentations     .               -               -  -  241 

Section  II. — Positions            ....  242 

Section- III. — Mechanism  of  Parturition         -  -  250 

Mare      -                -                -                -                -  -  251 

Coio        -                -                -                -                -  -  254 

Other  Animals          -----  255 

CHAPTER    III.— NECESSARY    AID    IN   NORMAL  PAR- 
TURITION         -                -                -                -  -  255 

Section  I. — Attention  to  the  Mother              -  -  256 

Section  II. — Attention  to  the  Offspring        -  -  265 

CHAPTER  IV.— SEQUELAE  OF  PARTURITION  -  -  268 

Section  I. — Functional  Modifications               -  -  268 

Section  II. — Organic  Modifications   -               -  -  275 


PART   SECOIsrD. 

DYSTOKIA. 

General  Considerations       .               -               .               -               .  279 

BOOK  I— MATEBXAL  DYSTOKIA        -             -             -  289 

CHAPTER  I.— DYSTOKIA  BY   PELVIC    CONSTRICTION  289 

Complete  Deformity  of  the  Pelvis          -                -                 -  290 

Exostoses  ------  291 


TABLE  OF  CONTENTS.  xx\ 


PAGR 


Fractures  ---...  291 

Tumours  in  the  Pelvic  Cavity                  -                  -                  .  293 

Indications  for  Surgical  Treatment     -                 -                 .  294 

CHAPTER     II.— DYSTOKIA     EY     DISPLACEMENT     OR 

CHANGED  RELATIONS  OF  THE  UTERUS           -  297 

Hernia  of  the  Uterus — Hysterocele        -                 -                 .  297 

Origin  and  Symptoms  in  Uni parous  Animals     -                 -  298 

Origin  and  Symptoms  in  Multiparous  Animals-                 -  300 

Pathological  Anatomy       -                  -                  .                 .  300 

Diagnosis           -                 -                 .                 .                 .  301 

Indications         .                 .                 .                 .                 .  303 

Deviation  of  the  Uterus           ....  306 

Diagnosis               .....  307 

Complications       -                 -                 .                 .                 .  308 

Indications             -                 -                 .                 .                 .  308 

Torsion  of  the  Uterus  :  Contorsio  Uteri                 -                 .  309 

History                   -                 -                 -                 .                 -  309 

Nature  and  Frequency          ....  312 

Etiology                 -                 -                 -                 -                 -  316 

Symptoms              -                 -                 .                 .                 .  318 

Diagnosis                -                 .                 .                 .                 .  321 

Prognosis                .....  326 

Pathological  Anatomy          ....  326 

Treatment              -                 -                 -                -                 -  328 

Torsion  of  the  I'terus  in  the  Mare         ...  340 

Causes    -                 -                 -                 -                 .                 -  341 

Symptoms              .....  341 

Prognosis  and  Treatment    ....  342 

Torsion  of  the  Uterus  in  other  Animals                 -                -  343 

CHAPTER   III.— DYSTOKIA    FROM    MORBID    ALTERA- 
TIONS IN  THE  (lENERATIVK  ORGANS        .                -  344 

1.  Utero-vaginal  Tumours    -                 .                 .                 .  344 

Diagnosis        .....  346 

Treatment      -                 -                 -                 .                 .  346 

Cancerous,  Carcinomatous,  or  Sarcomatous  Tumours    .  .347 
Condylomatous,      Papillomatous,     and       Lipomatous 

Tumours     -                 -                 -                 .                 .  348 

Fibroid  and  Myomatous  Tumours  -                 -                 -  348 

Thrombi  or  Ilacmatomata                  -                 -  349 

Serous  Cysts      .....  350 
Hernia    of    the    Bladder   into    the    Vagina :    Vaginal 

Cystocele    .....  35 1 

Treatment      -                 .                 -                 .                 .  352 

Tumours  in  the  Vicinity  of  the  Genital  Organs             -  353 

2.  Rigidity  of  the  Cervix  Uteri            -                -                -  354 

Symptoms      .....  354 

Diagnosis       .....  356 


TABLE  OF  CONTENTS. 

Prognosis 

Treatment 
Induration  of  the  Cervix  Uteri 

Symptoms 

Diagnosis       .  .  - 

Prognosis       -  .  . 

Pathological  Anatomy  - 

Treatment      -  -  - 

Complete  Obliteration  of  the  Os  Uteri 

Causes 

Symptoms 

Results 

Diagnosis        .  -  - 

Treatment 


PAOE 

-  356 

-  356 

-  361 

-  362 

-  363 

-  363 

-  364 

-  364 

-  365 

-  365 

-  366 

-  366 

-  366 

-  366 


CHAPTEE     IV.  —  OTHER     CAUSES      OF     MATERNAL 

DYSTOKIA         -                -                -                -                -  367 

1.  Anomalies  in  the  Placenta                        .                 -                -  367 

Schirrous  Chorion                 ....  367 

2.  Morbid  Adhesion  between  the  Foetus  and  Uterus                  -  368 

3.  Stricture  or  Occlusion  of  the  Uterus  by  External  Bands  or 

Membranes         .                 -                .                 -                 -  369 

4.  Persistent  Hymen     -----  369 

Treatment             .                 .                 -                .                 .  370 

5.  Vaginal  and  Vulvar  Constriction,  or  Atresia         -                 -  370 

Treatment             -                 -                 ,                 _                .  371 

BOOK  II.— FCETAL  DYSTOKIA             -             -             -  372 

GROUP   I.— OBSTACLES   INDEPENDENT  OF  PRESENTA- 
TIONS AND  POSITIONS          -                -                -                -  372 

CHAPTER  L— VARIOUS  CAUSES            -                -                -  373 

The  Umbilical  Cord  as  an  Obstacle         -                 -                 -  373 

Diagnosis                .....  374 

Indications             -                 -                 -                 .                 .  374 

Excess  in  Volume  of  the  Foetus              -                 -                 -  374 

Causes   .-----  375 

Diagnosis               .....  377 

Prognosis                -----  378 

Indications             .....  379 

Excess  in  Growth  of  Hair        ....  379 

Anomalies  in,  and  Diseases  of,  the  Foetal  Membranes          -  380 

Indications            .....  331 

Abnormal  Quantity  of  Placental  Fluid  -                -                .  381 

CHAPTER  IL— DISEASES  OF  THE  FCETUS        -                .  381 

Hydrocephalus          .                -                 .                 .                .  381 

Pathological  Anatomy          .                 -                -                 .  382 

Diagnosis                .....  386 

Indications            .                .                .                 -                 .  .386 

Ascites,  Anasarca,  and  Hydrothorax       -                -                 -  387 


\ 


TABLE  OF  CONTENTS.  xxiii 

I'AOK 

Cause  -  -  -  -  -  389 

Diagnosis  .  .  .  .  .  390 

Indications         .....  390 

Emphysema  .....  sm 

Indications         -  -  -  -  -  3ltl 

Polysarcia  -  -  -  -  -  391 

Indications         .....  392 

Contractions  .....  392 

Indications         .....  393 

Tumours  -  -  -  -  -  394 

Indications         .  .  .  .  .  394 

Death     -  -  -  -  -  394 

CHAPTER  III.— MONSTROSITIES  -  -  394 

Classification  .....  395 

Cl.\ss  I. — Simple  Monstrosities  -  -  -  396 

Order    I. — Simple    Monstrosities    through    Absence    of 

Parts  -  -  -  -  -  396 

Order  II. — Simple   Monstrosities  through  Smallness  of 

Parts  .....  306 

Order    III. — Simple    Monstrosities    through    Abnormal 

Division  of  the  Body     -  -  .  .  397 

Order  IV. — Simple  Monstrosities  through  Absence  of  the 

Natural  Division  of  Parts  -  -  -  397 

Order    V.  —  Simple    Monstrosities    through    Fusion     or 

Coalition  of  Organs  ....  397 
Order  VI. — Simple  Monstrosities  through  Abnormal  Posi- 
tion and  Form  of  Parts  -  -  -  397 
Order  VII.  —  Simple   Monstrosities   through    Excess   in 

Formation      .  .  .  .  .  398 

Order  VIII.— Hermaphrodites  -  -  -  398 

Cr.A?>!  II. — Trkiu-k  and  Doi'ule  Monstiukitiks  -  -  398 

Order  I. — Trigeminal  ^lonstrosities    -  -  -  398 

Order  II.— Monsters  with  Two  Heads  -  -  399 

Order  III. — Double-headed  Monstrosities,  with  the  Trunk 

"Wholly  or  Partially  Double  -  -  -  399 

Order   IV. — Monstrosities  with  a  Single  Head,  but    the 

Trunk  or  Limbs  more  or  less  Completely  Double       -  399 
Order  V. — Monstrosities  with  a  Single  Head  and  Trunk. 

and  more  than  Four  Limba  -  -  -  400 

Order  VI. — Monstrosities  with   the  Head,    Trunk,    and 

Limbs  more  or  less  Completely  Double       -  -  4(»U 

Origin  of  Monstrosities,  and  the  Lavs  of  Teratology    -  411 

Frequency  of  Monstrosities  -  -  -  415 

Distorted  Monstrosities      -  -  -  416 

Cyclopean  Monstrosity      -  -  416 

Pseudencephalian  Monstrosity  -  416 

Double-headed  Monstrosities  -  -  417 

Celosomian  Monstrosities  -  -  -  418 

Diagnosis        .....  418 


dv  TABLE  OF  COX  TEXTS. 

Prognosis        -  .  .  .  - 

Extraction      ----- 
Double  and  Triple  Monstrosities     -  -  - 

Diagnosis        -  -  -  -  . 

Extraction      -  -  .  .  . 

CHAPTER  IT.— DYSTOKIA  FROM  MULTIPARITY 

Diagnosis       ----- 
Extraction      .  -  .  .  . 

GROUP   II.— DYSTOKIA   FROM   MALPRESENTATION   OR 
MALPOSITION  OF  THE  FCETUS 


CHAPTER      I.  —  DYSTOKIA     DEPENDING 
ANTERIOR  PRESENTATION 


OX      THE 


A. — Normal  Anterior  Presentation 
Section  I. — Dystokia  from  Abnormal  Positions 

Dorso-pubic  Position  -  .  .  . 

Dorso-supra-Cotyloidean  Positions 
Section  II.— Dystokia  due  to  the  Hind-limbs 
Extended  Hind-limbs  retained  by  their  Stifles  - 
Hind-limbs  flexed  under  the  Body  pass  with  it  into  the 
Genital  Canal  -  .  .  . 

B. — Abnormal  Anterior  Presentatu)n  - 

Section  I.— Dystokia  due  to  the  Fore-limbs  - 
One  or  Both  Fore-limbs  crossed  over  the  Neck  - 
Fore-limbs  incompletely  extended       -  .  - 

One  or  Both  Fore-limbs  flexed  at  the  Knees 
One  or  Both  Fore-limbs  completely  retained     - 

Section  II.— Dystokia  due  to  the  Head 

Downward  Deviation  .  -  .  . 

Head  bent  under  the  Body  -  -  -  - 

Lateral  Deviation  to  the  Right  or  Left 
Deviation  Upward  and  Backward 

Section   III. — Dystokia  due  to  the  Heah  and  Fohe  or 
Hind  Limbs      ----- 
Head  retained,    and  with   it  One  or  Both  of  the  Fore- 
limbs  ----- 
Head  or  One  of  the  Fore-legs  retained,  and  One  or  Both 
of  the  Hind-legs  in  the  Genital  Canal 

CHAPTER  IL— DYSTOKIA   IN   THE    POSTERIOR  PRE- 
SENTATION -  -  -  -  - 

A. — Normal  Posterior  Presentation 
Section  I. — Dystokia  from  Abnormal  Positions 

Lumbo-pubic  Position  -  -  -  . 

Lumbo-supra-Cotyloidean  Positions  - 
Section  II. — Dystokia  due  to  the  Head  or  Fore-limbs - 

Head  and  Contracted  Neck  -  -  -  - 

Fore-limbs  .  .  .  .  . 


I'AGK 

419 
419 
420 
420 
421 

421 
423 

424 

42.-) 

426 
427 
427 

427 
428 
428 
428 

429 
433 

433 
434 
435 
436 
440 

443 
444 

446 
448 
453 

455 
455 
455 

456 
457 
457 
457 
459 
459 
459 
460 


TABLE  OF  CONTENTS.  xxv 

PAlIB 

B.— Ahnokmai-  Posterior  Prksentations                -                -  HJO 

Hock  Presentation                 ....  4(52 

Thigh  and  Croup  Presentation             -                 -                 -  4»»7 

CHAPTER  III.— DYSTOKTA   FRO^l   TR.\XSVP:RSE  PRK- 
SENTATIONS       -                -                -                -                -  472 

Section  I.— Dysiokia  iku-mthe  Durso-i-imhar  Fuesenta- 

TION    -                -                -                -                -                -  473 

Cephalo-ilial  Positions          .                .                .                .  473 

Cephalo-sacral  Position        .                 -                 -                 .  477 
Section     II.  —  Dvstokia    trom    the    Si  ernd-ahdominai, 

Prksknt.\tion  -               ...                -  478 

Cephalo-ilial  Positions          .                 .                 .                 .  478 

Cephalo-sacral  Position        ....  478 

BOOK  III.— OBSTETRICAL  OPERATIONS         -             -  483 

CHAPTER     I.  —  PRELIMINARY     PRECAUTIONS     AND 

OPERATIONS           -                -                -                -                -  484 

CHAPTER    II.— RECTIFICATION   OF   PRESENTATIONS 

AND  POSITIONS     -                -                -                -                -  487 

Retropulsion          .....  487 

Rotation                 -                 -                 -                 -                 -  491 

Version  -                 -                 -                 -                 -                 -  4111 

Extension  and  Flexion          ....  4'.l3 

CHAPTER  III.— MECHANICAL  MEANS  FOR  THE  EX- 
TRACTION OF  THE  FCETDS  -  -  4'.i8 
Section  I. — Cords  ano  Bands  -  -  -  4it9 
Halter,  Head-cord,  or  Head-collar  -  .'>01 
Section  II. — Pass-  or  Porte-Cords  -  -  OOS 
Section  III. — Crotchets  or  Hooks  -  -  -  -''H 
Section  IV.— Ckotciikt-Forceps  and  Forceps  -               -  -''IT 

CHAPTER    IV.  —  THE    EMPLOYMENT    OF    FORCE    IN 

DYSTOKIA             ....                 -  ;VJ3 

Section  I.— Diuechon  ok  Traction     -               -               -  i>'^4 

Section  II. — De(;ree  of  Traction        -  524 
Section   III. —  Mkans   for    dkvi-lopinc    the   Necessary 

Force    ...---  .'.28 
Section  IV. — Comparison  hetween  Manial  andMecuani- 

CAL  Force            ...               -               -  .')31 

CHAPTER  v.— EMBRYOTOMY                                  -                -  532 

Embryotomy  Instruments    -                 -                 -                 -  534 

Preliminary  Arrangements  for  Emhrvntomy      -                 -  540 
Craniotomy  or  Cephalotomy 
Puncture  of  the  Cranium     - 
Craniotomy 

Decapitation  and  Decollation 
Amputation  of  the  Limbs 


:.40 
541 
542 
542 
544 


Amputation  of  the  Fore-limbs  -     •'■*•'* 


xxvi  TABLE  OF  COXTENTS. 

Amputation  of  the  Hind-limbs 
Detruncation  or  Division  of  the  Body  of  the  Foetus 
Evisceration  .  .  .  -  . 

Thoracic  Evisceration       -  .  .  . 

Abdominal  Evisceration  -  -  -  - 

CHAPTER  YL— VAGINAL  HYSTEROTOMY 

CHAPTER  YIL— GASTRO-HYSTEROTOMY   OR   C^SAR- 

lAN  SECTION  -  .  -  .  . 

Indications  .  .  .  . 

Operation  _  .  .  . 

CHAPTER  VIII.— SYMPHYSIOTOMY      - 

CHAPTER  IX.— ARTIFICIAL  PREMATURE  BIRTH 

CHAPTER  X.— SUPPLEMENTARY  OBSERVATIONS  RE- 
GARDING MOTHER  AND  PROGENY 

BOOK  IV.— ACCIDENTS  AFTER  PARTUEITIOX 

CHAPTER    L— RETENTION    OF    THE    FCETAL    ENVE- 
LOPES        ---.-. 

Symptoms  and  Terminations 

Causes     .  .  -  -  . 

Treatment  .  .  .  . 

CHAPTER  IL— POST  PARTUM  HEMORRHAGE 

Symptoms  -  .  .  . 

Treatment  -  _  -  . 

CHAPTER  III.— INVERSION  OF  THE  UTERUS  - 

Symptoms               .  -                .  . 

Complications         .  .                .  . 

Prognosis                 .  .                 .  . 

Causes     -                 -  -                 .  . 

Treatment               .  .                 .  . 
Amputation  of  the  Uterus. — Metrotomy 

CHAPTER  IV.— INVERSION  OF  THE  VAGINA  - 

Symptoms  .  .  .  . 

Prognosis  .  .  .  . 

Treatment  .  _  .  . 

CHAPTER  v.— INVERSION  OF  THE  BLADDER 

CHAPTER       VI.  —  TRAUMATIC      LESIONS      OF      THE 
GENITAL  AND  NEIGHBOURING  ORGANS 

I. — Laceration  and  Rupture  of  tue  Uterus   - 

Treatment      -  .  -  .  . 

Rupture  of  the  Uterus  after  Parturition 
II. — Laceration  and  Rupture  of  the  Vagina    - 
Complications  of  Ruptured  Vagina 
III.— Thrombus  of  the  Vagina  and  Vulva 
IV. — Relaxation  of  the  Pelvic  Symphysis 


PAGE 

547 
548 
549 
550 
550 

551 


554 
556 
557 

561 

561 

562 
564 

564 
565 
566 
567 

574 
575 
576 

576 
577 
579 
580 
581 
583 
600 

603 
605 
605 
606 

608 

609 

609 
612 
613 
613 
616 
619 
619 


TABLE  OF  CONTENTS.  xxvii 

I'AOE 

V. — llllTlUE   OF   TIIK    Rl.ADUKR                  -                      -                      -  G20 

VI. — Rupture  of  the  Intestinks        -               -               -  G2() 

VII.  — RUITURE   OF   THE   Dl.WllRAGM            -                      -  620 

VIII. — Rupture  of  the  Ahdomixal  Muscles        -               -  G20 

IX. — Rupture  of  the  Sacro-sciatic  Lkjament                 -  (Vil 

X. — Rupture  of  the  Hkart                -               -               -  <i21 

BOOK  v.— PATHOLOGY  OF  rAKTUIilTJOX     -              -  G22 

CHAPTER  I.— VAGINITIS           ....  (•,i>2 

CHAPTER  II.-LEUCORRHCEA                 -                -                -  G24 
CHAPTER  III.— METRITIS,  METRO-PERITOXITIS,  AXI) 

PARTURIENT  FEVER  ....  025 
Symptoms  ....  025 
Terminations  ....  G2G 
Pathological]  Anatomy  -  -  -  G28 
Causes  -  -  -  -  -  G31 
Prognosis  ....  034 
Prophylaxis  ....  634 
Treatment  ....  G34 
CHAPTER  IV.— PARTURIENT  OR  PUERPERAL  APO- 
PLEXY.-PARTURIENT  COLLAPSE  -  -  G3G 
Symptoms  ....  037 
Duration,  Terminations,  and  Complications  -  G4(> 
Prognosis  -  -  -  -  042 
Causes  .  -  -  .  .  043 
Pathological  Anat<'niy  -  -  -  G4t) 
Nature  -  -  -  -  -  047 
Diagnosis  ....  653 
Prophylaxis  ....  653 
Curative  Treatment               -                -                -  654 

CHAPTER  v.— POST  PARTUM  PARALYSIS         -                -  65i) 

Symptoms                ....  651) 

Diagnosis                 ....  GGO 

Pathology               -                                -                -  660 

Prognosis                 ....  660 

Treatment               -                 -                 -                 -  601 

CHAPTER  VI.— ECLAMPSIA      ...  6G1 

Symptoms               ....  6G2 

Etiology  and  Pathology         -                 -                 -  Gt>5 

Diagnosis                 ....  GG7 

Prognosis                 ....  667 

Treatment               ....  607 

CHAPTER  VIL— EPILEPSIA  UTERINA.  -MANIA  PUER- 

PERALIS    ------  6G8 

Symptoms                -                  -                 .                 .  668 

Cause      .....  669 

Treatment               ....  661* 


U  TABLE  OF  COXTENTS. 

CHAPTER  VIII.— PARTURIENT  LAMIXITIS 

Symptoms 
Causes     - 
Treatment 

CHAPTER  IX— MAMMITIS  OR  MASTITIS 

Pathological  Congestion  of  the  Mammag 

Causes 

Symptoms  -  -  . 

Treatment 
Inflammation  of  the  MammEe 

Symptoms  -  -  . 

Course  and  Terminations 

Pathological  Anatomy 

Causes 

Complications   -  -  - 

Prognosis  .  .  - 

Treatment 

CHAPTER  X.-AGALACTIA      - 

CHAPTER  XI.— INJURIES  TO  THE  TEATS 

Fissures  -  .  . 

Causes 

Symptoms 

Treatment  ... 

Obliteration  of  the  Galactophorus  Sinus 

Symptoms 

Treatment  -  _  . 
Fistula  of  the  Teat 


PAGE 

670 
670 
671 
672 

673 

674 
674 
674 
676 
676 
677 
680 
685 
686 
690 
690 
690 

696 

697 
697 
697 
697 
698 
698 
698 
699 
700 


BOOK  YI.  — DISEASES   AND   ABNOKMALITIES    OF 

THE  YOUNG  ANIMAL    -             -             -             -  701 

CHAPTER  I.— ASPHYXIA  OF  THE  NEW-BORN  ANIMAL  701 

CHAPTER  11.— UMBILICAL  HAEMORRHAGE      -                -  702 

Treatment               ....  702 

CHAPTER  IIL— PERSISTENCE  OF  THE  URACHUS        -  703 

Treatment              ,                 .                 -                 .  703 

CHAPTER  lY— UMBILICAL  HERNIA  -                -                -  704 

Causes     -                 -                 -                 .                 .  705 

Pathological  Anatomj'            -                 -                 -  705 

Symptoms               .                 .                 _                 .  706 

Prognosis                 -                 .                 _                 .  7O6 

Diagnosis                 .                 _                .                 .  707 

Treatment                •                  -                  -                 -  707 

CHAPTER  v.— CEDEMA  OF  THE  UMBILICUS    -                -  713 

Treatment                ....  714 

CHAPTER  VI.— INFLAMMATION   OF   THE  UMBILICAL 

CORD          -                -                -                -                -                -  714 

Symptoms                ....  714 


TAliLE  OF  CiiyTKNTS.  xxix 

I'AOE 

Pathological  Anatomy           -                 -                 -  TIT) 

Causes     -                                 -                -                -  7ir» 

Treatment                                -                 -                 -  717 

CHAPTER  VII.— ARTHRITIS                     -                -                -  718 

Causes     ...                -                -  719 

Symptoms               ....  722 

Prognosis                  ....  724 

Pathological  Anatomy            -                -                -  724 

Treatment               ....  727 

CHAPTER  VIIL— INDIGESTION               -                -                -  729 

Causes     .                 -                 -                 -                 -  729 

Symptoms               ....  729 

Treatment                ....  730 

CHAPTER  IX.— GASTROINTESTINAL  CATARRH            -  730 

Symptoms                ....  7;5l 

Etiology                  ....  7;u 

Pathological  Anatomy            -                 -                 -  732 

Prognosis                 ....  732 

Treatment               -                 -                 -                 -  732 

CHAPTER  X.— DYSENTERY  OF  YOUNG  ANIMALS          -  733 

Symptoms               ....  733 

Pathological  Anatomy            -                 -                 -  735 

Etiology .....  736 

Diagnosis                 ....  737 

Prognosis                 ....  737 

Treatment               -                -                -                -  737 

CHAPTER  XL— RETENTION  OF  MECONIUM.-CONSTI- 

PATION      ......  739 

Causes     .....  739 

Symptoms               ....  739 

Treatment               ....  739 

CHAPTER  XII.— ECLAMPSIA  OF  YOUNG  ANIMALS       -  740 

Symptoms                -                 -                 -                 -  740 
Treatment               -                 -                 -                 -741 

CHAPTER  XIIL— TETANUS  AGNORUM               -  741 

Symptoms  -  ■  -  -741 

Etiology.                 -                 -  741 

Pathology                 ....  741 

Prognosis                 ....  741 

Treatment              ....  742 

CHAPTER  XIV.-CYANOSIS       ....  742 

CHAPTER  XY.— SKIN   DRYNESS   OF    THE   NEW-BORN 

ANIMAL     ..----  74:5 

CHAPTER  XVI.— IMPERFORATE  ANUS              -               -  74:'. 

Symptoms               ....  74.» 

Treatment                                 -                 -                 -  744 


XXX  TABLE  OF  COXTEXTS. 

PAGE 

CHAPTER  XVII.— IMPERFORATE  VULVA  AND  VAGINA  745 

CHAPTER  XVIII.— IMPERFORATE  PREPUCE   -  -  746 

CHAPTER  XIX.— OCCLUSION  OF  THE  EYELIDS  -  74G 

CHAPTER XX.— OCCLUSION  OF  THE  AUDITORY  CANAL  747 

CHAPTER  XXI.— TONGUE-TIE  -  -  -  747 

CHAPTER  XXIL— CLEFT  PALATE         -  -  -  748 

ADDENDUM.— Infectious  Abortion  -  -  -  749 

INDEX  -  -  -  -  -  -  751 


TEXT-BOOK  OF  VETERINAliY  OBSTETIilCS. 


INTRODUCTION. 

The  generation  and  development  of  animated  creatm-cs  is  correctly 
described  as  an  "  eminently  physiological  act,"  and  one  which  is  ordin- 
arily carried  out,  from  beginning  to  end,  as  a  perfectly  natural  process, 
and  without  any  extraneous  interference  being  required  for  its  accom- 
plishment. But,  speaking  now  with  regard  to  the  higher  orders  of 
viviparous  animals,  this  happy  termination  of  a  most  important  series 
of  phenomena  is  not  always  observed ;  and  not  infrequently  various 
causes — internal  as  well  as  external — may  operate  unfavourably  in  a 
number  of  ways,  and  more  or  less  imperil  the  perfect  development  or 
existence  of  the  young  creature,  or  compromise  the  health  or  life  of  the 
mother.  More  especially  is  this  danger  likely  to  occur  when  the  period 
arrives  for  the  expulsion  of  the  foetus  from  the  abdomen  of  its  parent. 

With  the  domesticated  animals,  when  these  obstacles  to  development 
or  birth  intervene,  in  order  to  remove  or  overcome  them,  and  assist  or 
supplement  the  natural  eflorts,  recourse  must  be  had  to  artificial  means, 
and  the  resources  of  science  and  art  are  accordingly  invoked. 

The  term  "  parturition"  (from  2)arturio,  to  bring  forth)  is  applied  to  the 
act  by  which  the  product  of  conception,  when  it  has  reached  a  certain 
stage  of  development,  is  expelled  from  the  body  of  the  mother ;  and  this 
act  is  that  which  is  usually  considered  to  be  the  most  critical  in  the 
existence  of  the  young  creature,  and  to  most  frequently  demand  atten- 
tion in  such  valuable  animals  as  the  Mare,  Cow,  Sheep,  liitch,  etc. 

The  parturition  of  the  domesticated  animals,  and  the  abnormal  con- 
ditions which  may  precede  or  follow  that  event,  come  within  the  province 
of  Veterinary -Science,  and  form  that  division  of  it  named  "  Obstetricy," 
which  has  aptly  been  designated  the  "  Science  of  Midwifery  "  when 
applied  to  this  division  of  human  surgery.    Though  it  is  that  which  has 


xxxJi  INTRODUCTION. 

been  selected  as  the  title  of  this  work,  and  though  it  is  also  that  which 
is  most  frequently  employed  in  technical  speech  by  the  Veterinarian,  yet 
it  is  not  so  correctly  applied  with  respect  to  animals  as  it  is  to  mankind ; 
inasmuch  as,  according  to  one  derivation,  it  implies  to  "  stand  before  " 
(from  ohstare,  to  stand  before),  whereas,  in  aiding  in  the  birth  of  animals, 
the  operator  generally  stands  behind  the  creature  which  is  in  difficulty ; 
though  if  the  derivation  from  ohstare,  which  also  means  to  "oppose," 
"hinder  progress,"  "offer  obstruction,"  be  accepted,  then  the  term 
is  quite  justifiable  and  expressive.  The  term  "  accouchement,"  so  often 
used  when  speaking  of  the  birth  of  a  human  being,  is  not  always  appro- 
priate when  employed  with  reference  to  this  event  in  animal  life,  as  the 
larger  domesticated  creatures  are  more  frequently  dehvered  of  their 
young  in  a  standing  than  a  recumbent  position. 

Instead  of  Obstetricy,  the  terms  "Tokology"  (tokos,  a  birth,  from 
TiKTeiv,  to  bring  forth,  and  Adyos,  a  discourse),  "  Tokognosia,"  "  Toka- 
rexeologia,"  and  "  Tokarexis  " — the  practice  of  Tokology — have  been 
introduced  ;  but  they  are  not  sufficiently  familiar  to  warrant  their  adop- 
tion at  present,  and  we  have  therefore  deemed  it  advisable  to  retain  the 
better-known  word. 

The  term  "Obstetrics"  is  not,  as  has  been  already  shown,  Umited  to  the 
act  of  parturition — certainly  one  of  the  most  important,  and  yet  difficult, 
of  all  the  animal  functions ;  for  it  includes  not  only  rules  which  should 
be  followed  in  order  to  remove  or  remedy  the  material  obstacles  or 
accidents  which  may  hinder  the  accomplishment  of  that  act,  but  likewise 
embraces  everything  connected  with  the  health  and  preservation  of  the 
female  parent  and  the  young  creature  while  they  are  in  the  closest 
relations  with  each  other  before  parturition,  as  well  as  for  some  time 
after  their  disjunction. 

It  therefore  essentially  comprehends  a  mechanical  portion,  which 
consists  in  devising  means  for  surmounting  obstacles  that  may  impede 
the  birth  of  the  young  animal ;  and,  scarcely  less  important,  a  thorough 
knowledge  of  those  complex  functions  and  conditions  connected  with 
conception,  generation,  and  the  parturient  state. 

The  Veterinarian,  then,  to  be  a  successful  obstetrician,  must  possess 
special  and  varied  information  of  a  highly  scientific  kind  in  the  domain 
of  anatomy,  physiology,  hygiene,  pathology,  surgery,  etc.,  and  to  this 
must  be  added  the  benefits  to  be  derived  from  experience ;  for,  as  has 
been  well  remarked  by  Saint-Cyr,  in  proportion  as  his  intervention  is 
salutary  and  beneficial  when  it  is  intelligent  and  opportune,  so  may  it  be 
fatal  and  disastrous  when  it  is  irrational,  or  even  inopportune.  His 
knowledge  of  the  subjects  above  named  must  be  grouped  in  a  certain 


INTRODUCTION.  xxxiii 

order,  so  as  to  form  a  doctrinal  code,  and  to  constitute  a  perfect  science, 
havinj^  its  object,  its  rules,  and  its  means  completely  defined. 

The  science  of  Veterinary  Obstetrics,  then,  demands  a  perfect  acquain- 
tance with  the  anatomy  and  physiology  of  the  generative  organs  and  tlie 
region  in  which  they  are  situated  in  the  different  animals.  The  study 
of  the  organs  concerned  in  generation  is  essential  to  acquiring  a  know- 
ledge of  their  several  functions,  and  it  is  only  through  understanding 
these  functions  that  we  can  appreciate  the  normal  or  abnormal  course 
they  may  pursue,  and  be  prepared  to  interfere  successfully  when  required. 
And  a  correct  notion  of  the  formation,  structure,  magnitude,  and  other 
features  of  the  region  containing  these  organs — and  which  has  been 
named  the  pelvic  cavity — is  absolutely  necessary  if  we  wish  to  under- 
stand the  act  of  parturition  in  the  several  animals,  and  be  able  to  render 
useful  service  when  delivery  of  the  young  creature  is  hindered  by 
mechanical  obstacles.  A  knowledge  of  the  physiology  of  these  organs 
and  the  phenomena  pertaining  to  generation — the  foi-mation  of  the  foetus, 
its  development  and  external  conformation,  and  its  connections  with 
the  parent,  with  gestation  and  the  modifications  it  produces  in  the 
organism — as  well  as  the  anomalies,  accidents,  and  diseases  which  may 
occur  during  this  period,  is  required,  in  addition  to  an  acquaintance  with 
that  of  the  final  act  which  we  have  named  "  parturition." 

The  four  chief  functions  of  the  generative  system  may  be  enumerated 
as  follows  :  menstruation  or  astncm,  conception,  gestation,  and  pi'^^^tiri- 
tion,  all  of  which  are  intimately  related  to  and  dependent  upon  each 
other — a  failure  or  defect  in  one  disturbing  their  relationship,  and  lead- 
ing to  sterility  or  irregularity  in  reproduction.  Deviations  or  anomalies 
in  form  or  structure  of  the  individual  organs  upon  which  these  functions 
rely  for  their  proper  performance,  will  also  tend  to  interfere  more  or 
less  with  their  accomplishment. 

Everything  connected  with  this  portion  of  the  subject,  which  termin- 
ates with  natural  or  spontaneous  parturition,  has  been  included  under 
the  head  of  Eutokia  (from  «?,  well,  and  toxos,  birth). 

The  ditTiculties  attending  parturition,  whether  they  depend  upon  the 
mother  or  the  fcctus,  or  upon  both,  with  the  means  for  overcoming 
them,  and  the  accidents  which  may  complicate  difiicult  parturition, 
come  under  the  general  designation  of  Dystokia  (from  5i?,  difficult,  and 
ro\o<i,  birth). 

This  arrangement  of  the  various  subjects  is  necessary  in  a  compre- 
hensive treatise  on  Obstetrics,  and  it  is  the  one  which  will  be  followed 
in  this  manual. 

The  maladies  to  which  the  parent  is  most  exposed  after  parturition, 


xxxiv  INTRODUCTION. 

and  their  medical  or  surgical  treatment,  as  well  as  the  condition  of  the 
young  animal  after  birth  and  up  to  the  time  of  weaning,  also  form  a 
portion  of  the  veterinary  obstetrist's  study. 

Such  is  the  plan  of  the  work  :  and  I  have  only  now  to  state  that  the 
animals  more  particularly  referred  to  are  of  the  Horse,  Ox,  Dog,  Pig, 
Sheep,  and  Goat  species ;  the  other  creatures  which  man  has  domesti- 
cated— such  as  the  Elephant,  Camel,  Eabbit,  and  Cat — coming  but 
rarely  within  the  observation  of  the  veterinary  practitioner. 

It  maybe  remarked  that  pregnancy  and  parturition  in  the  domesticated 
animals  differ  in  several  important  features  from  these  processes  in  the 
human  species — the  differences  being  mainly  due  to  the  dissimilarity  in 
their  respective  attitudes  :  the  quadrupedal  position  of  the  former,  and 
the  horizontal  direction  of  the  trunk,  giving  rise  to  peculiarities  which 
are  not  observed  in  our  own  species,  whose  vertical  and  bipedal  char- 
acteristics entail  wide  contrasts  in  this  respect. 

In  addition  to  the  knowledge  which  has  been  mentioned  as  necessary 
for  the  successful  prosecution  of  Veterinary  Obstetricy,  other  qualifica- 
tions must  be  looked  upon  as  essential.  The  practitioner  must  be  pos- 
sessed of  great  tact  in  manipulation,  a  certain  amount  of  mechanical 
skill,  much  patience,  and  readiness  in  device ;  and  in  addition,  for  the 
larger  animals,  address,  a  fair  amount  of  physical  strength,  and  the 
advantage  which  long  arms  and  fingers  confer. 

We  need  not  allude  to  the  immense  importance  of  this  branch  of 
Veterinary  Science  from  an  economical  point  of  view.  The  ever  in- 
creasing value  of  nearly  all  the  domesticated  animals,  and  the  necessity 
for  their  multiplication  to  supply  the  demands  and  meet  the  requirements 
of  a  widely-extending  and  rapidly-progressive  civilization,  render  every- 
thing connected  with  their  reproduction  of  great  moment  and  concern  ; 
while  to  assist  creatures  in  the  pangs  of  protracted  or  impotent  labour, 
and  to  prevent  or  abbreviate  suffering — in  all  probability  to  preserve 
their  life — previous  to,  during,  or  subsequent  to  the  occurrence  of  this 
physiological  act,  is  no  less  a  duty  than  it  should  be  a  source  of  satisfac- 
tion to  the  Veterinarian. 


PART    FIRST. 

EUTOKIA,  OR  TOKOLOGY. 

Those  divisions  of  Anatomy,  Physiology,  and  Pathology  which  are 
directly  related  to  the  processes  of  generation,  gestation  or  pregnancy , 
&nd  2^arti(rition,  as  well  as  that  act  itself,  belong  to  tlie  section  of  Obste- 
trics to  which  the  designation  of  EUTOKIA  («?,  ivell  or  favourable,  and 
Toxos,  birth),  or  TOKOLOGY,  has  been  given.  We  shall  discuss  each  of 
these  subjects  in  the  order  in  which  they  now  stand,  commencing  with 
the  anatomij  of  the  pelvis,  and  of  the  external  and  internal  organs  of 
generation. 

^ 

BOOK    I. 

OBSTETRICAL  ANATOMY. 

The  female  organs  chiefly  concerned  in  generation  and  parturition  are 
either  entirely  passive,  or  more  or  less  active ;  according  as  they  are 
composed  of  hard  or  bony,  or  soft  parts.  The  i^elvis  constitutes  the  first, 
while  the  second  are  composed  of  the  organs  and  structures  contained 
within  it,  or  more  or  less  directly  attached  to  it.  The  pelvis  also  forms 
the  passage  which  the  foetus  has  to  pass  through  in  order  to  reach  the 
external  world  in  the  act  of  parturition. 

The  soft  organs  are  the  vulva,  vagina,  uterus,  ovaries,  and  manuiuB  : 
the  latter  furnish  the  young  creature  with  its  proper  nourishment  imme- 
diately after  birth.  Of  these  soft  organs,  some  are  external,  and  others 
are  internal ;  the  first  are  the  vulva  and  mammae,  and  the  second  are 
the  vagina,  uterus,  and  ovaries.  The  vagina  and  the  greater  portion  of 
the  unimpregnated  uterus  are  contained  in  the  cavity  of  the  pelvis  ;  and 
the  ovaries,  as  well  as  the  uterus  during  pregnancy,  are  lodged  in  the 
abdomen. 

Our  study  will  commence  with  an  examination  of  the  pelvis  in  the 
various  domesticated  animals,  beginning  with  a  description  of  the  bones 
of  which  it  is  composed  ;  then  its  ligaments  ;  and,  lastly,  this  osseous 
framework,  which  is  of  much  importance,  will  be  considered  as  a  whole, 
and  from  an  obstetrical  point  of  view. 

Afterwards  the  external  and  internal  organs  of  generation  will  be 
described,  and  their  differences  noted  in  the  various  species. 

The  P]quine  species  will  be  taken  as  the  type,  and  the  differences  in 
the  other  species  compared  with  it. 


C  II  A  1^  T  !•:  K    I  . 
The  Pelvis. 

The  pelvis  is  the  large,  symmetrical,  more  or  less  horizontal,  or  horizon- 
tally conoidal  cavity  or  canal  which  continues  the  abdomen  posteriorly, 
and  with  which  it  communicates  in  front.  It  is  formed  of  bony  and 
ligamentous  walls,  and  contains,  sustains,  and  protects  a  portion  of  the 

1 


/ 


2  OBSTETRICAL  ANATOMY. 

genito-urinary  apparatus,  as  well  as  the  terminal  portion  of  the  ali- 
mentary canal.  It  is  situated  towards  the  end  of  the  spine,  and  is  sup- 
ported by  the  posterior  extremities,  with  which  it  is  connected  by  joints 
and  muscles.  For  the  hind  limbs,  as  well  as  for  some  of  the  powerful 
muscles  of  the  trunk,  the  pelvis  constitutes  a  most  important  fulcrum  or 
fixed  point  in  various  movements.  It  is  one  of  the  two  mechanical 
elements  concerned  in  the  act  of  parturition,  and  its  form  varies  more 
or  less  in  different  species ;  though  its  direction  is  always  rectilinear  in 
the  domesticated  animals,  and  not  incurvated  as  in  woman. 

SECTION  I.— BONES  OF  THE  PELVIS. 

The  pelvis  is  composed  of  three  principal  bones — the  two  coxce  or  ossa 
innominata,  and  the  sacrum  ;  and  to  a  certain  extent  of  the  coccygeal 
or  tail  bones.  At  an  early  period  of  life  these  bones  can  be  subdivided, 
but  after  a  certain  time  they  become  consolidated.  Each  coxal  bone, 
for  instance,  is  at  an  early  stage  of  intra-uterine  existence  composed  of 
cartilage  only ;  subsequently  three  centres  of  ossification  appear,  and 
these  extend  until  at  birth  they  have  coalesced  to  form  three  bones, 
which  are  united  by  cartilage.  In  addition  to  these  centres,  two  com- 
plementary nuclei  are  present,  one  of  which  constitutes  what  is  termed 
the  anterior  iliac  crest  or  spine  and  the  ilio-pectineal  line  or  ridge,  and 
the  other  the  ischiatic  tuberosity.  After  birth,  the  three  chief  portions 
of  the  coxae  are  completely  ossified,  and  meet  in  the  acetabulum — where 
they  are  closely  joined — and  at  the  pubic  symphysis,  where  the  coxa  of 
one  side  meets  its  fellow  of  the  other.  In  youth,  the  different  parts  of 
each  coxa  are  very  thick,  the  spongy  tissue  being  abundant,  and  the 
compact  tissue  scanty ;  as  the  animal  advances  in  age,  the  former 
diminishes  and  the  latter  increases  in  density  and  thickness,  the  two 
layers  closely  approaching  each  other. 

1.  Os  Innominatum. 

The  coxa  or  os  innominatum  is  a  pair  bone,  there  being  one  on  each 
side ;  it  belongs  to  the  trunk,  through  its  concurrence  in  the  formation 
of  the  pelvis,  and  also  to  the  posterior  limb,  of  which  it  constitutes  the 
first  ray  or  haunch. 

It  is  a  flat  bone,  widely  expanded  at  either  extremity,  rather  con- 
stricted in  the  middle  portion,  and  curved  or  twisted  in  two  different 
directions,  its  anterior  part  forming  an  obtuse  angle  with  the  posterior; 
so  that  while  its  external  surface  is  inferior  in  the  hinder  poi'tion,  the 
anterior  looks  outwards,  or  even  upwards,  in  front.  At  its  middle 
portion  it  offers  a  wide  and  deep  articular  depression  surrounded  by  a 
high  rim — the  cotyloid  cavity  or  acetabulum — in  which  the  corresponding 
articular  head  of  the  femur  is  lodged  and  moves.  Above  this  cavity  is 
a  marked,  roughened  thin  ridge — the  supra-cotyloid  crest  or  ischiatic 
S2)ine,  into  which  the  sacro-sciatic  ligament  is  fixed. 

Below  the  cotyloid  cavity,  and  inclining  inwards,  is  a  large  circular 
or  oval  aperture,  which  is  occupied  by  the  obturator  muscles,  and  is 
named  the  fora7nen  ovale  or  sub-pubic  opening  or  foramen. 

The  two  coxae  are  united  inferiorly  in  the  median  line,  and  posteriorly 
by  an  articulation  or  solid  suture — the  symphysis  pubis  or  ischio-pubic 
symphysis,  and  form  by  this  junction  a  kind  of  V-shaped  figure,  the 
widest  portion  of  which  is  in  front,  and  renders  the  lateral  diameter  of 
the  pelvis  more  extensive  before  than  behind.  Above,  they  articulate, 
with  the  sacrum. 


THE  I'KLl'lS. 


S 


Each  coxa,  as  has  been  stated,  is  composed  of  three  portions  whicli 
unite  at  the  acetabuhnn  ;  and  although  consoHdated  into  one  piece,  yet 
they  are  separately  described  as  if  distinct.  The  names  of  these  divi- 
sions are  ilium,  ischiian,  a.nd  jyu bis. 

Ilium. — The  ilium,  hip,  or  liaunch  hone  (as  ilium),  frives  its  name  to 
the  region  it  occupies.  It  is  the  largest  of  the  three  bones,  as  well  as 
being  that  which  is  most  elevated.  In  shape  it  is  irregularly  triangular 
and  tlat,  and  is  directed  obliquely  downwards,  inwards,  and  backwards; 
it  has  two  faces,  three  borders,  and  three  angles.  Its  cvteniai  or  superior 
face,  or  dorsum,  is  marked  by  some  muscular  imprints,  and  is  curved  in 
its  widest  part  to  form  a  concave  space — the  external  iliac  fossa,  which 
lodges  the  gluteal  muscles.  The  internal  or  inferior  face,  or  venter, 
offers  a  smooth  external  portion — the  iliac  surface,  into  which  is  im- 
planted the  iliac  psoas  or  iliacus  muscle  ;  and  an  internal  roughened, 


Fig.  1. 

Pelvis  ok  thk  Mare 

A,  Ilium  ;  13,  I'ubia  ;  C,   Ischium  ;  D,  Foramen  Ovale  ;  E,  Tuberosity   of   the 
Ischium  ;  F,  Cotyloid  Cavity. 

ear-shaped,  irregularly  diarthrodial  surface,  most  apparent  from  behind 
--the  auricular  facet,  for  articulation  with  the  sacrum. 

The  anterior  border,  or  crest  of  the  ilium,  is  slightly  concave,  and  bears 
a  rugged  lip  for  muscular  insertion.  The  external  border  is  thick  and 
roughened,  and  grooved  for  the  passage  of  bloodvessels ;  inforiorly  it 
has  three  nutrient  foramina.  The  internal  border  is  thin  and  concave, 
especially  in  its  posterior  part,  where  it  constitutes  the  (jreat  sciatic 
notch  ;  it  affords  attachment  to  the  sacro-sciatic  ligament.  The  spine 
or  ridge  of  the  same  name  partly  belongs  to  it. 

The  external  angle,  antcro-supcrior  spinous  jyrocess,  or  point  of  the  hip, 
is  a  wide,  thick,  and  flattened  portion,  bearing  four  tuberosities  afford- 
ing attachments  to  muscles.  The  internal  or  antero-intcrnal  angle  or 
supero-posterior  spinous  process,  is  a  rough  tuberosity  curving  upwards 
and  backwards  to  form  an  angle  with  the  corresponding  portion  of  the 
opposite  ilium — the  sumtnit  of  the  croup.  The  inferior,  posterior  or  coty- 
loid angle  (concurring  in  the  formation  of  the  acetabulum),  is  very  large 


4  OBSTETRICAL  AX  ATOMY. 

and  prismatic  in  shape.  Posteriorly,  it  offers  a  concave  articular  sur- 
face (acetabular),  and  above  this  cavity  is  the  supra-cotyloid  ridge  or 
crista  ilii — an  elongated  eminence  passing  backwards,  sharp  at  its 
summit,  smooth  internally,  and  roughened  externally,  which  is  continu- 
ous anteriorly  with  the  inner  border  of  the  bone,  divides  its  iliac  and 
articular  surfaces,  becomes  lost  on  the  anterior  margin  of  the  pubis,  and 
laterally  limits  the  anterior  circumference  or  border  of  the  pelvic  cavity 
■ — the  linea  ilio-pectinea. 

The  ilium  is  therefore  united  to,  or  in  contact  with,  the  sacrum 
superiorly,  and  inferiorly  and  posteriorly  with  the  two  bones  next  to  be 
described. 

Ischium. — The  ischium  {os  sedentarum  of  man)  is  next  in  size  to  the 
ilium,  and  the  most  posterior  of  the  three  bones.  In  form  it  is  flat  and 
irregularly  quadrilateral ;  and  is  composed  of  a  thick  solid  portion — the 
body,  and  a  narrow  part — the  neck.  It  has  tivo  faces,  four  borders,  and 
four  angles. 

The  upi^er  face  is  smooth  and  nearly  flat,  and  forms  part  of  the  floor 
of  the  pelvic  cavity.  The  loiver  or  external  face  bears  some  rugged 
imprints,  particularly  towards  the  symphysis. 

The  anterior  border  is  thick  and  concave,  and  posteriorly  circumscribes 
the  obturator  or  oval  foramen.  The  loostcrior  border  is  straight  and 
directed  obliquely  forward  and  inward,  composing,  with  the  corre- 
sponding border  of  the  opposite  bone,  a  large  notch — ihejnibic  or  ischiatic 
arch.  Throughout  its  extent  it  exhibits  a  roughened  depi'essed  lip, 
which  projects  on  the  lower  face — this  is  the  spine.  The  external  border 
is  thick  and  concave,  affords  attachment  to  the  sacro-sciatic  ligament, 
and  forms  the  small  sciatic  notch.  The  internal  border  joins  its  homo- 
logue  of  the  opposite  side,  to  complete  the  ischio-puhic  symphysis. 

The  external  or  cotyloid  angle  is  the  most  voluminous,  and  shows  an 
excavated  diarthrodial  facet,  forming  part  of  the  acetabulum,  and  the 
posterior  extremity  of  the  crista  ilii,  limited  by  a  small  transverse  fissure 
which  separates  it  from  the  external  border  of  the  bone.  The  antero- 
internal  angle  joins  the  posterior  angle  of  the  pubis.  The  postero- 
external angle  is  the  most  important  from  an  obstetrical  point  of  view,  as  it 
constitutes  what  is  commonly  named  the  point  of  the  hip ;  with  the 
corresponding  bone  of  the  opposite  side,  it  forms  the  ischiatic  tuberosity 
{tuber  ischii) — a  thick,  up-curved  prismatic  mass  which  is  continued  by 
a  prominent  ridge  elongated  from  before  to  behind,  the  thin  margin 
of  which  is  curved  outwards  and  downwards.  The  distance  between 
the  external  tuberosities  of  the  two  ischii  gives  the  width  of  the  ischial 
arch,  and  allows  an  estimate  to  be  formed  of  the  transverse  diameter 
of  the  posterior  opening  of  the  pelvis.  The  postero-internal  angle  con- 
stitutes, with  that  of  the  other  ischium,  the  summit  of  the  triangular 
notch  or  space  named  the  '  ischial,'  or  '  pubic  arch '  in  some  species. 

Pubis. — The  pubis  {pecten  or  share-bone)  is  the  smaller  of  the  three,  and 
is  situated  between  the  ilium  and  ischium.  It  is  irregularly  triangular, 
and  is  described  as  having  two  faces,  three  borders,  and  three  angles. 

The  upper  face  is  concave  and  smooth,  and  concurs  in  forming  the 
floor  of  the  pelvis.  In  the  pelvis  of  many  Mares  it  has  a  more  or  less 
marked  depression,  apparently  produced  at  the  expense  of  the  anterior 
portion  of  the  bone,  which  is  thin  ;  while  in  the  Horse  it  is  generally 
much  thicker  at  this  part,  and  instead  of  a  depression  the  surface  may 
be  plain  or  even  convex.     The  loiver  face  is  rough,  and  traversed  on  its 


THE  I'KIA'IS.  6 

whole  length  by  a  wide  groove  which  reaches  the  bottom  of  the  acetabu- 
lum, and  lodges  the  pubio-femoral  ligament  and  a  very  large  vein. 

The  anterior  border  is  thin  and  uneven,  and  is  curvetl  like  the  arc  of 
a  circle  ;  it  concurs  in  forming  the  anterior  circumference  of  the  pelvis. 
The  posterior  border  is  thick  and  concave,  and  in  front  circumscribes  the 
oval,  sub-pubic,  or  obturator  foramen.  It  is  channelled,  near  the  aceta- 
bulum, by  a  fissure  that  passes  obliquely  downwards  and  inwards.  The 
internal  border  joins  that  of  the  opposite  pubic  bone  in  the  middle  line, 
to  form  the  anterior  portion  of  the  ischio-pubic  or  pelvic  symphysis. 

The  external  or  cotyloid  angle  is  the  thickest,  and  constitutes  the 
largest  portion  of  the  roughened  depi'essed  surface  at  the  bottom  of 
the  acetabulum.  The  internal  angle  is  united  to  the  corresponding 
angle  of  the  opposite  bone.  The  posterior  angle  is  fused  at  an  early 
period  with  the  antero-internal  angle  of  the  ischium,  to  form  the  inner 
boundary  of  the  obturator  foramen. 

The  pubis  does  not  alter  much  in  form  with  age,  but  retains  its 
convex  shape,  while  the  part  around  the  acetabulum  is  of  considerable 
thickness  :  a  circumstance  which  tends  to  diminish  the  pelvic  cavity  to  a 
notable  degree.  During  life,  the  pubic  bones  gradually  lose  their  spongy 
tissue,  and  to  such  an  extent  that  in  old  age  it  has  almost  disappeared, 
and  the  parts  are  translucid. 

It  may  also  be  well  to  note  that  the  compact  tissue  is  most  abundant 
in  the  vicinity  of  the  acetabulum,  that  cavity  being  the  point  where  the 
impulsive  efforts  communicated  to  the  body  by  the  posterior  limbs  are 
concentrated  ;  at  this  part,  also,  ossification  connncnces. 

2.  Sacru7H. 

The  sacrum  (os  basilare  of  man)  may  be  said  to  terminate  the  vertebral 
spine  posteriorly,  and  results  from  the  fusion  of  five  vertebra)  into  a 
single,  voluminous,  pyramidal  or  triangular  mass.  It  encloses  the 
pelvic  cavity  above,  and  articulates  in  front  with  the  last  lumbar 
vertebra,  behind  with  the  first  coccygeal  or  tail-bone,  and  laterally  with 
the  ossa  innominata.  It  has  an  2ipper  and  a  lojccr  face,  tiro  lateral 
borders,  a  base  or  anterior  extremit;/,  summit  or  posterior  cxtremiti/,  and 
central  canal. 

The  upper  face  shows  the  supra-spinous  processes  or  supra-sacral  spine 
(though  the  processes  only  meet  at  their  base).  On  each  side  of  this 
spine  is  a  channel  in  which  are  four  openings — the  supra-sacral  foraminci, 
which  communicate  with  others  on  the  inferior  face.  The  lower  face  is 
smooth,  and  slightly  concave  from  before  to  behind  ;  this  is  the  roof  of 
the  pelvic  cavity,  and  shows  traces  of  its  being  composed  of  five  bones, 
as  well  as  offers  four  foramina  for  the  passage  of  the  sub-sacral  nerves. 

The  two  lateral  borders  are  thick  and  concave,  and  posteriorly  show  a 
rugged  lip.  In  front  is  an  irregular  oblique  surface  for  articulation  with 
the  ossa  innominata ;  this  is  divided  into  two  portions,  the  lower  of 
which,  slightly  uneven  and  diarthrodial,  is  the  auricular  surface  ;  the 
upper  is  for  the  insertion  of  the  sacro-sciatic  ligament. 

The  base,  or  anterior  extremit;/,  is  articulated  by  a  shghtly  oval  and 
convex  surface  with  the  last  lumbar  vertebra,  and  forms  with  the  spine 
a  salient  angle  looking  down  towards  the  abdominal  cavity,  named  the 
sacro-vertebral  angle.  Laterally,  it  is  united  to  the  two  coxa,  between 
which  it  is  fixed  like  a  horizontal  wedge.  In  front  it  shows  the  open- 
ing of  the  spinal  canal. 


6  OBSTETRICAL  ANATOMY. 

The  summit  or  posterior  extremity  likewise  offers  the  opening  of  the 
spinal  canal,  and  a  surface  for  articulation  with  the  first  tail-bone.  The 
central  canal  is  a  continuation  of  that  in  the  other  vertebrae,  for  the 
passage  of  the  spinal  cord.  In  this  bone,  however,  instead  of  being 
circular  it  is  triangular,  and  diminishes  in  width  posteriorly. 

The  position  of  the  sacrum  is  more  or  less  inclined  downwards  from 
before  to  behind,  according  to  the  breed  of  the  Mare. 

3.  Coccyx. 

The  coccygeal  or  tail  bones  are  a  series  of  small,  cylindrical,  or  irregu- 
larly prismatic  pieces,  from  fifteen  to  eighteen  in  number,  behind  the 


Fig.  -1. 

Pelvis  ov  the  Cow. 

A,  Ilium  ;  B,  Pubis ;  C,  Ischium  ;  D,  Foramen  Ovale ;  E,  Sciatic  Spine  ;  F, 
Cotyloid  Cavity  ;  G,  Tuberosity  of  the  Ischium. 

sacrum,  the  first  three  of  which  may  be  said  to  belong  to  the  pelvis. 
They  form  the  base  of  the  tail. 

Differences  in  the  Bones  of  the   Pelvis  of  other  Animals. 

In  all  the  domesticated  animals  the  coxae  are  nearly  horizontal,  and 
the  ilium  has  a  vertical  direction. 

Goio. 

In  the  pelvis  of  the  Cow,  the  space  between  the  coxge  is  no  greater 
before  than  behind  ;  they  are  not  so  solid  or  voluminous,  comparatively, 
as  in  the  Mare.  This  is  more  particularly  the  case  with  the  ilium,  the 
iliac  concavity  of  which  is  not  so  wide.  It  is  more  vertical  than  in  the 
Mare.  The  ischium,  though  thinner  than  in  the  Mare,  has  a  much 
wider  surface,  and  is  more  curved  from  before  to  behind  and  from  side 
to  side  ;  while  the  ischiatic  spine,  or  supra-cotyloid  crest,  is  very  promi- 
nent and  thin.  Three  tuberosities  are  observed  on  the  postero-external 
angle. 


THE  r ELVIS.  7 

The  pubis  is  wide  and  thin  ;  it  has  no  channel  on  its  inferior  face,  and 
the  upper  face  is  very  concave.  The  foramen  ovale  is  large,  and  its 
mar<^in  thin.     The  symphysis  is  ossified  earlier  than  in  the  Mare. 

The  sacrum  is  longer,  and  more  curved  and  voluminous  than  that  of 
the  Mare.  The  lateral  borders  are  sharp  and  directed  downwards.  It 
is  composed  of  the  same  number  of  vertebras  as  in  the  Horse.  The 
articular  surfaces  for  union  with  the  coxic  approach  the  vertical  direc- 
tion. 

The  coccygeal  hones  are  stronger  and  more  tuberous  ;  they  are  from 
sixteen  to  twenty  in  number. 

The  pelvis  of  the  Cow  is  therefore  less  developed  than  that  of  the 
Mare,  though  it  has  more  extensive  bony  walls  ;  it  is  also  lighter  and 
less  voluminous.  We  shall  see  that  it  likewise  differs  in  its  form  and 
direction,  and  that  this  has  a  notable  influence  in  the  mechanism  of 
parturition. 


Fig.  3. 

Pklvis  ok  thk  Sheki". 

A,  Ilium  ;  B,  Pubis  ;  C,  I>schium  :  D,  Foramen  Ovale  ;  E,  Cotyloid  Cavity. 

Slicep  and  Goat. 

In  the  Sheep  and  Goat,  the  bones  of  the  pelvis  greatly  resemble  those 
of  the  Cow.  The  ischium,  instead  of  being  curved  in  a  longitudinal 
direction,  however,  is  nearly  rectilinear,  and  the  external  iliac  fossa  is 
divided  into  two  portions  by  a  small  longitudinal  crest.  The  pelvis,  on 
the  whole,  is  more  horizontal  and  longer  than  in  the  Cow. 


Bitch  ami  Cat. 

In  the  Bitch  and  Cat,  the  lateral  diameter  of  the  pelvis  is  greater 
before  than  behind  ;  the  ilimn  is  almost  vertical,  and  its  external  face 
is  much  depressed.  The  space  which  forms  the  pubic  arch  only  occu- 
pies the  inner  moiety  of  the  posterior  border  of  the  ischium,  which  is 
very  broad  ;  between  the  arch  and  the  ischial  tuberosity  is  a  roughened 
lip,  which  is  directed  downwards.  The  sacrum  is  somewhat  quad- 
rangular ;  it  is  composed  of  three  bones,  which  are  consolidated  at  an 
early  age,  and  the  lateral  surfaces  for  articulation  with  the  ilium  are 
turned  outwards  and  almost  vertical.     There  are  only  tliree  vertebral 


9  OBSTETRICAL  ANATOMV. 

foramina.     The  coccygeal  bones  are  strong  and  tuberous,  and  the  first 
five  or  six  are  as  perfect  as  the  true  vertebral  bones. 

Pig. 

The  pelvis  of  the  Pig  resembles  that  of  the  Sheep.  The  crest  of  the 
iliiwi  is  convex,  and  there  is  no  external  protuberance  on  the  symphysis 
pubis.  The  jiubis  is  narrovs^;  and  the  ischiuvi,  instead  of  a  crest,  has  a 
tuberous  prominence.  The  sacrum  is  formed  by  four  vertebrae,  w^hich 
do  not  become  fully  consolidated  for  a  long  time,  and  it  is  sometimes 
difficult  to  discover  w^here  the  sacrum  ends  and  the  coccyx  begins.  The 
spinous  processes  are  absent ;  and  the  neural  arch  being  deficient  on 
each  side,  the  spinal  canal  is  open  above.  There  is  nothing  particular 
to  note  in  the  coccygeal  bones. 

SECTION  II.— ARTICULATIONS  OF  THE  PELVIS. 

The  bones  of  the  pelvis  are  united  by  articulations  and  ligaments? 
as  well  as  fibrous  bands,  which  are  complementary.  A  knowledge  of 
these  is  of  some  importance  to  the  obstetrist.     The  articulations  are 


Fig.  A. 

Lateral  Ligaments  of  the  Sacrum  and  Pelvis. 

a,  Superior  Sacro-iliac  Ligament  ;  h,  Sacral  Ligament  ;  c,  Lateral  Sacro-iliac 
Ligament ;  d,  Sacro-sciatic  Ligament  ;  e,  Small  Sciatic  Notch  ;  /,  Great 
Sciatic  Notch. 

five  in  number  :  (1)  the  mcro-lumhar,  (2,  3)  the  two  sacro-iliac,  (4)  the 
ischio-pubic  symphysis,  and  (5)  the  sacro-coccygeal  articulations.  The 
ilio-sacral  and  sacro-sciatic  hgaments  complete  the  subject  of  this 
section. 

1.  Sacro-lumbar  Articulation. 

The  sacro-lumbar  articulation  is  formed  between  the  anterior  face  or 
base  of  the  sacrum,  and  the  last  lumbar  vertebra;  the  union  takes 
place  by  five  articular  surfaces  and  thick  fibro-cartilages,  and  numerous 
strong  hgaments  bind  the  two  bones  closely  and  very  firmly  together, 
so  as  to  allow  only  a  very  restricted  amount  of  movement  between  them. 
It  would  appear  that  these  bones,  though  so  hmited  in  their  movements 
on  each  other,  yet  are  never  anchylosed  in  old  age  nor  yet  by  accident, 
even  if  all  the  other  vertebrye  in  this  region  should  happen  to  be  con- 
solidated. 


riiK  I'KLris.  » 

This  arrangement  is  particularly  remarkable  in  the  Mare,  on  which  it 
confers  great  strength  and  solidity.  It  is  not  present  in  the  Cow  ;  con- 
sequently, that  animal  is  liable  to  a  kind  of  incomplete  luxation,  which 
may  at  times  become  an  obstacle  in  parturition. 

We  have  already  alluded  to  the  salient  angle  formed  by  the  union  of 
the  last  lumbar  vertebra  with  the  sacrum  [sacro-vertebral  aiujle),  and 
which  looks  downward  into  the  abdominal  cavity.^ 

2,  3.  Sacro-iliac  Articulations. 

The  sacro-iliac  articulation  of  each  side  establishes  the  union  of  the 
posterior  limbs  with  the  spine,  and  is  formed  by  the  sacrum  and  ossa 
ilii ;  it  belongs  to  tiie  arthrodial  class  of  joints.  The  two  surfaces  which 
come  into  apposition  have  been  already  described,  and  it  only  now  re- 
mains to  point  out  that  the  sacrum  is  fixed  between  the  antero-superior 
extremities  of  the  ossa  ilii  like  a  horizontal  wedge  or  the  keystone  of  an 
arch  inverted  ;  the  transverse  diameter  is  greater  below  than  above  — 
the  pressure  it  has  to  resist  being  from  below.  The  oblong  roughened 
surfaces  on  the  sacrum  and  ilium  have  a  layer  of  cartilage  between 
them  to  diminish  shock  and  facilitate  movement,  which  is  further  pro- 
moted by  each  articulation  being  provided  with  a  synovial  membrane, 
though  the  amount  of  synovia  secreted  is  very  trifling.  The  union  of 
the  bones  at  this  part  is  strengthened  by  three  powerful  ligaments  :  the 
sacro-iliac — superior  and  inferior,  and  the  sacro-iliac  inopcr.  There  is 
also  the  sacra-sciatic  or  sacro-iscJiiatic  to  be  noticed  hereafter.  Though 
the  movements  of  this  articulation  are  very  limited,  but  still  useful  in 
locomotion  and  parturition,  yet  it  rarely,  if  ever,  becomes  consolidated. 
The  diarthrodial  union  between  the  bones  appears  to  be  chiefly,  if  not 
exclusively,  intended  to  obviate  the  fractures  which  must  occur  had 
they  been  united  in  a  more  solid  manner  ;  while  the  two  articulations 
being  the  centre  towards  which  all  the  impulsive  efforts  of  the  posterior 
extremities  converge,  a  great  degree  of  mobility  would  not  be  compatible 
with  their  solidity. 

4.  Ischio-puhic  Synipliysis. 

The  syviphrjsis  pubis,  as  it  is  sometimes  termed,  is  the  amphiarthrosis 
formed  by  the  union,  inferiorly,  of  the  two  ossa  pubis  and  ischia.  The 
articulation  is  consolidated  by  means  of  a  layer  of  fibro-cartilage  between 
the  margin  of  these  bones,  which  becomes  ossified  more  or  less  com- 
pletely and  rapidly  according  to  species  ;  and  by  a  layer  of  white  liga- 
mentous fibres  —  short  and  compact — which  pass  across  above  and 
below,  the  latter  being  the  strongest.  The  movements  of  this  articula- 
tion are  very  limited,  and  depend  solely  upon  the  elasticity  of  the 
interosseous  cartilage  ;  they  are  abolished  when  ossification  occurs. 
This  happens  in  the  majority  of  horses  before  adult  age  ;  though  some- 
times the  posterior  portion  is  cartilaginous  after  this  period. 

5.  Sacro-coccygeal  Articulations. 

These  resemble  those  of  the  vertebra}  in  general,  there  being  a  thick 
disc  of  fibro-cartilage  placed  between  each  tail-bone,  the  first  of  which 

'  This  angle  ia  much  more  marked  in  wom.an,  and  'n  named  the  promontory  ;  it  i« 
immediately  at  the  entrance  to  the  pelvis,  and  for  these  reasons  it  is  frequently  a  cause  of 
difficult  parturition  in  her;  while,  from  its  less  development  and  distance  from  the 
pslvis,  it  offers  no  obstacle  in  animals. 


10 


OBSTETRICAL  ANA  TOMY. 


is  joined  to  the  posterior  extremity  of  the  sacrum.  Their  solidity  is 
further  assured  by  a  common  fibrous  sheath  which  completely  envelops 
them,  but  without  interfering  with  their  mobility.  This  mobility  greatly 
favours  parturition  ;  but  it  must  be  noted  that  not  infrequently  the 
first  coccygeal  bone  is  completely  ossified  with  the  sacrum,  and  as  this 
necessarily  limits  the  elevation  of  the  tail,  it  diminishes  the  supero- 
inferior  diameter  of  the  posterior  opening  of  the  pelvis,  and  may  in  this 
way  prove  an  obstacle  to  the  expulsion  of  the  foetus. 

DiFFEKENCES    IN    THE    PeLVIC    AeTICULATIONS    OF    OTHER    AnIMALS. 

In  all  the  domesticated  animals  other  than  the  Equine  species,  the 
sacrum  is  joined  to  the  last  lumbar  vertebra  by  t^iree  diarthrodial 
surfaces  only — the  head  of  the  body  and  two  transverse  inocesses ;  these 
latter  on  the  vertebrae  are  not  in  immediate  contact  with  the  base  of  the 


Fig.  5. 

Ligaments  of  the  Lumbar  Vertebr.e,  Sacrum  and  Pelvis,  seen  from  below. 

a,  Intertransverse  Ligament  of  the  Lumbar  Vertebrae  ;  b.  Capsular  Ligament  of 
the  Spinous  Process  of  the  Fifth  and  Sixth  Lumbar  Vertebrje  ;  c,  Capsular 
Ligament  of  the  Sacrum  ;  d,  Inferior  Sacro  iliac  Ligament ;  e.  Obturator 
Ligament  ;  /,  Transverse  Ligament  of  the  Ischio-pubic  Symphysis. 


sacrum,  an  interosseous  ligament  uniting  them.  Therefore  it  is  that, 
in  the  Coxv  more  particularly,  there  is  greater  mobility  in  the  sacro- 
lumbar  articulation,  and  the  possibility  of  a  greater  increase  in  the 
supero- inferior  diameter  of  the  pelvis  when  it  is  subjected  to  such 
eccentric  pressure  as  the  passage  of  the  foetus  would  produce. 

Cow. 

In  the  Cow  the  ischio-pubic  symphysis  is  considerably  longer  than  in 
the  Mare,  not  rectilinear,  and  much  curved  downwards  in  the  middle  ; 
across  this  concavity  on  the  floor  of  the  pelvis,  the  foetus  passes  during 
parturition.  In  the  Cow  ossification  of  the  symphysis  is  less  complete, 
and  does  not  take  place  until  much  later  than  in  the  Mare,  though  it 
may  in  some  instances  be  found  entirely  accomplished  in  old  animals. 
Ossification,  according  to  Saint-Cyr,  commences  in  the  Cow  at  the 
ischial  arch,  and  proceeds  forwards  ;  while  in  the  Mare  it  begins  at  the 


77//;  I'KJJ'JS.  11 

pubis  and  extends  backwards.  The  same  authority  remarks  that  this 
symphysis  in  the  Cow  has  often  a  sahentcrest  projecting  into  the  pelvic 
cavity,  which,  if  it  does  not  offer  a  very  considerable  obstacle  to  the 
passage  of  the  feetus,  may  nevertlieless  greatly  fatigue  tlie  obstetrist 
when  his  hand  is  engaged  between  it  and  the  young  creature,  during  the 
straining  of  the  mother. 

Sheep  and  Goat. 

In  these  animals  the  ischio-puhic  symphysis  is  rectilinear  ;  the  inter- 
posed cartilage  is  not  ossified  until  very  late  in  life,  and  almost  never  in 
those  which  have  had  many  young.  The  same  remarks  are  applicable 
to  this  symphysis  in  the  Pig. 

Bitch  and  Cat. 

The  symphysis  in  the  Bitch  and  Cat  scarcely  ever  ossifies  ;  so  that 
these  animals,  when  advanced  in  age,  still  have  a  notable  degree  of 
mobility  in  this  region,  and  the  diameter  of  the  pelvic  cavity  may  be 
proportionately  increased. 

Sacro-sciatic  Ligament. 

The  sacro-sciatic  ligament  (Fig.  4,  d)  transforms  the  pelvic  cavity  into 
a  complete  canal,  by  filling  up  the  space  on  the  side  of  the  pelvis, 
between  the  sacrum  and  coxai.  It  is  a  wide  membranous  expansion, 
composed  of  white  fibrous  tissue — -the  fibres  crossing  each  other  in 
different  directions,  and  sei-ves  rather  to  enclose  this  portion  of  the 
pelvic  space  than  to  maintain  the  solidity  of  the  sacro-iliac  articulation. 
It  is  irregularly  quadrilateral,  its  superior  border  being  rectilinear,  and 
attached  along  the  rough  crest  on  the  side  of  the  sacrum,  as  well  as  to 
the  first  two  or  three  coccygeal  bones.  Its  anterior  border  is  irregular, 
and  not  well  defined,  but  it  is  inserted  above  into  the  base  of  the 
sacrum,  and  below  into  the  inner  border  of  the  ilium,  circumscribing  in 
its  middle  the  opening  which  has  been  named  thegi'eat  ischiatic  notcli, 
through  which  the  gluteal  vessels  and  nerves,  as  well  as  the  sciatic 
nerves,  pass,  and  to  the  compression  of  which  against  the  bones  of  the 
pelvis  during  pregnancy  may  be  due  cramp  of  the  posterior  limbs, 
or  even  more  or  less  persistent  paralysis  ;  the  inferior  border  is  attaclied 
to  the  spine  of  the  ischium,  as  well  as  to  the  ischiatic  tuberosity,  and 
between  these  insertions,  and  immediately  behind  the  cotyloid  cavity, 
it  forms  the  small  ischiatic  notch,  the  opening  through  which  the 
obturator  internus  muscle  passes  ;  while  the  j^osterior  border,  not  well 
limited,  completes  the  posterior  circumference  of  the  pelvic  cavity,  and 
divides  into  two  layers,  between  which  lies  the  semimembranosus 
muscle,  and  above  it  is  mixed  up  with  the  enveloping  sheath  of  the  tail 
muscles  and  bones. 

The  inner  face  of  this  wide  ligament  is  covered  by  peritoneum  to  the 
extent  of  one-third  in  front ;  and  behind  it  is  in  direct  relation  with 
various  organs  contained  in  the  pelvic  cavity,  by  means  of  an  abundant 
loosi-  connective  tissue.  Its  crtcrnal  face  is  traversed  by  the  sciatic 
ner\-es  and  covered  by  muscles. 

There  are  no  notable  differences  in  this  ligament  in  the  various 
species  of  animals  we  are  dealing  with. 


12  OBSTETRICAL  ANATOMY. 

SECTION  III.— THE  PELVIS  AND  ITS  CAVITY. 

Having  now  studied  the  individual  portions  which  compose  the 
pelvis,  as  well  as  the  manner  in  which  they  are  united,  it  remains  to 
consider  this  region  in  its  entirety,  and  with  regard  to  its  general  con- 
formation, dimensions,  axes,  and  other  important  features.  This  study 
is  of  much  moment  from  an  obstetrical  point  of  view,  and  for  the  full 
comprehension  of  the  mechanism  of  parturition. 

The  cavity  of  the  pelvis  is  the  space  between  the  inlet  and  outlet. 
In  the  human  female  it  lodges  nearly  the  whole  of  the  uterus,  and  in 
the  early  days  of  pregnancy  the  foetus  also.  This  is  not  the  case  with 
the  domesticated  animals,  owing  to  their  different  attitude,  until  the 
act  of  parturition  carries  the  progeny  there.^  With  its  two  openings, 
the  pelvic  cavity  is  capable  of  more  or  less  increase  in  capacity  in 
every  direction,  through  relaxation  of  the  pubic  and  sacro-iliac  articu- 
lations and  sacro-sciatic  ligaments.  The  yielding  of  the  latter  is  very 
noticeable  in  the  larger  animals  immediately  before  parturition,  as  well 
as  the  elevation  of  the  coccyx  by  the  body  of  the  foetus  in  its  passage 
outwards.  It  is  also  a  fact  of  daily  observation  that  the  pelvis  per- 
manently widens  in  animals  which  have  had  young  frequently ;  this 
accounts  for  the  peculiar  rocking  gait  they  exhibit  in  progression,  which, 
in  some  of  the  domesticated  creatures  at  least,  is  no  doubt  due  to  per- 
sistent relaxation  in  the  articulations  above  mentioned. 

It  may  be  again  observed  that  the  anterior  margin  of  the  floor  of  this 
cavity  is  nearly  straight,  and  its  posterior  border  is  deeply  cut  into  by 
the  ischial  arch,  while  the  floor  itself  often  offers  some  diversities. 
For  instance,  it  may  be  convex  in  front  and  concave  behind,  or  vice 
versa,  the  concavity  being  separated  from  the  convexity  by  a  transverse 
ridge,  which  may  also  be  represented  by  a  series  of  small  conical 
eminences ;  or  the  floor  may  be  a  smooth  plane  sloping  upwards  from 
before  to  behind,  with  a  kind  of  raised  border  surrounding  the  anterior 
contour  of  the  obturator  foraiuen. 

We  will  first  notice  the  pelvis  of  the  Mare,  and  proceed  to  compare 
it  with  the  other  domesticated  animals. 

Mare. 

Considered  in  a  general  manner,  the  pelvis  of  the  Mare  represents 
a  slightly  cone-shaped  bony  cavity  at  the  posterior  part  of  the  trunk, 
completing  or  continuing  the  abdominal  cavity  ;  the  base  of  this  conical 
space,  intersected  obliquely  downwards  and  backwards,  is  anterior : 
its  axis  forms,  with  that  of  the  abdomen,  a  very  wide  angle,  the  sinus 
of  which  is  inferior.  The  summit  or  narrowest  part  of  the  cavity  is 
posterior.  With  regard  to  conformation,  it  offers,  for  convenience  of 
description,  an  external  and  internal  surface,  and  tico  openings. 

External  Surface. — This  surface  may  be  considered  as  consisting 
of  four  regions,  j^lcines,  or  faces.  The  superior  region  or  croup  is  the 
narrowest,  and  is  slightly  oblique  downwards  and  backwards,  the 
degree  of  obliquity  varying  not  only  in  different  breeds,  but  also  in 
different  animals  of  the  same  breed  and  species.     In  the  Mare  it  is 

^  Girard  thought  that,  in  the  Bitch,  one  of  the  young  in  the  body  of  the  uterus  might 
occupy  this  space  ;  but  Rainard  could  not  verify  this :  all  his  examinations  of  prej^nant 
animals  which  had  died  before  bringing  forth  their  young  proved  the  body  of  the  uterus 
to  be  quite  empty. 


THE  I'KLriS. 


13 


indicated  by  the  droop  or  slope  of  the  croup,  whicli  is  generally  greater 
than  that  of  the  Cow.  It  is  more  conspicuous  in  common  than  in 
^vell-bred  horses,  in  which  the  croup  is  almost  horizontal,  and  the  tail 
nearly  on  a  level  with  its  highest  point.  The  width  of  this  region  also 
varies  not  only  with  the  height  and  volume  of  tlie  animal's  l)ody,  hut 
also  according  to  breed— the  draught  or  coarse-bred  Horse  having  a 
wider  croup  than  the  thorough-bred  one.  This  region  is  constricted 
from  before  to  beliind,  and  shows,  on  the  middle  line,  the  spinous  pro- 
cesses of  the  sacrum  and  the  first  coccygeal  vertebrte ;  and  on  each 
side  the  channels  into  which  open  the  four  sacral  foramina. 

The  inferior  region  is  nearly  horizontal,  and  is  slightly  convex. 
Formed  by  the  pubic  and  ischial  bones,  it  offers  in  the  middle  the 
symphysis  pubis,  on  each  side  the  subpubic  channels  and  the  obturator 
foramen,  and  outwardly  the  cotyloid  cavities  tlirough  which  the  pelvis 
rests  on  the  posterior  limbs. 


Fig.  6. 

LONCITl'DINAL    SECTION  OK    A    MaKK's    PeLVIS 


The  lateral  regions  are  more  extensive  than  the  others ;  they  are  in- 
clined downwards  and  inwards,  and  are  wider  before  than  behind. 
On  each  are  observed  the  crest  of  the  ilium  and  tlie  two  anterior  iliac 
spines,  the  external  iliac  fossa,  the  great  sciatic  notch,  the  spine  of 
the  ischium,  the  small  sciatic  notcli,  and  the  tuberosity  of  the  ischium. 

The  internal  surface  (Fig.  6),  as  has  been  already  mentioned,  is 
formed  partly  of  bony  and  partly  of  ligamentous  walls,  and  circum- 
scribes the  pelvic  cavity,  which  is  a  continuation  of  that  of  the  abdomen, 
and  with  which  it  communicates  by  a  wide  osseous  circle — the  anterior 
opening  or  inlet  of  the  pelvis.  A  transverse  section  of  this  canal  shows 
that  it  is  oval-shaped,  the  largest  portion  being  towards  the  pubis,  and 
the  narrowest  towards  the  sacrum. 

The  internal  surface  is  more  regular  than  the  external,  but  it  cannot 
be  divided  into  two  portions  like  the  liuman  pelvis,  the  inner  aspect 
of  the  ilia  not  being  excavated  to  form  an  anterior  cavity.  It  may, 
however,  be  considered  as  having  /owr  concave i)lanes,  an  anterior  opening 
or  inlet,  and  a  jwsterior  opening  or  outlet. 

The  superior,  sacral,  or  rectal  plane,  or  roof  of  tlie  p)clvis  is  formed 
by  the  lower  face  of  the  sacrum,  and  is  in  contact  ■with  the  rectum, 


14 


OBSTETEIGAL  ANA  TOMY. 


subsacral  vessels,  and  sympathetic  nerves.  It  is  slightly  concave 
longitudinally. 

The  inferior  plane,  or  floor  of  the  pelvis,  is  constituted  by  the  upper 
surface  of  the  pubic  bones  and  ischia.  It  is  rectilinear  from  before  to 
behind,  and  concave  from  side  to  side.  The  symphysis  pubis  occupies 
the  median  line;  it  is  salient,  and  varies  in  length  according  to  the 
size  of  the  animal,  being  usually  about  six  or  seven  inches.  In  front, 
at  the  pubis,  is  a  depression  more  or  less  marked,  in  which  the  pre- 
viously-emptied bladder  can  be  lodged  during  the  passage  of  the  foetus. 
On  each  side  is  the  obturator  foramen,  which  is  partly  closed  by  the 
internal  obturator  muscles,  and  through  which  the  obturator  vessels 
and  nerves  make  their  exit. 

The  two  lateral  planes  are  formed  by  the  inner  surface  and  spine  of 
the  ischia,  and  in  great  part  by  the  sacro-sciatic  ligaments  ;  the  sciatic 
notches  belong  to  them,  and  they  are  traversed  from  before  to  behind 


rig.  7. 

Diagram  of  the  Mare's  Pelvic  Axis. 
A,  Inlet ;  B,  Outlet, 


by  the  obturator  vessels  and  nerves,  and  pierced  by  the  gluteal  and 
ischio-muscular  vessels  and  nerves,  the  internal  pudic  and  the  great 
and  small  sciatic  nerves.  As  has  been  stated,  it  is  the  compression  of 
these  nerves  by  the  uterus  and  its  contents  which  causes  the  cramps 
pregnant  animals  experience  towards  the  termination  of  gestation. 
The  lateral  planes  are  readily  dilatable  during  parturition. 

Anterior  Opening  or  Inlet  (Figs.  7,  8,  9). — This  opening,  which  is 
continuous  with  the  abdominal  cavity,  and  may  also  be  designated  the 
brim,  anterior  circumfereyice,  or  abdominal  ojjening  of  the  pelvis,  is  nearly 
circular,  or  shghtly  oval,  the  widest  part  corresponding  to  the  symphysis 
pubis.  It  is  a  little  obliquely  inclined  downwards  and  backwards,  and 
is  limited  above  by  the  anterior  border  of  the  sacrum  and  its  articula- 
tions with  the  lumbar  vertebra  and  ilia  ;  below,  by  the  anterior  border 
of  the  pubic  bones  ;  and  on  each  side,  by  the  ileo-pectineal  ci-est  and  a 
portion  of  the  inner  aspect  of  the  ilia.  Owing  to  this  circumference 
being  entirely  bony,  and  also  to  the  solidity  of  the  articulations  between 
the  different  bones,  the  inlet  of  the  pelvis  cannot  be  dilated  to  any 
appreciable  degree  under  the  most  violent  efforts,  even  supposing  the 


THK  l- ELVIS.  IS 

sacro-iliac  and  ischio-pubic  ligaments  to  become  softened  and  relaxed 
before  pregnancy — a  change  which  must  be  indeed  rare  in  the  Mare. 

It  is  by  the  inlet  that  the  fcetus  enters  the  pelvic  cavity,  and  a  know- 
ledge of  its  dimensions  is  therefore  of  much  moment  to  the  obstetrist. 
These  dimensions  are  ascertained  by  taking  the  diameter  of  the  openiiif 
at  several  points,  but  two  diameters  are  generally  recognised  :  a  siipcro- 
inferior  and  a  transverse.  The  supcro-inferior,  or  sacro-pubic  diameter 
(Figs.  8,  9,  a,  6),  rather  oblique,  is  the  width  between  the  sacro-vertebral 
angle  and  the  symphysis  pubis.  This  is  generally  the  largest  diameter, 
though  exceptions  are  met  with  now  and  again  ;  it  is  the  diameter 
which  should  receive  the  widest  part  of  the  fcetus  when  it  entei-s  the 
pelvis.  It  varies  with  the  size  of  the  Mare,  but  is  usually  between 
eight  and  ten  inches.  The  transverse  or  bis-iliac  diameter  is  measured 
from  one  ileo-pectineal  crest  to  another,  and  is  generally  less  than  the 
supero-inferior,  though  sometimes  it  may  be  equal,  or  even  greater.  It 
is  from  seven  to  nine  inches. 


Fig.  8. 

Ini.kt  ok  the  Pklvis  ok  thk  Mahk  :  WiDK  Tklvis. 

/),  Supero-inferior,  or  S.icro-pubic  Diameter  ;  c  d,  Superior  Bis-iliac 
Diameter  ;  e  /,  Inferior  Bin-iliac  Diameter  ;  e  i,  /  /i,  Ohlique,  Ilio-sacrul, 
or  Sacroiliac    Diameters  ;  J  K,  Middle  Diameter. 


It  may  be  observed  that  Franck  gives  two  oblique  transverse  diameters, 
and  Saiut-Cyr,  in  the  new  edition  of  his  work,  follows  him,  though  the 
two  do  not  agree  in  their  measurements.  I  do  not  see  much  advantage 
to  be  gained  from  the  adoption  of  these  oblique  diameters,  which  render 
the  measurements  more  complicated,  especially  in  view  of  the  fact 
that  the  pelvis  varies  in  form — the  transverse  diameter  not  unfrequently 
exceeding  that  of  the  vertical ;  but,  following  Saint-Cyr's  example,  I 
give  them  here,  as  in  some  respects  they  may  be  useful : 

In  this  measurement  there  are  two  transverse,  or  bis-iliac  diameters,  a 
superior  and  an  inferior.  The  superior  (Figs.  H,  9,  c,  d)  is  about  the 
upper  third  of  the  pelvic  cavity,  and  corresponds  to  the  shoulder  and 
hip  joints  of  the  foetus  when  it  is  in  the  f/orso- and  lumbo-sacral  positions 
— the  most  frequent;  while  the  inferior  {c, f)  is  drawn  at  the  lower 
fourth  of  the  cavity,  corresponding  to  the  elbow  and  stifle  joints  of  tin; 
foetus.  The  upper  diameter  is  sometimes  less  than  the  sacro-pubic  (as 
in  Fig.  9) ;  but  more  frequently  it  is  equal,  or  even  superior  to  it.     Tlie 


16 


OBSTETPdCAL  ANATOMY. 


inferior  bis-iliac  diameter  sometimes  slightly  exceeds  the  sacro-pubic, 
but  generally  it  is  less.  The  oblique,  ilio-sacral,  or  sacro-iliac  diameters 
(Figs.  8,  ^,  e  i,  f  h),  pass  from  the  articulations,  the  names  of  which 
they  bear,  through  the  middle  of  the  inlet,  to  the  ilio-pectineal  crest  on 
the  opposite  side — just  about  the  centre  of  the  cotyloid  cavity.  Their 
length  is  between  that  of  the  sacro-pubic  and  superior  bis-iliac  diameters, 
and  they  ai'e  only  important  to  note  when  the  inlet  approaches  a  circular 
outline  (Figs.  8, 12),  as  then  the  foetus  may  pass  through  the  cavity  with 
its  dorso-sternal  diameter  corresponding  to  one  of  them ;  while  in  more 
oval  pelves  it  rotates  slightly  in  its  progress,  its  larger  axis  correspond- 
ing more  or  less  with  that  of  the  inlet— that  is,  to  the  dotted  lines  in 
Figs.  9,  11. 

PosTEBiOE  Opening  oe  Outlet  (Fig.  7,  b). — This  is  also  sometimes 
named  the  pei-ineal  circumference,  or  recto -^iretliral  opening  ;  it  includes 
in  its  contour  the  rectum  and  vagina,  and  is  related  to  the  vulva  and 


Inlet  of  the  Pelvis  of  the  Mare  :  Narrow  Pelvis. 

h,  Supero-inferior,  or  Sacro-pubic  Diameter ;  c  d,  Superior  Bis-iliac 
Diameter  ;  e  /,  Inferior  Bis-iliac  piameter  ;  e  i,  f  h,  Oblique,  Ilio-sacral, 
or  Sacro-iliac  Diameters. 


anus,  which  are  external  to  it.  Owing  to  the  horizontal  direction  of 
the  Mare's  pelvis,  this  outlet  is  limited  above  by  the  apex  of  the  sacrum 
and  the  base  of  the  coccyx  ;  below,  by  the  ischial  arch,  formed  by  the 
junction  of  the  two  ischia ;  and,  laterally,  by  the  upper  surface  of  the 
ischia  and  posterior  border  of  the  sacro-sciatic  ligaments.  The  opening 
is  oval. 

The  diameters  are  ordinai-ily  much  less  than  those  of  the  inlet — per- 
haps to  the  extent  of  one-fifth  ;  but  this  circumstance  has  rarely  any 
influence  in  parturition,  as  the  opening  is  very  dilatable,  owing  to  the 
relaxation  that  takes  place  in  the  sacro-sciatic  ligaments  during  the  later 
months  of  pregnancy,  and  the  great  mobility  of  the  sacrum  and  coccyx, 
which  allows  the  supero-inferior  diameter  to  be  increased  considerably. 

It  may  be  noted  that  the  pelvis  of  the  female  Ass  differs  but  little 
from  that  of  the  Mare,  so  far  as  shape  is  concerned,  its  inlet  being 
generally  oval  from  above  to  below,  the  sacro-pubic  diameter  slightly 
exceeding  the  transverse  in  measurement. 


THE  VELVIH. 


17 


Differences  in  otheu  Animals. 

Coxc. 

In  the  Cow  the  pelvis  (Fig.  10)  is  longer  than  in  the  Mare,  and  less 
vertical ;  the  ischio-pubic  symphysis  is  also  longer,  and,  instead  of 
being  straight,  is  very  curved,  so  that  the  floor  of  the  pelvis  is  concave 
in  every  direction.  The  ischial  arch  is  more  deeply  cut  at  the  sym- 
physis, and  the  posterior  borders  of  the  ischia  join  at  an  acute  angle  or 
V-shape,  the  opening  being  supero-posterior.  The  external  border  of 
these  bones  is  higher,  and  the  sciatic  spine  or  supra-cotyloid  crest  is 
thinner  and  more  elevated.  So  that,  altogether,  the  bony  parietes  of 
the  Cow's  pelvis  are  more  extensive,  comparatively  speaking,  than  the 
Mare's.  The  sacral  surface  is  more  concave,  and  the  sacro-sciatic 
ligaments  longer,  tliough  narrower. 

The  pelvic  cavity  (Figs.  11,  12)  of  the  Cow  is  also  less  wide,  when 
compared  with  its  height.     The  diameters  of  the  i/i/c^  — which  is  more 


Fig.  10. 
Lo.vciTfDiSAL  Section  ok  tiik  Cow'.s  Pelvis. 


oblique  than  in  the  Mare — are  very  unequal ;  the  difference  between 
the  sacro-pubic  and  the  transverse,  according  to  Saint-Cyr,  being  one- 
third  (nine  and  six  inches)  ;  while  it  is  narrower  at  its  lower  part,  and 
not  so  markedly  oval  as  in  the  Mare.  Its  sides  are  also  nearly  parallel 
for  some  distance,  so  that  its  sacro-pubic  diameter  is  greater  than  its 
transverse  ;  the  difference  varying,  according  to  Saint-Cyr's  measure- 
ments, in  favour  of  the  first  from  3  centimetres  (Fig.  12)  to  104  centi- 
metres (Fig.  11). 

The  dimensions  of  the  outlet  are  not  so  reduced  as  in  the  Mare  ;  they 
are  more  equal,  and  are  about  those  of  the  transverse  diameter  of  the 
inlet.  It  therefore  results  that  the  pelvis  of  the  Cow  is  more  cylindrical 
and  less  conical  than  that  of  the  Mare  ;  but  this  feature  does  not  render 
parturition  any  easier,  for  tliougli  the  outlet  is  a  little  larger  than  in 
the  latter  animal,  yet  this  advantage  is  counterbalanced  by  the  length 
of  the  pelvic  cavity,  the  greater  extent  of  its  bony  walls,  and  the  very 
marked  cun-ature  of  the  symphysis.  So  it  is  that,  while  it  rarely 
happens  that  the  Foal  experiences  any  difficulty  in  passing  through  the 
cavitv,  once  it  has  fairly  cleared  the  inlet,  in  the  Cow  parturition  takes 

2 


18 


OBSTETRICAL  ANATOMY. 


longer,  and  it  is  not  at  all  infrequent  for  the  Calf  to  become  fixed  in  the 
pelvis,  there  to  remain  unless  removed  by  artificial  means. 

It  is  also  to  be  noted  that  the  floor  of  the  pelvic  cavity  is  on  a  much 


Fig.  11. 

Inlet  op  the  Cow's  Pelvis  :  Narkow  Pelvis. 

a  b,  Supero-inferior,  or  Sacro-pubic  Diameter  ;  c  d,  Superior  Bis-iliac 
Diameter  ;  e  f,  Inferior  Bis-iliac  Diameter  ;  e  i,  /  h,  Oblique,  Ilio-sacral, 
or  Sacro-iliac  Diameters. 

higher  level  than  that  of  the  abdomen ;  consequently,  the  abdominal 
muscles  are  not  inserted  into  the  margin  of  the  pubis,  as  in  Solipeds, 
but  more  posterior  and  lovrer,  and  have  a  strong  tendon  fixed  into  the 


Fig.  12. 
Inlet  op  the  Cow's  Pelvis  :  Wide  Pelvis. 
a    b,     Supero-inferior,    or    Sacro-pubic     Diameter  ;     c    d,     Superior     Bis-iliac 
Diameter  ;    e  /,   Inferior  Bis-iliac  Diameter  ;   e  i,  f  h,   Oblique,   Ilio-sacral, 
or  Sacro-iliac  Diameters  ;  J  K,  Middle  Diameter. 

pubic  symphysis— the  transverse  ligament  of  Goubaux.  Therefore  it  is 
that  a  kind  of  steep  step  has  to  be  ascended  by  the  Calf  before  it  can 
enter  the  pelvic  cavity,  and  this  explains  why  it  often  remains  fixed 
against  this  upper  level  at  the  inlet. 


THE  I' K LI' IS.  I'J 

Sheep  and  Goat. 

With  these  animals  the  pelvis  does  not  differ  to  any  notable  extent — 
except,  of  course,  in  size — from  that  of  the  Cow.  The  syviplujiiis  is 
nearly  rectilinear  in  its  direction,  and  its  ossification  occurs  at  a  very 
much  later  period  than  in  the  Cow  or  Mare  ;  this  allows  the  diameters 
of  the  pelvic  cavity  to  be  increased  during  parturition,  and  accounts  for 
the  rarity  of  ditVicult  births  in  the  Sheep  and  Goat. 

Puj. 

The  general  conformation  of  the  pelvis  in  the  Pig  is  not  unlike  that 
of  Ruminants,  except  that  the  sacro-vcrtchral  angle,  or  '  promontory  of 
the  sacrum,'  is  more  salient,  the  canal  longer,  the  ylane  of  its  anterior 
circumference  more  oblique,  and  the  direction  of  the  ischio-puhic  sym- 
physis perfectly  rectilinear.  The  pelvic  cavity  is  very  large  in  proportion 
to  the  size  of  the  young  at  birth  ;  therefore  it  is  that  accidents  are  very 
rare  during  the  act  of  parturition. 

BitcJt  and  Cat. 

In  these  creatures  the  sacro-vertcbral  angle  is  still  more  marked  than 
in  the  Pig,  and  diminishes  the  inlet  of  the  pelvis  to  a  notable  extent  ; 
the  direction  of  the  symphysis  is  rectilinear,  and  the  general  outline  of 
the  pelvic  cavity  is  nearly  cylindrical,  though  the  inlet  is  larger  below 
than  above.  The  ischiii7n,  innnediately  above  the  obturator  foramen, 
is  wide  and  shallow,  and  rises  abruptly  to  almost  a  right  angle  ;  this  is 
the  narrowest  part  of  the  canal,  and  liere  it  is  that  the  passage  of  the 
foetus  is  obstructed  in  small  females  wliich  have  been  impregnated  by 
large  dogs.  It  must  be  remarked,  however,  that  the  late,  and  often 
incomplete,  ossification  of  the  symphysis  allows  a  certain  amount  of 
dilatation  of  tlie  canal,  and  renders  the  passage  of  a  comparatively  large 
foetus  possible. 

Differences  in  the  Pelvis  accokding  to  Sex. 

There  is  a  considerable  difference  in  the  size  and  conformation  of  the 
male  and  female  jjelvis  in  the  domesticated  animals,  as  might  be 
expected  from  the  sexual  functions  being  so  diverse  in  the  two  creatures, 
the  female  pelvis  being  larger  in  every  sense,  but  more  particularly  in 
its  transverse  diameter.  These  differences  have  only  been  carefully 
studied  in  the  Equine  species,  but  they  exist  in  a  somewhat  similar 
degree  in  the  pelvis  of  other  species. 

In  the  Mare,  in  addition  to  the  pelvis  being  wider  than  that  of  the 
Horse,  the  inlet  is  nmch  larger,  the  ilio-pectineal  crests  are  further 
apart,  and  the  distance  between  the  lower  face  of  the  sacrum  and  the 
anterior  border  of  the  pubis  is  much  greater,  the  ilia  and  pubis  being 
broader  and  more  concave.  On  the  upper  surface  of  the  Mare's  pelvis, 
the  sacro-sciatic  notches  are  very  deep  ;  the  inner  border  of  the  ilium 
forms  a  very  concave  line,  and  the  ischiatic  spines  are  widely  separated. 
The  tioor  of  the  pelvis  is  wide,  and  the  bones  composing  it  have  a 
tendency  to  assume  the  same  horizontal  direction.  In  the  Horse,  the 
ischiatic  border  does  not  describe  a  regular  curve  ;  it  is  composed  of 
two  nearly  straight  portions,  which  unite  where  the  neck  of  the  ilium 
begins.     The  supra-cotyloid  crests  are  not  much  separated,  and  are 


20 


OBSTETRICAL  ANATOMY. 


turned  outwards,  and  the  two  portions  of  the  floor  of  the  canal  are 
directed  very  obliquely  downwards  and  inwards.  In  the  Mare  the 
ischial  arch  is  wider  than  in  the  Horse,  and  forms  a  regular  curve  in 


Fig.  1.3. 
Bones  of  Pelvis  op  Mare. 


joining  the  tuber  ischii ;  while  in  the  Horse  these  tuberosities  are  not 
nearly  so  wide  apart,  and  the  ischial  arch  forms  a  somewhat  acute 
angle,  the  margin  of  which  is  nearly  straight.     The  obturator  foramina 


Fig.  H. 
Bones  of  Pelvis  of  Horse. 


are  also  large  and  almost  circular  in  the  Mare,  while  they  are  small  and 
oval  in  the  Horse  ;  the  ischio-pubic  symphysis  is  farther  from  the 
cotyloid  cavities  in  the  former  than  in  the  latter. 

The  sacrum  is  also  broader  and  longer  in  the   Mare,  and   in   the 


Till-:  Ph'LI'IS. 


21 


majority  of  animals  it  is  more  concave  from  before  to  behind.  The  first 
coccygeal  vertehr*  are  larger  and  more  flexible,  and  carried  at  a  greater 
elevation  than  in  the  Horse. 

This  ditierence  of  conformation  in  the  pelvis  of  the  Mare  is  adapted 
to  the  passage  of  the  foetus  through  the  canal,  and  it  causes  the  animal 
to  appear  lower  in  the  forehand  than  the  Horse,  in  which  the  croup  is 
not  so  high.  It  is  rare  to  find  a  -\Iare  which  has  the  croup  so  square  as 
the  Stallion,  the  hind  quarter  of  which  is  almost  equal  in  depth,  breadth, 
and  length. 

The  width  of  the  pelvis  of  the  Mare,  as  before  observed,  produces  a 
rocking  motion  during  progression,  and  this  is  all  the  more  mai'ked  as 
the  animal  has  been  fre(iuently  bred  from  ;  for  the  same  reason  the 
speed  is  not  so  great,  and  it  has  been  remarked  that  Mares  which  have 
had  several  foals  are  not  well  adapted  for  the  circus. 

The  diflerences  in  the  pelvis  of  the  Mare  and  the  Horse  are 
sometimes  noticeable  at  birth ;  but  they  are  generally  most  apparent 
when  the  adult  period  has  been  reached,  and  the  body  has  acquired  its 
definitive  form.  In  both  sexes,  the  supero-inferior  diameter  of  the  inlet 
is  greater  than  the  transverse  in  early  life. 

Some  idea  of  the  difference  in  the  dimensions  of  tlie  pelvic  cavity  in 
the  Mare  and  Horse,  may  be  obtained  from  the  following  measurements 
of  two  animals  about  the  same  in  size  : 


Mare         

Horse        

Vertical  Diameters. 

Horizontal  Diameters. 

Between  the 

Sacrum  and 

Pubis. 

Between  the 

Sacrum  and 

Ischium. 

Between  the 
Pectineal  Ridges. 

Betwoen  the 
Ischial  Spines. 

9  inches.              6^xi  inches. 
8       »                   6fV      „ 

9^  inches. 
8         „ 

7i  inches. 

The  differences  in  the  pelvis  in  the  two  sexes  are,  perhaps,  not 
so  marked  in  the  smaller  domesticated  animals  until  the  female  has 
brought  forth  young  several  times. 


SECTION  IV.— CAPACITY  OF  THE  PELVIS,  OR  PELVIMETRY. 

We  have  already  casually  alluded  to  the  capacity  of  the  pelvic  cavity  in 
the  largerdomesticated  animals, and  toitsdiameters;  audit  will  be  inferred 
that  these  must  vary  with  the  different  sizes  existing  in  the  Mare,  Cow, 
Pig,  and  Bitch  ;  though  in  others  which  are  generally  of  uniform  volume 
— as  the  Sheep,  Goat,  Ass,  and  Cat — the  pelvis  does  not  offer  much 
diversity.  In  this  respect  the  latter  species  resemble  mankind,  in  the 
female  of  which  a  difference  in  size  does  not  make  much  difference  in 
pelvic  dimensions — half  an  inch  probably  covering  the  variations.  But 
in  the  Mare  or  Cow,  if  we  compare  a  small  with  a  large  animal,  this 
difference  in  diameters  may  extend  to  nearly  two  or  three  inches. 

The  subject  oi  pclvimetrn  is  very  important  to  the  accoucheur  of  the 
human  species,  as  the  female  pelvis  is  particularly  liable  to  be  deformed 
or  defective  in  its  proportions.  It  is  not  nearly  of  so  much  moment  to 
the  veterinary  obstetrist,  as  the  head  of  young  animals  generally 
experiences  no  difficulty  in  passing  through  the  pelvic  cavity,  except 


22 


OBSTETRICAL  ANATOMY. 


sometimes  in  the  Carnivora  or  in  cases  of  hydrocepiialus  ;  and  also 
because  the  less  value  of  animal  life  leads  the  operator,  when  in  diffi- 
culties, to  sacrifice  the  foetus  rather  than  endanger  the  existence  or 
value  of  the  mother. 

It  is^  nevertheless,  useful  to  know  the  diameters  of  the  pelvis  of  dif- 
ferent animals,  in  order  not  only  to  fully  understand  the  mechanism  of 
parturition,  but  also  with  regard  to  the  indications  they  may  furnish  in 
many  cases  of  dystokia. 

We  have  shown  that  the  pelvic  canal  in  the  large  and  small  Herbivora 
is  somewhat  of  an  oval  shape,  the  narrowest  part  being  above,  and  the 
widest  below  ;  and  that  in  the  Carnivora  it  is  somewhat  cylindrical. 
This  diffei'ence  in  outline  is  conformable  with  the  shape  of  the  foetal 
thorax,  which  in  the  former  is  deeper  than  it  is  wide,  particularly  at 
the  period  of  birth.  During  parturition,  the  foetus  of  Herbivorous 
animals  is  so  placed,  generally,  that  the  withers  and  shoulders  are 
towards  the  roof  or  superior  plane  of  the  pelvis ;  while  the  sternum  and 


iucee^    ^¥%«^ 


Fig.  15.  Fig.  16. 

Median  Section  of  the  Pelvis  of  the  Horse  (Fig.  15)  and  Maee  (Fig.  16). 

1,  Sacrum  ;  2,  Two  first  Coccygeal  Vertebra  ;  3,  Two  last  Lumbar  Vertebrae  ; 
4,  Ischio-pubic  Sj-mphysis  ;  a  h,  Axis  of  the  Pelvic  Cavity  ;  c  d,  Supero- 
inferior  Diameter  of  the  Inlet  ;  e  f,  Supero-inferior  Diameter  of  the  Outlet  ; 
c  g,  Vertical  Diameter  of  the  Inlet  ;  i  h,  Vertical  Diameter  of  the  ]Mid- 
pelvis  ;  kf,  Vertical  Diameter  of  the  Outlet. 

anterior  limbs,  which  form  a  larger  mass,  rest  on  the  floor  or  inferior 
plane.  The  passage  of  the  thorax  of  the  foetus  in  these  animals  is, 
apart  from  other  causes,  the  chief  difficulty  in  parturition.  In  the 
human  female,  it  is  the  head  of  the  foetus.  The  thorax  of  the  Carni- 
vorous foetus  is  not  nearly  so  deep,  comparatively  ;  it  is  therefore  better 
adapted  to  pass  through  the  nearly  circular  canal. 

The  term  diameter,  in  obstetrics,  is  emploj^ed  to  designate  the  distance 
between  certain  points  in  the  pelvic  cavity,  and  by  which,  practically, 
we  may  compare  the  capacity  of  that  space  with  the  volume  of  the 
largest  part  of  the  foetus  that  has  to  pass  through  it. 

In  the  human  species  four  diameters  are  usually  given  for  the  inlet 
and  outlet  of  the  pelvis,  and  some  veterinarians  also  furnish  these 
measurements.  They  are  :  (1)  a  vertical  or  sacro-pubic,  from  the  sacro- 
lumbar  articulation  to  the  ischio-pubic  symphysis  ;  (2)  a  transverse, 
passing  between  the  most  concave  portion  of  the  ilia  ;  and  (3,  4)  two 
oblique,  from  the  ilio-pectineal  line  of  one  side  to  the  sacro-lumbar 
articulation  of  the  other. 


THE  PELVIS.  28 

Chauveau,  in  his  measurements  of  the  Horse's  pelvis,  gives  these  four 
measurements  for  the  inlet  (mean  vertical,  8^  inches ;  transverse,  8A 
inches;  oblique,  8^  inches);  but  for  the  outlet  only  the  vertical  and 
transverse  (mean  vertical,  Oi  inches  ;  transverse,  7  inches).  Eainard, 
for  the  inlet,  j^ives  three  diameters  ;  (1)  a  supcro-inferior,  from  the  sacro- 
lumbar  articulation  to  the  anterior  border  of  the  ischio-pubic  sympliysis; 
(2)  a  tranavcrse,  from  the  inner  surface  of  the  cotyloid  angle  on  one  side 
to  the  same  point  on  the  opposite  side  ;  (3)  a  vertical,  from  the  middle 
of  the  sacrum  to  the  ischio-pubic  symphysis  in  the  larger  animals,  and 
to  the  sacro-coccygeal  articulation  in  the  smaller.  But  for  the  outlet  he 
lias  only  two  diameters:  (1)  a  vertical,  from  the  posterior  part  of  the 
ischio-pubic  symphysis  perpendicularly  to  the  sacrum  or  its  prolonga- 
tion, the  coccyx ;  (2)  a  transverse,  from  one  ischial  tuberosity  to  the 
other. 

The  most  important  diameter  is  certainly  that  between  the  middle  of 
the  sacrum  and  the  ischio-pubic  symphysis  in  the  larger  animals,  and 
the  sacro-coccygeal  articulation  and  ischio-pubic  symphysis  in  the 
smaller  creatures.  For  it  must  be  remembered  that  the  pelvis  of  the 
domesticated  animals  oilers  a  very  inclined  plane,  and  if,  placing  it  in 
the  position  of  the  human  pelvis,  we  draw  a  horizontal  line  from  the 
symphysis  towards  tlie  spine,  it  will  be  found  that  this  line  does  not 
touch  the  sacro-lumbar  articulation,  but  the  middle  of  the  sacrum  in  the 
large,  and  the  sacro-coccygeal  articulation  in  the  smaller  animals.  This 
point  is  the  nanrowest  through  which  the  fatus  has  to  pass,  and  in 
which  it  will  meet  most  resistance  ;  for  while  the  top  of  its  shoulder  is 
towards  the  sacrum,  its  chest  is  resting  on  the  pubis.  So  that  it  may 
be  said  that  this  is  really  the  first  solid  resistance  to  be  overcome  in 
parturition. 

Considering  the  variations  in  size  in  some  species,  it  is  not  possible  to 
give  general  measurements  for  all ;  but  we  may  follow  the  example  of 
Eainard,  and  give  average  diameters  for  different-sized  animals.  These 
are  tabulated  as  follows;  the  last  column,  headed  '  Symphysis,' gives 
the  length  of  the  floor  of  the  pelvis. 


24 


OBSTETRICAL  ANATOMY 


Species. 

Height. 

OPENINGS. 

Symphysis. 

Inlet. 

Outlet. 

Diameters.              Measures. 

Diameters. 

Measures. 

Horse 

15  hands 

Supero-inferior    9i  in. 
Vertical                9:^  in. 
Transverse           9^  to  9^  in. 

Vertical 
Transverse 

6yV  in. 
74  in. 

9  to  9i  in. 

14  hands 

Supero-inferior    9^^  to  9i  in. 
Vertical               SjV  in. 
Transverse           S/jj  to  9  in. 

Vertical 
Transverse 

6  to  6^  in. 
63^  to  7  in. 

S^^in. 

12  hands 

Supero-inferior    8,%  to  S^'^^jin. 
Vertical                JtV  in. 
Transverse         \  7J  to  T^^  in. 

Vertical 
Transverse 

4y3^to4yVin. 
OyV  to  5i  in. 

7^  to  7i 
in. 

Ass 

Medium 
size 

Supero-inferior    1^-^  in. 
Vertical                5y\  in. 
Transverse          4j^  in. 

Vertical 
Transverse 

4yV  in. 
3y^77  in. 

Sf-iT  in. 

Cow 

Medium 
size 

Supero-inferior   SjV  in. 
Vertical                Jro  in. 
Transverse           7iV  in. 

Vertical 
Transverse 

7t%-  in. 
7\  in. 

4J^  in. 

Sheep 

Ordinary 
size 

Supero-inferior    4yi^  in. 
Vertical               2i%  in. 
Transverse           S^V  in. 

Vertical 
Transverse 

3|  in.  (varies) 
2^4,  in. 

2  in. 

Goat 

Medium 
size 

Supero-inferior    4|  in. 
Vertical                2^  in. 
Transverse           3^  in. 

Vertical 
Transverse 

2|in. 
2|in. 

2|in. 
4  in. 

Pig 

27i  in. 
Length 
from 
snout  to 
tail,  54| 
in. 

Supero-inferior   4  in. 
Vertical                3x%^  in. 
Transverse           Sy^  in. 

Vertical 
Transverse 

2Ain. 
4  in. 

Dog 

Large 

Supero-inferior   2^  in. 
Vertical               2  in. 
Transverse           2  in. 

Vertical 
Transverse 

2iin. 
2  in. 

2  in. 

Small 

Supero-inferior   2  in. 
Vertical                ly'V  in. 
Transverse           ly%  to  ly'V  in. 

Vertical 
Transverse 

2  in. 

l{^  in. 

IViT  in. 

Cat 

Ordinary 
size 

Supero-inferior   2^  in. 
Vertical              i  2  in. 
Transverse           1^^  in. 

i 

Vertical 
:  Tnuisverse 

2\  in. 

ly«(r  in. 

1 

:  ly«^  in. 

Some  veterinarians,  however,  as  already  stated,  who  have  made  this 
subject  an  almost  special  study,  only  specify  two  diameters — -the  supero- 
inferior  or  sacro-puhic,  and  the  transverse  or  bis-iliac.  The  following 
are  the  measurements  furnished  by  four  of  these  authorities  : 


77/ A-  fKU'ls. 
MARE. 


B;mineiMtcr 
Diuiiictont.                          and 
Rncff. 

Cftmten- 
UanuH. 

Arloing. 

Snint- 
Cyr. 

UcinarkM. 

iM.frr.                             InchoD. 

Inches. 

Iiichw. 

Inches. 

Supero-inferior  Diameter      9  to  10 

n 

9 

sr 

•Theaverageof  '2Sm^a- 
surements  of  Mares 
vary  ill!,'  from  l.'M,  to 
161  hands  in  height.. 

'Transverse  Diameter           11  to  ]2.\ 

i 

H 

H 

8A+ 

fTbeaverage  of  ^Smea- 
aurenienis  as  above. 

1                             OlTLET. 

1 

Supero-inferior  Diameter       9  to  10 

n 

1 

Transverse  Diameter                 9 

H 

n 

COW. 


I 

Diixnicters. 

Baumeistor 
and 
Reuff. 

Cars  ten- 
Harms. 

Arloing. 

«^^*-  '                 Remarks. 

Islet. 

Inches. 

Inches. 

Inches. 

Inches. 

Supero-inferior  Diameter 

9  to  9i 

8i 

104*    *The  average  of  5  mea- 
surements of  Cows  of 
different    sizes     and 
breeds. 

Transverse  Diameter 

6^  to  7? 

7 

— 

7it    flbid. 

OlTLCT. 

Supero-inferior  Diameter 

9 

Transverse  Diameter 

9 

6i 

It  will  be  seen  from  these  measurements  that  no  great  practical  utility 
can  be  derived  from  pelvimetry,  so  far  as  averages  are  concerned  ;  as  the 
diameters  of  the  pelvis  must  vaiy  with  the  size  and  other  peculiarities 
in  an  animal's  conformation  ;  so  that  we  may  have  considerable  differ- 
ences. In  the  Mare  alone,  Saint-Cyr  found  a  difference  in  the  supero- 
inferior  diameter  of  2V  inches,  and  in  the  transverse  diameter  of  2.^ 
inches. 

With  the  view  of  determining  the  capacity  of  the  pelvis  of  the  living 
animal  at  a  given  time,  external  pelvimetry  has  been  resorted  to.  This 
consists  in  ascertaining  the  distance  between  the  angles  of  the  haunch 
on  each  side,  that  between  the  two  ischial  tuberosities,  and  that  between 
the  coxo-femoral  articulation  and  the  highest  part  of  the  croup.  To 
find  out  the  first,  a  piece  of  wood  is  placed  vertically  against  each 
haunch,  and  the  space  between  them  is  measured  ;  for  the  second,  a 
tape  measures  the  distance  between  the  ischial  tuberosities  ;  and  for 
the  third,  a  piece  of  wood  is  placed  horizontally  across  the  summit  of 
the  croup,  while  another  is  laid  in  the  same  direction  along  the  trochanter 
and  the  ischial  tuberosity,  the  vertical  distance  between  the  two  pieces 
giving  the  measurement.  Taking  into  consideration  the  shape  of  the 
pelvis,  it  has  been  calculated  that  the  transverse  diameter  of  the  outlet 
should  be  nearly  equal  to  one-fourth  of  the  distance  between  the 
haunches,  added  to  that  between  the  ischial  tuberosities  ;  while  the 
supero-inferior  diameter  of  the  outlet  is  supposed  to  be  equal  to  three- 
fourths  of  the  vertical  distance  separating  the  coxo-femoral  articulation 
from  the  summit  of  the  croup.  These  measurements  only  give  the  sup- 
posed diameters  of  the  outlet ;    but  Arloing,  who  has  devoted  much 


26  OBHTETRICAL  ANJT03IY. 

attention  to  pelvimetry  in  animals,  points  out  the  means  whereby  the 
diameters  of  the  inlet  may  be  attained. ^ 

This  method  is,  however,  so  complicated  and  unsatisfactory,  that  it 
requires  further  elaboration  before  it  can  be  recognised  as  useful  and 
reliable. 

Saint-Cyr  has  endeavoured,  in  a  somewhat  similar  manner,  to  arrive 
at  some  criterion  as  to  the  diameters  of  the  inlet  of  the  pelvis — which 
is,  after  all,  the  most  important  in  parturition — in  the  living  animal 
For  the  sacro-jmhic  diameter,  he  has  taken  for  guide  the  height  of  the 
Mare,  supposing  that  the  two  should  be  nearly  always  constant  in  their 
relations  ;  and  to  fix  this  relation,  the  diameter  was  measured  in  twenty- 
eight  animals  of  various  sizes.  Taking  the  average  of  these  twenty-eight 
measurements,  and  dividing  it  by  the  average  of  the  heights,  the  quotient 
obtained  gave  the  co-efficient,  by  which  it  was  necessary  to  multiply  the 
height  of  any  Mare  to  find  the  sacro-pubic  diameter  of  its  pelvis.  For 
the  transverse  or  bis-iliac  diameter,  the  width  of  the  croup  measured 
between  the  external  angles  of  the  ilia  (taken  by  a  tape),  or  between  the 
coxo- femoral  articulations  (taken  by  a  large  pair  of  compasses),  was 
adopted.  But  it  was  soon  discovered  that  one  and  the  same  co-efficient 
would  not  serve  for  all  cases ;  as  in  common-bred  lymphatic  horses,  the 
bones  are  large,  the  soft  textures  abundant,  and  the  pelvic  cavity  less 
than  would  be  surmised  from  the  width  of  the  croup ;  while  in  those 
which  are  well-bred,  the  bones  are  smaller  and  denser,  the  soft  tissues 
more  condensed,  and  the  pelvic  space  large,  comparatively  speaking. 
So  that  the  co-efficient  had  to  be  less  in  the  latter  than  the  former. 

The  results  of  Saint-Cyr's  measurements  and  calculations  are  fairly 
reliable,  and  the  external  measurements  do  not  differ  very  widely  in 
their  indications  from  those  furnished  by  actual  measurement  of  the 
pelvic  cavity. 

This  method,  however,  even  when  accepted  as  perfectly  reliable,  only 
furnishes  us  with  the  dimensions  of  the  well-formed  normal  pelvis  ;  it 
gives  no  information  with  regard  to  internal  deformities,  for  the  estima- 
tion of  which  it  is  necessary  to  have  recourse  to  '  direct  exploration,' 
either  through  the  vagina  or  rectum,  by  which  we  may  not  only  dis- 
cover the  character,  but  also,  approximately,  the  extent  of  the  deformity. 
"Internal  pelvimetry"  may  also  be  resorted  to  in  this  way;  and  in 
practice,  after  a  little  experience,  it  will  be  found  sufficiently  simple  and 
trustworthy  to  be  of  much  service.  This  internal  measurement  of  the 
pelvic  cavity  cannot  be  satisfactorily  made  by  means  of  compasses  or 
other  instruments  in  the  living  animal,  as  in  w^oman  ;  but  the  hand  may 
be  successfully  employed  in  ascertaining  the  different  diameters  by 
spans — as  the  thumb  from  the  index  to  the  middle  finger,  and  even 
widely  spread  to  the  little  finger ;  the  distance  between  these  being  pre- 
viously known,  we  may  readily  ascertain  with  sufficient  accuracy  the 
diametrical  capacity  of  the  pelvis. 

The  axis  of  the  jjelvis  is  the  term  given  to  an  imaginary  line  drawn 
through  the  pelvic  canal  from  before  to  behind,  at  an  equal  distance 
from  the  circumference.  In  the  human  pelvis  there  are  ttoo  axes — 
those  of  the  upper  and  lower  outlet,  and  a  knowledge  of  them  is  of 
much  importance  in  midwifery ;  they  form  an  obtuse  angle  with  each 
other,  and,  when  combined  with  the  inclination  of  the  pelvis,  w^e  observe 
that  the  direction  the  human  foetus  must  take  is  somewhat  tortuous  or 

1  The  calculations  and  measurements  are  given  in  Saint-Cyr's  "  Traite  d'Obstetrique 
Veterinaire,"  second  edition,  p.  26. 


EXTEItS'AL  nnCAXS  tiF  (!h:Xt:i!ATIi>X.  27 

curved.  In  animals  there  is  only  one  axis,  and  that  is  almost  rectili- 
near, the  sacro-vertehral  angle  or  "  promontory"  heint;  comparatively 
little  developed,  and  the  sacrum  passinj^  almost  in  a  direct  line  from  the 
vertebral  colunm.  This  rectilinear  direction  of  the  pelvic  axis  is  greatly 
to  the  advantage  of  animals  during  parturition  ;  so  that  the  axis  of  this 
canal  requires  but  little  notice  from  the  veterinary  obstetrist,  except) 
when  the  passage  is  very  constricted. 


CHAPTEK  II. 
Female  Generative  Organs. 

The  genital  onjans  of  the  female  are  much  more  complicated  than  those 
of  the  male,  because  of  the  far  greater  sliare  they  take  in  the  process  of 
generation.  They  are  usually  described,  according  to  their  situation, 
as  external  and  iyiternal ;  or  from  their  function — as  cojjulativc  and 
formative. 

Proceeding  from  the  exterior  to  the  interior,  these  organs  may  be 
enumerated  as  follows  :  the  vulva  and  viamnue  or  mammary  (jlanih,  the 
vagina,  litems,  Fallopian  tubes,  and  ovaries.  We  will  describe  these  in 
the  above-mentioned  order,  taking  the  Mare  again  as  the  type,  and 
indicating  the  diflferences  in  the  other  domesticated  animals. 

SECTION  I.— EXTERNAL  OIKJANS  OF  GENERATION. 
ThK    VlLVA. 

The  external  orifice  of  the  generative  organs,  the  vulva,  appears  as  a 
vertically  elongated  slit,  situated  beneath  the  anus,  between  the 
perineum  and  ischial  arch  and  the  posterior  margin  of  the  two  hind 
quarters.  It  jjresents  two  thick  lijis  or  labia,  and  two  covnnissures, 
externally  ;  and  internally  it  forms  a  cavity  which  is  continuous  with 
that  of  the  vagina,  and  extends  beyond  the  meatus  nrinarius.  The 
limit  between  the  vulva  and  vagina  is  not  perceptible  in  the  adult,  but 
is  always  conspicuous  iu  the  foetus. 

Tlie  lips  {labiic  vulv(C)  are  usually  in  contact,  and  they,  with  the 
opening  which  separates  them  {rivue  vulvcc),  vary  in  si/.e  according  to 
age  and  condition.  They  are  slightly  prominent  and  thick,  being  com- 
posed of  firm,  fiexiblo,  and  elastic  tissue,  which  is  covered  with  a  fine, 
smooth,  unctuous  skin  destitute  of  hair,  but  rich  in  pigment  in  the 
majority  of  animals.  Internally,  they  are  covered  by  mucous  mem- 
brane, a  continuation  of  that  lining  the  vagina,  and  which  is  constantly 
lubricated  by  a  greasy  mucus  possessing  a  special  odour,  according  to 
the  species  of  animal  ;  on  the  free  border  of  the  vulva  this  membrane 
and  the  skin  meet* 

At  the  junction  of  the  labia  above  and  below  are  the  coviviiss^tres,  due 
to  this  junction.  The  superior  commissure  is  situated  close  to  the  anus, 
from  which  it  is  only  separated  by  a  narrow  space — the  perincruvi.  It 
is  very  angular,  and  corresponds  to  the  foiirchctte  in  woman.  The 
inferior  commissure  is  obtuse,  rounded  and  more  voluminous;  it  lodges 

'  The  two  lips  coTTes|wind  to  the  labia  majora  of  wninaii  :  there  are  no  labia  minora 
in  aniniala 


28 


OBSTETRICAL  AXATOMY 


the  clitoris,  and  is  situated  immediately  above  the  raphe.  The  cavity 
of  the  vulva  sometimes  contains  the  hymen,  which  separates  it  from  the 
vagina  at  a  certain  period  of  life  ;  it  also  contains  the  meatus  2irinarius 
and  its  valve,  as  well  as  the  clitoris. 

The  structure  of  the  vulva  consists  of  the  mucous  viembrane  lining  its 
interior,  and  which  is  covered  by  pavement  epithelium ;  an  erectile 
structure  connected  with  it,  named  the  vaginal  bulb  ;  two  constrictor 
muscles;  two  muscular  ligaments,  fascice,  etc.  The  mucous  membrane 
is  continuous  with  that  of  the  vagina  and  bladder  ;  it  is  usually  of  a 
pink  or  rosy  tint,  but  at  the  period  of  oestrum  it  has  a  bright-red  hue. 
Near  the  margin  of  the  labia  it  frequently  shows  black  pigmentary 
patches,   which   give   it   a  marbled    appearance.     It  is  provided  with 


Fig.  17. 

The  Generative  Organs  of  the  Mare  in  situ. 

1,  Body  of  the  Uterus  ;  2,  2,  Cornua  of  the  Uterus  ;  3,  Vagina  ;  4,  Bladder  ; 
5,  Rectum  ;  6,  Sphincter  of  the  Anus  ;  7,  Constrictor  Mu-cle  of  the  Vulva  ; 
8,  Bulb  of  the  Vagina;  9,  Ovary  and  Fimbriated  Body;  10,  Fallopian 
Tube  ;  11,  Kidney;   12,  12,  Broad  Ligament. 


numerous  mucous  follicles  and  sebaceous  glands  ;  the  latter  are  chiefly 
found  near  the  free  border,  and  particularly  around  the  clitoris  and  the 
space  between  it  and  the  inferior  commissure,  where  they  aggregate  to 
form  several  small  sinuses.  This  membrane  is  also  furnished  with 
great  numbers  of  papillae.  The  vaginal  bulb  is  wholly  composed  of 
erectile  tissue  with  wide  spaces,  which  constitutes  the  jjlexus  retiformis. 
This  tissue  passes  from  the  base  of  the  clitoris  to  the  sides  of  the  vulva, 
where  it  terminates  in  a  round,  salient,  or  ring-like  lobe.  Covered  by  the 
posterior  constrictor  of  the  vulva,  this  bulb  communicates  inferiorly  with 
the  cavernous  veins,  and  the  afflux  of  blood  into  its  meshes  diminishes 
the  capacity  of  the  vulva,  thereby  concurring  to  render  the  coaptation 
of  the  copulatory  organs  more  complete  during  coition. 


KXTKHXAL  on<IANs  of  (lEXEItAriON.  29 

The  muscles  of  the  vulva  are  constrictors — an  anterior  and  posterior 
— and  are  vohuitary.  The  anterior  coustrictor  is  analoj^'ous  to  Wilson's 
muscle  in  the  male,  and  is  formed  of  arciform  fibres  which  surround 
the  sides  and  lower  part  of  the  vagina  at  its  conmiencenient,  its 
extremities  being  continued  by  means  of  aponeurotic  fascicuH  as  far  as 
the  sides  of  the  rectum,  where  they  disappear.  Posteriorly,  this  muscle 
is  confounded  with  the  next  to  be  described.  The  posleriur  constrictor 
{constrictor  ciinm)  is  analogous  to  the  constrictor  of  the  vagina,  and 
forms  a  real  sphincter;  it  is  comprised  within  the  substance  of  the  lips 
of  the  vulva.  Superiorly,  its  fibres  are"  mixed  with  those  of  the  anal 
sphincter,  and  are  attached  to  the  sacrum  by  means  of  the  suspensory 
ligaments.  Inferiorly,  the  most  forward  are  fixed  to  the  base  of  the 
clitoris,  and  the  middle  are  prolonged  to  both  sides  of  the  thighs,  where 
they  are  inserted  into  the  skin.  Inwardly,  this  muscle  is  in  relation 
with  the  vaginal  bulb  and  the  mucous  membrane  of  the  vulva.  Its 
external  face  is  separated  from  the  skin  of  the  lips  by  a  very  vascular 
cellulo-fibrous  tissue,  which  is  capable  of  contracting,  and  in  the  midst 
of  which  are  observed  some  isolated  red  nmscuhvr  fasciculi — ^given  off 
from  the  principal  nuiscle. 

The  posterior  constrictor  of  the  vulva  is  very  powerful,  and  in  acting 
during  copulation  contracts  the  vagina  and  compresses  the  penis ;  by 
reason  of  its  attachment  to  the  clitoris,  when  it  acts  it  erects  that  organ. 
In  Mares  which  are  rutting,  the  movements  of  the  clitoris  are  frequent, 
and  it  then  projects  outwards  ;  this  is  particularly  observed  after  mic- 
turition, and  in  this  case  the  fibres  of  the  constrictor  attached  to  the 
clitoris  elevate  the  latter  by  acting  on  its  base,  those  fibres  which  are 
inserted  into  the  skin  of  the  thighs  depressing  the  inferior  commissure 
of  the  vulva,  which  exposes  that  very  sensitive  erectile  body  lodged  in 
this  space. 

The  vuiscuhir  liijaments  of  the  vulva  in  reality  correspond  to  the 
li(jamcntuin  suspcnsorium  of  the  penis  in  the  male  ;  they  arise  from  the 
lower  face  of  the  sacrum,  and  descend  as  flat  bands  until  they  untie 
beneath  the  rectum,  when  they  pass  in  several  fasciculi  into  the  lips  of 
this  part,  and  mix  with  the  fibres  of  the  posterior  constrictor.  They 
are  composed  of  non-striated  fibres.  The  skin,  as  already  mentioned, 
is  very  tine  and  thin,  black  in  the  great  majority  of  Mares,  has  scarcely 
any  hair,  and  is  very  unctuous,  odorous,  and  elastic.  The  bulk  of  the 
vulva  is  made  up  of  subcutaneous  fascia,  to  which  the  skin  closely 
adheres  ;  as  well  as  adipose  and  connective  tissue,  and  bloodvessels  and 
nerves. 

The  clitoris  is  an  exact,  but  miniature,  counterpart  of  the  corpus 
cavernosuni  of  the  male  penis.  From  two  to  three  inches  in  length, 
this  body  commences  by  two  roots  attached  to  the  iscliial  arch,  and 
which  are  covered  by  a  rudimentary  ischio-cavernous  nmsclc.  After 
being  fixed  to  the  ischial  sympliysis,  by  means  of  a  suspensory  ligament 
similar  to  that  of  the  male,  it  passes  backward  and  [)rojects  into  the 
vulvar  cavity,  towards  the  inferior  commissure,  in  which  it  is  lodged. 
Its  free  extremity  is  enveloped  in  a  mucous  cap — the  prcpntium,  which 
is  plicated  in  dit}erent  directions  ;  and  towards  the  centre  of  the  tubercle 
is  a  follicular  cavity  containing  sebaceous  matter,  and  which  represents 
that  in  the  extremity  of  the  male  penis.  In  every  respect  tlie  clitoris 
resembles  that  organ,  having  a  fibrous  framework,  erectile  tissue, 
cavernous  vessels  or  "  plexus  retiformis,"  and  a  pair  of  muscles — the 
crcctorcs  clitoridis.     This  organ  is  more  especially  the  seat  of  venereal 


30  OBSTETRICAL  ANATOMY. 

excitation  during  coition.  It  is  present  in  all  the  domestic  female 
animals,  and  is  frequently  erected  while  they  are  in  "  heat,"  as  well  as 
in  the  act  of  copulation.  It  is  abundantly  supplied  with  nerves,  which 
endow  it  with  most  acute  sensibility,  and  the  mucous  membrane 
enveloping  it  is  usually  dark  coloured  or  marbled,  though  in  white 
Mares  it  may  be  colourless. 

The  meatus  urinarius  is  the  orifice  of  the  urethra,  which  is  a  very 
short  canal  in  the  female.  This  canal  passes  immediately  beneath  the 
anterior  sphincter  muscle  of  the  vulva,  and  after  a  brief  course  (about 
two  inches)  in  the  textures  composing  the  floor  of  the  vagina,  opens 
into  the  vulvar  cavity  at  from  four  to  six  inches  from  its  exterior.  This 
opening,  which  is  on  the  floor  of  the  cavity,  is  covered  by  a  wide  dupli- 
cature  of  the  lining  membrane  that  acts  as,  and  is  designated,  the  valve 
of  the  meatus  or  vagina  (valvula  vagince) ;  its  free  border  is  turned 
backwards,  and  it  would  thus  appear  to  direct  the  urine  towards  the 
external  opening  of  the  vulva,  and  prevent  its  reflux  into  the  vagina. 
Eainard  states  that  this  valve  is  more  extensive  as  the  vagina  is  narrow, 
and  consequently  as  the  female  is  young ;  it  has  been  compared  to  the 
hymen  of  woman.  Brugnone  was  of  opinion  that  it  was  attached  to 
the  upper  surface  of  the  vagina  by  a  small  cord,  and  that  it  was  the 
rupture  of  this  by  the  forced  entrance  of  the  penis  which  caused  the 
slight  flow  of  blood  from  the  vulva  observed  in  Mares  put  to  the  horse 
for  the  first  time.  This  is  no  doubt  the  hymen  to  which  he  refers — a 
membrane  found  generally  in  the  i'illy,  though  not  often  in  the  Mare, 
but  which,  when  present,  separates  the  vulvar  from  the  vaginal  cavity. 
This  membrane  forms  a  circular  partition,  fixed  by  its  circumference  to 
the  vulvo- vaginal  walls  along  with  the  valve  of  the  meatus,  and  is 
perforated  by  one  or  more  openings,  which  are  sometimes  very  small. 

The  existence  of  the  hymen  in  animals  has  been  denied,  but  that  it  is 
present  sometimes,  though  rarely,  there  can  be  no  doubt,  and,  as  in 
woman,  when  imperforate  it  leads  to  retention  of  secretions.  Not 
infrequently  old  brood  Mares  show  in  this  situation  pediculated  appen- 
dices, which  are  the  debris  of  this  mucous  septum. 

The  urethral  orifice  of  the  Mare  is  wider  than  that  of  the  Horse,  and 
will  readily  admit  a  large  catheter.  In  passing  that  instrument,  it  is 
well  to  remember  that  the  urethral  canal  curves  forward  and  downward, 
and  that  the  valve  must  be  raised  either  with  the  point  of  the  instru- 
ment or  the  finger  before  the  passage  can  be  entered. 

In  ordinary  circumstances  the  vulva  is  retracted,  and  with  Mares 
which  have  foaled  several  times  the  labia  usually  exhibit  as  many 
wrinkles  or  folds  as  parturition  has  been  frequent. 

During  oestrum,  but  especially  towards  the  termination  of  pregnancy, 
the  labia  become  tumified  and  soft,  the  inferior  commissure  descends, 
the  vulvar  opening  is  enlarged,  and  from  it  is  discharged  a  quantity  of 
tenacious  stringy  mucus. 


Differences  in  the  Vulva  of  other  Animals. 

Cow. 

In  the  Cow  the  lips  of  the  vulva  are  larger,  softer,  and  thicker  than 
in  the  Mare,  and  the  inferior  commissure,  angular  and  prolonged  into  a 
curved  peak,  is  furnished  with  a  tuft  of  hair.  The  meatus  urinarius  is  dis- 
posed as  in  the  Mare ;  but  in  the  interior  of  the  urethral  canal,  fixed  to  its 


EXTER^TAL  ORGAXS  OF  UEXEILI  TlnX.  31 

lower  aspect,  is  a  valve  whose  free  margin  is  directed  backwaz-ds  ;  this 
valve  surmounts  a  cul-de-sac  about  the  third  of  an  inch.  This  valve  of 
the  canal  must  be  remembered  in  passing  the  catheter  into  the  bladder. 
About  an  inch  within  the  entrance  of  the  vulva,  and  imbedded  within 
the  substance  of  its  lips,  are  the  vulvo-va<ji)ial  (jhoids  {(/laiulnla  vagince, 
S.  Duvcrncyi,  S.  Bartholini) — large  almond-shaped  bodies  whose  widest 
exti'emity  is  directed  upwards,  and  the  narrow  end,  situated  near  the 
clitoro-sciatic  muscle,  is  prolonged  into  their  excretory  canals.  These 
are  conglomerate  glands,  whose  excretory  ducts  unite  to  form  a  kind  of 
sinus  that  at  last  opens  into  the  vulva,  about  the  third  of  an  inch  from 
the  labia.  The  clitoris  is  longer,  and  more  tortuous  and  slender  than  in 
the  Mare,  and  contains  a  dense  fibrous  nucleus  of  a  spiral  shape.  The 
vaginal  bulb  is  much  more  extensive  than  in  the  Mare,  and  is  continued 
to  the  clitoris,  where  it  is  covered  by  a  thick  muscle,  which  descends 
from  the  extremity  of  the  sacrum,  and  terminates  on  the  clitoris.  The 
same  changes  occur  in  the  vulva  of  the  Cow  as  in  the  Mare  during 
oestrum,  and  towards  the  termination  of  pregnancy ;  the  mucous 
secretion  of  the  vagina  is  more  abundant  in  the  Cow,  however,  and 
persists  longer. 

SJicep. 

In  the  Sheep  which  has  not  copulated,  a  filamentary  band,  stretching 
across  the  constriction  between  the  uro-genital  canal  and  the  vagina, 
represents  the  hipnen.  The  2Ialpi(jhian  canals  open  into  that  passage 
near  the  constriction,  and  the  crura  of  the  clitoris  are  enfolded  Isy 
erector  muscles ;  while  the  clitoris  itself  protrudes  immediately  within 
the  peak  of  the  vulva. 

Pi'.h 
In  the  Pig,  the  urctJira  opens  between  two  longitudinal  ridges  ;  but 
the  surface  of  these  and  other  similar  prominences  in  the  uro-genital 
passage  is  interrupted  by  numerous  fine,  wavy,  oblique  furrows.  There 
is  no  vaginal  valve,  as  in  the  other  animals.  The  clitoris  is  comparatively 
small,  and  the  inferior  commissure  of  the  vulva  is  still  moi-e  acute  and 
pointed  than  in  the  Cow  and  Ruminants  in  general.  Towards  the 
meatus  are  numerous  fine  points — the  openings  of  glands  analogous  to 
the  prostates ;  and  on  the  sides  of  that  orifice  are  two  small  fossaa 
surrounded  by  a  raised  border. 

Bitch  and  Cat. 

In  the  Bitch  the  vulva  is  triangular,  and  the  inferior  commissure 
acute.  The  clitoris  is  a  small  tubercle,  and  the  uretlira  opens  between 
a  little  transverse  fold  and  the  triangular  flattened  clitoris;  beyond  this 
is  a  second  transverse  crescentic  fold,  with  its  concavity  opposite  that 
of  the  preceding.  In  the  Cat,  a  small  cartilage  or  l;one  exists  in  the 
clitoris  ;  this  is  not  found  in  any  other  of  the  domesticated  animals. 

The  Peiunj:um  is  the  name  given  to  the  space  between  the  superior 
commissure  of  the  vulva  and  the  lower  margin  of  the  anus.  Its  length 
varies  in  different  species,  and  in  different-sized  animals  of  the  same 
species  ;  but  it  is  shorter  in  creatures  which  have  produced  young  than 
in  those  which  have  not.  It  is  composed  of  various  tissues — externally 
is  the  smooth,  tine,  and  very  elastic  skin,  with  the  vertical  prominent 
line  passing  down  its  middle — the  "  raphe  ;"  beneath  this  are  connective 


:32  OBSTETRICAL  ANATOMY, 

and  adipose  tissue,  and  fascia,  with  various  muscles,  bloodvessels,  and 
nerves. 

The  internal  limits  of  the  vulva  are  defined  by  the  constriction  or 
■bulb,  which  forms  a  marked  prominence  in  early  life,  but  tends  to  dis- 
.appear  in  relaxed  folds  after  the  animal  has  brought  forth  young  several 
times.  The  dimensions  of  this  aperture  are  rather  adapted  for  the 
passage  of  the  foetus  than  the  penis  ;  though  its  narrowness  is  some- 
times an  obstacle  to  delivery  in  a  primipara.  The  limbs,  body,  or  head 
of  the  foetus  are  at  times  arrested  at  the  superior  or  perineal  com- 
missure, which  they  so  distend  as  to  threaten  laceration  of  that  part. 
In  emaciated  animals,  and  particularly  Mares,  the  vulva  is  deeply 
retracted  above  the  ischia,  and  consequently  disposes  them  to  be  injured 
in  this  region  during  coitus,  by  the  accidental  introduction  of  the  male 
organ  into  the  anus — the  mechanical  action  of  which  damages,  and  may 
even  rupture,  the  rectum.  Eainard  alludes  to  several  occurrences  of 
this  kind,  which  terminated  in  the  death  of  the  Mares. 

SECTION  11.— THE  MAMM^. 

The  mamvice,  or  udders,  may  be  said  to  be  appendices  to  the  external 
organs  of  generation.  They  are  the  glands  destined  to  secrete  the  fluid 
— milk — which  is  to  nourish  the  young  animal  for  some  time  after  birth. 
In  early  life  they  are  rudimentary,  but  become  developed  with  age,  and 
attain  their  full  dimensions  when  the  female  is  capable  of  reproduction ; 
and  especially  at  the  full  period  of  gestation,  when  their  function  is 
about  to  be  carried  on  actively.  After  parturition  their  largest  develop- 
iment  is  reached,  and  when  the  young  creature  has  completed  its  term 
■of  sucking,  they  lose  their  activity  and  diminish  considerably  in  size. 
In  the  Mare  they  are  two  in  number,  placed  beside  each  other  in  the 
inguinal  region,  about  nine  inches  in  front  of  the  vulva,  where  they 
take  the  place  of  the  scrotum  in  the  male.  Externally,  they  appear  as 
two  hemispherical  masses  separated  by  a  shallow  furrow;  each  has  in 
its  centre,  on  each  side  of  the  mesian  line,  a  conical,  slightly  flattened 
prolongation  named  the  teat  or  niijple,  which  is  perforated  by  several 
orifices  from  which  the  milk  escapes,  and  by  which  the  young  creature 
obtains  that  fluid  by  suction.  The  two  glands  are  retained  in  their 
position  by  the  fii:ie  thin  skin  covering  them,  and  which,  destitute  of 
hair  at  the  extremity  of  the  teats,  though  elsewhere  provided  with  a 
soft  short  down,  is  smooth,  pliable,  and  unctuous  from  the  presence  of 
sebiparous  follicles.  At  the  base  of  the  teat  are  a  number  of  small 
tubercles,  which  correspond  to  the  areola  of  the  nipple  in  woman ;  these 
;are  the  glands. 

The  mammge  are  also  attached  to  the  abdominal  tunic  by  means  of 
several  wide,  short,  but  elastic  bands,  which  bear  some  analogy  to  the 
suspensory  ligaments  of  the  prepuce  in  the  male. 

In  STRUCTURE  each  udder  oft'ers  an  envelope  of  yclloio  elastic  fibrous 
tissue,  glandular  tissue,  the  simises  or  galactopUorous  reservoirs,  and  the 
lactiferous  ducts,  with  excretory  canals  or  onilk  ducts. 

The  elastic  envelope,  joined  at  the  mesian  line  with  that  of  the  oppo- 
site udder,  is  strengthened  by  wide  bands  detached  from  the  tunica 
abdominalis ;  it  furnishes  from  its  internal  face  numerous  prolongations 
which,  crossing  each  other  in  the  mass  of  the  gland,  form  septa  or  parti- 
tions that  divide  it  into  distinct  lobes  and  lobules,  which  are  in  this  way 


EXTERNAL  OKGAXS  OF  GEXEILITIUX.  88 

somewhat  independent  of  each  other  ;  so  that  one  or  more  may  be 
diseased  or  deranged  in  function,  without  the  otiiers  being  involved. 
Externally,  this  envelope  is  closely  adherent  to  tlie  skin,  through  the 
medium  of  a  thin  but  dense  layer  of  connective  tissue. 

The  (jlctiuhdar  tissue  offers  the  same  arrangement  as  other  conglome- 
rate glands,  and  is  composed  of  acini  or  caical  vesicles  clustered,  like 
grapes  on  their  stalk,  around  the  tuhiili  lactifcri,  or  ultimate  terminations 
of  the  excretory  ducts.  These,  commencing  by  cul-de-sac  extremities, 
open  into  one  another  to  form  dilatations  {ampnlUe),  and  finally  con- 
verge into  a  number  of  principal  canals,  which  end  in  the  galacto- 
phorous  sinuses  (sinus  lactei).  The  acini  of  the  lobules,  as  well  as  the 
ducts,  are  lined  by  polyhedral  epithelium ;  this  becomes  spherical  and 
infiltrated  with  fat  during  lactation. 

The  galactopliorous  sinuses  or  reservoirs  are  situated  slightly  above 
the  base  of  the  teat,  and  are  generally  two  in  number — one  in  front, 
the  other  behind  ;  though  there  are  sometimes  three,  and  even  four. 
They  nearly  always  comnmnicate  with  each  other,  and  are  prolonged 
into  the  teat  by  a  corresponding  number  of  terminal  and  independent 
excretory  canals,  whose  orifices  are  always  very  narrow,  and  are  seen 
at  the  free  extremity  of  that  body,  which  is  obtuse  and  rounded. 
Collectively,  these  excretory  canals  are  much  wider  at  tiie  base  of  the 
teat  than  at  the  extremity  ;  the  orifices  are  usually  behind  each  other, 
and  are  about  a  line  apart ;  and  the  canals  and  orifices  are  lined  by 
a  fine  membrane  which  is  continuous  with  the  skin,  the  latter  being 
closely  adherent  at  this  part. 

The  length  of  the  teats  varies  with  use ;  the  elastic  or  dartoid  tissues 
surrounding  them,  composed  of  non-striated  circular  and  longitudinal 
fibres,  renders  them  capable  of  a  kind  of  erection,  under  the  influence 
of  stimuli.  The  extremity  of  the  teat  is  well  provided  with  this  tissue, 
which  acts  as  a  sphincter,  and  prevents  the  passive  flow  of  the  milk. 

Connective  tissue,  bloodvessels,  nei"ves,  and  absorbents  complete  the 
organization  of  the  mamma?.  The  arteries  are  given  oft'  from  the 
external  pudic ;  the  veins  are  of  two  orders — deep,  which  follow  the 
arteries,  and  superficial.  The  nerves  are  derived  from  the  renal  or 
mesenteric  plexus. 

As  before  mentioned,  the  mamma>  undergo  remarkable  modifications 
at  the  age  of  puberty  and  the  termination  of  gestation  ;  and  these 
changes  have  reference  not  only  to  their  volume  and  secretion,  but  also 
to  their  minute  structure.  In  the  young  or  virgin  Mare,  they  are  hard, 
and  can  scarcely  be  perceived ;  and  their  dimensions  are  not  nmch 
increased  in  those  which  have  had  only  one  or  two  foals,  though  the 
teats  are  usually  larger  than  before  ;  but  when  they  have  borne  several 
foals,  the  mamnue  continue  somewhat  enlarged  and  pendulous.  When 
gestation  is  not  going  on,  the  glandular  cul-de-sacs  are  contracted  and 
wasted-looking;  tlie  lining  membrane  is  shrivelled  on  itself,  and  covered 
with  only  a  polygonal  epithelium.  .\t  the  termination  of  gestation, 
however,  the  mannna;  assume  the  functions  of  the  uterus  to  a  certain 
extent ;  the  vesicles  become  enlarged,  and  new  ones  are  developed  ;  the 
epithelium  presents  a  spherical  shape,  is  charged  with  fat  granules,  and 
fills  the  acini  ;  the  entire  gland  has  become  progressively,  but  greatly 
increased  in  si>:e,  and  instead  of  being  soft  to  the  touch  it  now  feels 
firm.  Shortly  before  parturition  the  secretion  of  milk  commences,  and 
soon  after  that  event  the  glandular  cavities  become  fully  distended,  and 

3 


34 


OBSTETIUCAL  AXA  TOMY. 


assume  their  maximum  dimensions,  which  are  maintained,  with  shght 
variations,  during  the  entire  period  of  lactation.  When  this  period  is 
terminated,  the  secretion  gradually  ceases,  and  the  gland  again  assumes 
its  quiescent  condition,  and  nearly  its  ordinary  size.^ 

DlFFEEENCES    IX    OTHEK    AxiMALS. 

Coic. 

In  the  Cow  the  mammae  are  also  inguinal  as  in  the  Mare,  and  each 
lateral  mass,  although  enveloped  in  a  single  fibrous  capsule,  is  made  up 
of  two  quite  distinct  glands— or  "  quarters,"  as  they  are  commonly 
termed — and  which  can  be  seen,  or  felt  as  limited  by  a  slight  depression. 
Each  gland  has  its  corresponding  teat,  much  more  developed  than  that 
of  the  Mare  ;  so  that  this  animal  really  possesses  four  mammae  and  four 
teats.     The  glands  are  compacted  into  a  roundish  mass,  which  is  more 


Fig.  18. 

.Section  or  Uddek  of  Cow. 

a,  Anterior  Quarter  ;  h.  Posterior  Quarter ;  g,  Septum  between  the  Quarters  ; 
c,  c.  Section  of  the  Lactiferous  Ducts  ;  (/,  d.  Lactiferous  Sinus  or  Milk 
Cistern  ;  e,  e,  Orifice  of  the  Teat ;  f,  Large  Lymph  Gland  in  the  Posterior 
Quarter. 


or  less  pendulous  when  they  are  in  active  function  ;  in  the  centre  of 
each,  and  at  the  base  of  the  teat,  there  is  a  single  large  galactophorous 
sinus,  which  is  the  general  confluent  of  all  the  lactiferous  ducts, 
and  opens  externally  through  the  teat  by  a  single  excretory  canal. 
This  canal  is  widest  at  its  commencement,  and  narrow  at  its  termina- 
tion at  the  end  of  the  teat.  The  walls  of  the  latter  are  very  thick, 
elastic,  and  retractile.  Not  infrequently  there  are  found  behind  the 
foui  teats  one  or  two  rudimentary  teats,  which  are  generally  imperforate ; 
though  in  very  rare  instances  they  have  been  observed  to  be  perforate 
and  to  yield  milk. 

1  Li  the  male  Horse  we  find  rudimentary'  teats,  which  are  concealed  within  the 
prominent  annular  fold  of  integument  towards  the  extremity  of  the  prepuce.  They  are 
not  i  hvays  present,  however ;  though  they  are  so  in  the  Ass,  which  has  them  largely 
devel   ped. 


KXTHIiXAL  onnAXS  OF  (1K.\ KiLlTIoX. 


35 


The  teats  of  the  Cow  are  fjenerally  from  two  and  a  half  to  three  and 
a  half  inches  in  length,  and,  as  has  been  said,  this  lenj^'th  varies  accord- 
in"^  as  the  animal  has  reared  a  large  or  small  number  of  calves.  The 
two  anterior  are  generally  the  longest,  and  the  corresponding  (juarters 
furnish  more  milk  than  the  others.  The  dartoid  tissue  around  the  free 
extremity  of  the  teat,  acting  as  a  sphincter,  prevents  the  passive  escape 
of  the  milk  from  the  orifices  of  the  excretory  ducts;  for  if  a  small  cannula, 
scarcely  larger  than  one  of  these  ducts,  be  inserted  slightly  beyond  the 
orifice,  the  secretion  immediately  Hows.  And  when  the  end  of  a  teat 
has  been  wounded,  or  when  the  elastic  tissue  of  this  part  has  been  divided 
in  the  performance  of  some  operation,  there  is  no  longer  any  obstacle  to 
the  emission  of  the  milk. 

The  arteries  that  supply  the  mamm®  of  the  Cow  with  blood  are 
derived  from  the  external  pudic.  The  branch  of  each  side,  on  reaching 
the  lateral  glands,  divides  into  two  principal  trunks,  one  of  which  goes 
to  a  corresponding  quarter;   that  which  is  destined  for  the  posterior 


B 

.  o.;v 


«• 


Fifc-.  19. 

A.  Lob'ile  of  the  Mainniie  filled  with  Milk  ; 
r..  Milk  Globules  ;  C,  Colostrum  :  a.  Cell 
with  a  \'ir<ible  Nucleus;  /*,  Cells  fmrn 
which  the  Nucleus  has  disappeared. 


Fig.  20. 
Skc-i'ion  ok  thk  Cow's  Te.\t. 
o,  ti.  Principal  Lactiferous  Ducts  ; 
/;.  Lactiferous  Sinus  ;  r,  r.  Acini ; 
(I,  Klastic  or  iJartoid   Tissue  of 
the  Teat ;  <\  Orifice  of  the  Teat. 


gland  beuds  at  a  right  angle  backwards,  the  branch  for  the  anterior 
quarter — the  largest — descending  perpendicularly,  to  become  subdivided 
into  numerous  ramuscles  and  terminal  twigs.  The  veins  and  nerves 
are  derived  as  in  the  Mare. 

In  the  Cow,  the  secretion  of  inilk  can  be  excited  and  maintained  by 
regular  "  milking,"  the  only  suspension  occurring  before  the  birth  of 
another  calf. 

Sheep  ami  Goat. 

In  the  Sheep  and  Goat  there  are  only  two  mamnijc,  as  in  the  Mare 
and  Ass,  though  they  are  formed  on  the  same  plan  as  in  the  Cow.  They 
are  also  inguinal,  somewhat  hemispherical  and  voluminous,  particularly 
in  the  Goat,  and  each  is  provided  with  a  single  conical,  well-detached 
teat.  The  latter  animal  has  sometimes,  in  addition,  two  posterior  rudi- 
mentary teats,  and  the  galactophorous  sinus  of  each  ordinary  teat  is 
very  large,  the  walls  of  the  teat  being  thin  ;  it  is  capable  of  containing, 
in  some  instances,  nearly  three  ounces  of  milk. 


36  OBSTETRICAL  ANATOMY. 

Pig. 

In  the  Pig  the  mammae  are  ten  or  twelve  in  number,  disposed  by 
pairs  in  two  parallel  rows  extending  from  the  inguinal  region  to  beneath 
the  thorax,  and  distinguished  as  inguinal,  abdominal,  and  thoracic 
mammae.  They  have  not,  as  in  the  larger  animals,  any  sinuses,  the 
lactiferous  canals  of  each  teat  joining  directly  to  form  a  variable  number 
of  excretory  ducts,  which  open  at  the  free  extremity  of  the  teat  by 
from  five  to  ten  orifices.  The  limits  of  each  gland  are  denoted,  extern- 
ally, by  a  slight  vertical  depression,  and  a  trilling  convexity  correspond- 
ing to  the  teat. 

The  mammas  of  this  animal  are  scarcely  perceptible  while  they  are 
not  active  ;  but  during  lactation  they  form  two  series  of  well-developed 
eminences,  divided  on  the  middle  line  by  a  wide  and  deep  furrow. 

Bitch. 
In  the  Bitch  there  are  eight  to  ten  mammae,  arranged  as  in  the  Pig. 
When  the  latter  number  is  present  they  are  disposed  on  each  side  as 
two  pectoral,  two  abdominal,  and  one  inguinal. 

The  secretion  of  milk  is  a  special  function  of  the  mammary  glands, 
and  takes  place  in  the  caecal  vesicles  of  the  lobules.  The  fluid  is  con- 
veyed from  these  into  the  lactiferous  ducts  and  sinuses,  where  it  is 
stored  until  a  certain  period  :  this  retention  after  a  time  distends  the 
glands  very  much,  and  puts  the  elastic  envelope  greatly  on  the  stretch  ; 
while  the  teat  also  increases  in  size,  length,  and  firmness.  When  this 
distension  becomes  inordinate,  it  causes  the  animal  uneasiness  and 
pain,  and  if  not  relieved  by  natural  or  artificial  means  it  may  occasion 
mischief.  In  the  majority  of  cases,  the  pressure  of  the  envelope  on  the 
contained  fluid  overcomes  the  resistance  of  the  sphincter  at  the  end  of 
the  teat,  and  relief  is  afforded  in  this  way. 


CHAPTEE  III. 
Internal  Organs  of  Generation. 

The  internal  or  formative  organs  of  generation  are  contained  within 
the  pelvis  and  abdomen,  and  comprise  the  vagina  (which  some  writers 
include  with  the  external  organs),  uterus,  Fallopian  tubes,  and  ovaries. 

SECTION  I.— THE  VAGINA. 
The  Vagina  is  a  musculo-membranous  canal  of  variable  dimensions, 
with  thin  walls  ;  it  extends  almost  horizontally  within  the  pelvic  cavit}^ 
from  the  vulva  posteriorly  to  the  uterus  anteriorly,  the  cervix  or  neck 
of  which  it  embraces  in  a  kind  of  semicircular  ciil-de-sac.  The  rectum 
lies  above  it,  and  the  bladder  below ;  on  each  side  are  the  ureters  and 
the  walls  of  the  pelvis,  and  posteriorly  it  is  surrounded  by  adipose  and 
loose  connective  tissue.  When  distended  it  is  cylindrical  in  form,  but 
usually  its  sides  are  in  contact.  Its  length  is  variable,  of  course,  but 
in  a  full-sized  Mare  it  is  about  a  foot  long.  It  is  maintained  in  position 
anteriorly  by  folds  of  peritoneum,  which  attach  it  to  the  rectum  above 
and  to  the  bladder  beneath,  the  attachment  to  the  rectum  being  accom- 
plished through  the  medium  of  the  loose  connective  tissue  referred  to. 
But  this  tissue,  which  also  unites  it  to  the  bladder,  is  here  close  and 


INTERNAL  ORGANS  OF  OENKllA  TloN. 


37 


firm,  and  this  fact  may  serve  to  explain  why  the  rectum  is  so  rarely 
involved  in  displacements  of  the  uterus,  while  the  bladder  is  always 


Fig.  -1. 

i;knkr.\tive  Okgans  ov  the  Mare:  Isolated  axi>  Paktly  Oi'Kxkd. 

1, 1,  OvaricH  ;  2,  2,  Fallo'.ian  Tubes  ;  3,  Pavilion  <>f  tlie  Tub*;,  Kxternal  Face  ; 
4,  Ibid.,  Inner  Face,  showing  the  Opening  in  the  Middle;  .">,  Ligament  of 
the  Ovary  ;  6,  Intact  Horn  of  the  I'teruH  ;  7,  A  Horn  opened  ;  8,  Body  of  the 
Uterus,  Upper  Face  ;  '.»,  Broad  Liiraineut ;  10,  Cervix,  with  its  numerous 
folds,  or  Palma  plirala  ;  11,  Cnl-df-snc  of  the  Vagina;  12,  Interior  of  the 
Vagina,  «-ith  it*  Folds  of  M»icou«  Membrane  ;  1">,  Urinary  Meatus  and  its 
Valve,  14  ;  ir>,  Mucou'f  Fold,  Ji  Vestige  of  the  Hj-men  ;  16,  Interior  of  the 
Vulva;  17,  Clitoris;  18,  18,  Labia  of  the  Vulva;  H»,  Inferior  Commissure 
of  the  Vulva. 

more  or  less  so.  Laterally,  it  is  attached  to  the  muscular  and  aponeu- 
rotic structures  in  the  cavity  of  the  pelvis.  Internally,  it  is  lined  by 
a  thin  mucous  membrane,  which  is  always  abundantly  covered  with 


38  OBSTETPJCAL  ANATOMY. 

mucus  (in  woman  this  mucus  is  acid,  while  that  of  the  uterus  is 
alkaHne),  and  is  disposed  (in  the  Mare)  in  longitudinal  rugie,  which 
are  more  conspicuous  after  several  births.  These  rugae  no  doubt  favour 
the  dilation  of  the  canal  during  coitus  or  the  passage  of  the  foetus ;  a 
transverse  ridge,  already  described  as  existing  on  the  lower  face  of  the 
canal,  covers  the  meatus.  This  membrane  is  continuous  with  that 
of  the  vulva,  and  anteriorly,  at  the  cul-de-sac,  it  is  reflected  over  the 
cervix  of  the  uterus,  which  projects,  like  a  cauliflower  in  shape,  into 
the  cavity.  It  is  provided  with  papillae,  and  covered  with  pavement 
epithelium.  It  usually  has  a  pale  pink  hue,  but  at  the  period  of 
oestrum  its  colour  becomes  heightened  to  a  bright  red,  and  its  secretion 
is  considerably  increased. 

Externally,  the  vagina  is  invested  by  a  muscular  coat,  which  is 
enveloped  by  an  abundant  layer  of  connective  tissue,  and  traversed  by 
a  large  number  of  bloodvessels  ;  in  front,  how^ever,  this  tunic  is  invested 
in  peritoneal  membrane,  which  is  applied  in  a  circular  manner  around 
it,  to  pass  over  the  uterus. 

The  vagina  is  supplied  with  blood  by  the  internal  pudic  artery ;  its 
veins  are  disposed  as  an  encircling  plexus,  and  terminate  in  the  satellite 
trunk  of  the  artery.  The  vagina  serves  for  copulation  and  the  passage 
of  the  foetus.  At  the  periods  of  oestrum  and  parturition,  the  mucous 
secretion  is  more  active  than  at  other  times.  In  youth  it  is  contracted  ; 
after  copulation  its  dimensions  are  increased,  and  these  are  greatest 
during  parturition.  In  old  age  it  is  much  diminished;  in  the  third  or 
fourth  months  of  gestation  in  the  larger  animals,  it  becomes  elongated 
from  displacement  of  the  uterus,  which  is  carried  farther  forward  into 
the  abdominal  cavity ;  towards  the  termination  of  this  process  its 
length  diminishes  as  the  uterus  acquires  increased  volume,  and  to 
such  an  extent  does  this  occur,  that  at  the  commencement  of  parturi- 
tion, if  the  foetus  is  large,  and  especially  if  there  be  two  foetuses,  the 
posterior  wall  of  that  receptacle,  pushed  back  into  the  pelvis,  nearly  or 
entirely  effaces  the  cavity  of  the  vagina,  and  even  in  some  instances 
thrusts  it  between  the  labia  of  the  vulva  or  beyond. 

The  vagina  has  been  found  partially  divided  into  two  canals  by  a 
niedian,  though  incomplete,  vertical  septum,  which  was  so  short  that 
it  could  not  be  said  to  form  a  double  vagina. 

Differences. 
Coiv,  Sheep,  and  Goat. 
In  the  Cow  the  canal  is  longer  and  wider  than  in  the  Mare ;  the 
mucous  membrane  of  the  vagina  is  thicker,  is  disposed  in  transverse 
rugae  as  in  the  human  species,  and  at  each  side  of  the  passage  for  a 
certain  distance,  between  the  mucous  and  muscular  layers,  there  exists 
a  mucous  canal  that  opens  into  the  vulvar  cavity,  in  front  of,  and  at 
the  side  of  the  meatus  urinarius. 

The  uses  of  these  canals,  which  are  not  present  in  the  Sheep  or  Goat, 
and  rarely  in  the  Mare,  and  which  are  usually  known  as  the  "  canals  of 
Gaertner,"  are  unknown.  They  pass  backwards  into  the  broad  ligaments 
of  the  uterus,  and  terminate  in  a  cul-dc-sac.  They  probably  have  some 
function  during  fa^tal  life. 

Puj. 

In  the  Pig  these  canals  are  present  ;  the  folds  of  mucous  membrane 
are  longitudinal,  and  gradually  subside  towards  the  line  of  separation 


INTERNAL  OKCANS  <>F  t! EXKliATION.  39 

between  the  vagina  and  vulva.    The  vagina  is  from  eight  to  nine  inches 
long. 

Bitch  and  Cat. 

There  are  no  "  GaDrtner's  canals"  in  the  Bitch  or  Cat.  The  vagina  is 
of  comparatively  great  length,  and  has  longitudinal  ruga),  which  are 
interrupted  by  transverse  folds.  In  both  animals  the  canal  is  wider 
towards  the  vulva  than  towards  the  uterus,  and  its  walls  are  rendered 
very  thick  by  white  fibrous  tissue,  in  addition  to  the  non-striated 
muscular  fibres  it  contains. 

SECTION  II.— THE  UTERUS. 

The  L'teuus,  or  womb  (Figs.  17,  1 ;  21,  8),  is  an  elongated  musculo- 
membranous  sac  which  receives  the  ovum,  and  constitutes  the  recep- 
tacle for  the  nutrition,  development,  and,  finally,  after  a  certain  period, 
the  expulsion  of  the  fcrtus.  It  is  situated  in  the  sublumbar  region 
of  the  abdomen,  towards  the  inlet  of  the  pelvic  cavity,  into  which  its 
posterior  extremity  enters.  This  portion — the  body — represents  a  simple 
cylindrical  reservoir,  slightly  flattened  above  and  below,  while  the 
anterior  part  is  bifid  ;  the  two  divisions — the  cornua  or  horns — curve 
upwards  and  forwards.  The  body  is  situated  horizontally  beneath  the 
rectum,  which  is  in  contact  with  it  after  passing  between  the  two 
cornua  ;  on  each  side  of  its  upper  external  face  it  receives  the  insertions 
of  wide  ligaments  ;  and  its  sides  and  anterior  face  are  in  contact  with 
the  intestines.  Its  lower  surface  is  in  contact  with  the  bladder  and  the 
pelvic  curvature  of  the  colon  ;  while  its  anterior  extremity  is  continuous 
with  each  of  the  cornua,  and  the  posterior  is  separated  from  the  vagina 
by  the  constriction  named  the  col,  cervix,  or  neck  of  the  uterus.  The 
cornua  are  cylindrical  tubes,  and,  lodged  among  the  intestines  occupy- 
ing this  region,  proceed  at  an  angle  from  the  body  in  an  upward  direc- 
tion, describing  two  curves — an  inferior,  convex,  which  is  free  ;  and  a 
superior,  concave,  to  which  the  suspensory  ligaments  are  attached. 
Each  horn  has  also  a  posterior  extremity  or  base,  a  continuation  of  the 
body  of  the  uteinis ;  and  an  anterior  extremity  or  summit,  rounded  into 
a  cnl-de-sac,  which  is  turned  upwards,  and  has  at  the  bottom  a  small 
tubercle,  the  insertion  of  the  oviduct. 

Floating  in  the  abdominal  cavity,  like  the  intestines,  the  uterus  is 
also  attached,  as  they  are,  by  two  membranous  bands  which  suspend 
them  from  the  sublumbar  region,  and  are  consequently  designated  the 
broad  or  suspensory  lit/aments  of  the  uterus  ;  also,  from  the  general 
resemblance  to  the  wings  of  a  bat,  the  alca  vespertilionis.  These  bands, 
derived  from  the  peritoneum  of  the  abdomen,  are  lartjer  in  front  than 
behind,  and  in  shape  are  irregularly  triangular ;  beliind,  they  are  close 
to  each  other,  but  in  front  diverge  like  the  sides  of  the  letter  V,  They 
descend  from  the  lower  face  of  the  lumbar  region,  and  attach  them- 
selves, by  their  inferior  border,  to  the  sides  of  the  upper  surface  of  the 
body  and  the  smaller  curvature  of  the  cornua ;  their  anterior  border 
is  free  and  sustains  the  oviducts  and  ovaries,  the  first  being  included 
between  the  two  layers  of  the  ligament,  while  the  ovary,  placed  within 
it,  also  receives  a  layer  detached  froju  the  principal  one,  which  with 
it  forms  a  little  cup-shaped  cavity.  Another  small,  long,  and  narrow 
band  of  peritoneum  is  observed  external  to  the  broad  ligament ;  this 
can  be  traced  posteriorly  to  the  internal  inguinal  ring,  and  anteriorly 
it  presents  a  little  enlarged  appendix.     Between  the  two  layers  com- 


40  OBSTETRICAL  AXATOMY. 

posing  this  band,  is  a  thin  muscle  similar  to  the  cremaster  of  the  male 
before  the  descent  of  the  testicle  into  the  scrotum  ;  this  band  is  the 
analogue  of  the  round  ligament  in  woman.  The  uterus  is  also  main- 
tained in  position  by  the  vagina  posteriorly,  and  by  the  peritoneum, 
which  at  this  part  forms  four  bands  —  the  recto-uterine  and  vesico- 
uterine. 

The  interior  of  the  uterus  is  divided  into  three  compartments,  cor- 
responding to  its  divisions  into  body  and  cornua.  The  cavity  of  the 
body  communicates  with  the  vagina  by  a  narrow  canal  which  traverses 
the  constriction  or  cervix  of  the  uterus,  and  is  designated  the  canal  of 
the  cervix.  In  all  the  domesticated  animals,  except  the  Rabbit,  this 
canal  is  prolonged  into  the  anterior  extremity  of  the  vaginal  cavity  like 
the  end  of  a  tap  into  a  barrel ;  forming  a  very  marked  protrusion — the 
cervix.  In  this  is  the  opening  {orificiuyn  uteri  externum)  leading  from 
the  vagina  to  the  body  of  the  uterus — the  os  titeri  or  os  tincce ;  around 
this  aperture  the  utero-vaginal  lining  membrane  is  curiously  arranged 
in  transverse  rugae  disposed  in  a  circular  manner,  and  which  gives  to 
this  prominent  part  the  appeai'ance  of  a  radiating  flower.  In  woman 
the  rugae  of  the  canal  are  differently  disposed,  and  resemble  the  branches 
from  the  stem  of  a  tree ;  consequently,  they  have  been  named  the 
arbor  vitce  uterina  or  imhna  plicata. 

The  uterus  is  composed  of  three  membranes — an  external,  or  serous ; 
Q,  middle,  ox  nvuscular ;  and  an  internal,  or  mucous  tunic.  The  serous 
or  peritoneal  membrane  envelops  all  the  organ,  and  is  in  reality  only 
an  expansion  of  the  broad  ligaments,  which  are  prolonged  backwards 
on  the  posterior  extremity  of  the  vagina,  which  they  encircle  and  then 
pass  to  the  rectum  and  bladder,  as  well  as  to  the  lateral  parietes  of  the 
pelvis,  constituting  the  four  ligaments  already  referred  to.  Between 
the  two  cornua  this  membrane  forms  a  peculiar  fraenum,  which  is  very 
developed  in  Solipeds.  Owing  to  this  arrangement,  the  cervix  does  not 
receive  any  peritoneal  covering.  The  muscular  layer  is  composed  of 
longitudinal  and  circular  fibres,  analogous  to  those  of  the  small  in- 
testines. At  the  insertions  of  the  broad  ligaments  into  the  uterus,  a 
series  of  fasciculi  are  given  off  from  this  layer,  which  pass  up  between 
the  folds  composing  them,  and  have  been  found  throughout  their 
extent,  especially  towards  the  ovaries.  The  fibres  composing  this  coat 
belong  to  the  class  of  non-striated  or  involuntary  muscles,  being  made 
up  of  fusiform  nucleated  fibres  lodged  in  a  matrix  of  exceedingly 
coherent  granular  matter.  The  appearance  of  this  coat  is  different  to 
that  of  ordinary  muscle,  being  much  more  dense  and  of  a  faint  yellowish- 
red  hue,  like  the  middle  coat  of  arteries  or  the  small  intestines.  The 
superficial  set  of  fibres  are  irregularly  longitudinal  in  their  direction, 
and  frequently  interlace  with  each  other  ;  the  deep  set  are  circular, 
especially  around  the  orifice  of  each  oviduct  and  the  os  uteri,  w^here 
they  are  thick  and  close ;  though  even  among  these  fibres  irregular 
fasciculi  pass  in  different  directions.  Both  layers  are  thicker  in  the 
cornua  than  the  body  ;  their  obvious  function  is  to  diminish  the  volume 
of  the  uterus  during  parturition. 

At  an  early  period  of  life  these  fibres  are  perceptible,  but  during  gesta- 
tion they  are  greatly  increased,  and  present  a  manifest  striation.  Their 
increase  is  doubtless  to  permit  the  necessary  dilatation  of  the  uterus, 
without  allowing  its  parietes  to  become  too  attenuated  and  feeble ; 
though  to  some  extent  they  do  diminish  in  thickness,  according  to  the 
species.     The  inner  set  are  loosely  adherent  to  the  lining  or  mucous 


INTERXAL  OKGAXS  OF  GENERATION.  II 

membrane  of  the  uterus.  A  rich  venous  network  is  lodged  in  the 
muscular  tunic  of  this  organ. 

The  miicdus  hiyer  is  a  thin,  dehcate,  pulpy  membrane,  covered  by 
ciliated  columnar  epithelium  in  the  body  and  cornua  of  the  organ, 
ordinary  cylindrical  squamous  or  stratified  epithelium  in  the  canal  of 
the  cervix,  like  that  of  the  intestines,  and  tessellated  or  squamous  on 
the  rugae  of  the  cervix.  This  ditlers  from  ordinary  mucous  mem- 
brane in  the  presence  of  a  very  delicate  sub-mucous  connective  tissue, 
in  which  the  utricular  glands,  blood  and  lymph  vessels,  as  well  as  nei-ves 
supplying  the  membrane,  are  situated  ;  for  this  reason  it  appears  to 
receive  its  vascular  supply  directly  from  the  muscular  coat,  its  vessels 
being  continuous  with  those  of  that  layer.  This  difference  is  probably 
related  to  its  intermittent,  though  higher,  organising  function. 

In  the  cervix,  the  basement  membrane  covers  multitudes  of  villi,  the 
points  of  which  in  woman  are  nipple-shaped,  with  a  depression  in  the 
centre  ;  within  the  cervix  tliese  villi  are  very  large,  but  in  the  body  of 
the  organ  there  are  none.  The  membrane  here  is  remarkable  for  the 
series  of  longitudinal  rugic  formed  on  it,  and  which  are  not  effaced  by 
ordinary  distention  of  the  organ  ;  though  they  disappear  during  the 
increase  in  size  of  its  cavity  in  pregnancy.  On  these  ruga^  and  in  the 
fosste  between  them,  particularly  towards  the  cervix,  are  a  great 
number  of  simple  mucous  and  special  cylindrical  glands.  The  first  are 
particularly  abundant  towards  the  cervix  ;  some  here  and  there  have 
closed  mouths,  are  enlarged,  and  form  small  vesicular  prominences, 
which  have  been  named  tlie  "ova  of  Naboth  "  {ovtila  NabotJii),  from 
tlieir  supposed  identity  with  the  ovarian  ova. 

The  cylindrical,  uterine,  or  wtv'iculsLV  glands  (qlandiihe  iitriculares),  are 
situated  close  to  each  other;  they  are  sometimes  bifurcated,  frequently 
spiral,  and  terminate  in  a  cul-de-sac  in  the  substance  of  the  mucous 
membrane,  something  like  the  agminate  glands.  In  the  Mare  they  are 
long,  slender,  and  tortuous,  and  divide  repeatedly  in  the  deeper  part  of 
the  mucosa,  and  in  such  a  manner  that  numerous  branching  tubes  are 
connected  with  a  single  stem  or  gland-duct.  They  are  lined  by  columnar 
cells,  which  project  vertically  into  the  gland  tube  :  these  cells  have  a 
ciliary  movement.  The  utricular  glands  do  not  exist  at  birth,  and  it  is 
probable  that  they  are  only  fully  developed  when  sexual  maturity  is 
reached.  At  certain  periods,  as  during  (tstrum,  they  throw  out  a  large 
quantity  of  very  viscid,  almost  transparent,  mucus.  They  are  secreting 
structures,  and  during  gestation  play  a  most  important  part,  becoming 
largely  developed,  and  furnishing  a  thin,  white,  albuminous  fluid,  tlie 
so-called  "  uterine  milk.''  This  secretion  comes  more  particularly  in 
contact  with  the  intervillous  portions  of  the  fcetal  placenta,  in  which  are 
curious  pockets  that  act  as  receptacles  for  this  milk,  which  is  absorbed 
by  the  vessels  on  their  walls. 

The  uterus  is  sujiplied  with  blood  by  the  uterine  and  utcro-ovarian 
arteries,  which  arise  from  the  posterior  aorta,  and  passing  between  the 
layers  of  the  broad  ligament  reach  the  uterus.  The  first  divides  into 
two  branches — an  ovarian  and  a  uterine  ;  the  former  is  very  flexuous  and 
goes  to  the  ovary,  while  the  second  passes  to  the  cornua  of  the  uterus, 
where  its  ultimate  divisions  anastomose  with  those  of  the  proper  uterine 
artery.  This  vessel,  on  reaching  the  smaller  curvature  of  the  cornua, 
also  divides  into  two  portions — an  anterior,  anastomosing  its  branches 
with  the  utero-ovarian  ;  and  a  posterior,  spreading  over  the  body  of  the 
organ  and  communicating  with  the  artery  of  the  vagina.     The  blood  is 


42 


OBSTETRICAL  ANATOMY. 


conveyed  from  the  uterus  by  corresponding  veins,  which  are  more 
numerous  than  the  arteries,  and  are  capable  of  great  distention.  Tliey 
have  no  valves.  In  animals  which  have  bred  frequently,  the  vessels  are 
greatly  enlarged  and  very  fiexuous ;  indeed,  from  an  early  period  the 
arteries  are  remarkable  for  their  large  size,  their  tortuous  course,  and 
their  frequent  anastomoses  ;  while  the  considerable  calibre  of  the  veins 
is  as  conspicuous  as  the  complex  networks  they  form. 

The  lymphatic  vessels  issuing  from  the  organ  are  as  remarkable  for 
their  large  size  as  for  their  number ;  they  all  proceed  towards  the  sub- 
lumbar  region. 

The  nerves  are  derived  from  the  small  mesenteric  and  pelvic  plexuses. 


rig.  22. 
Nerves  of  Maee's  Uterus. 
a,  Anterior  Abdnmiual  Ganglion  ;  b,  Posterior  Abdominal  Ganglion  ;  c,  A 
Lumbar  Ganglion  of  the  Sympathetic  Chain  ;  d',  d.  Anterior  Hypogastric 
Nerves  ;  e.  Lymphatic  Connection  with  the  Right  Pelvic  Plexus  :  f,  ;/, 
Branches  from  the  Third  and  Fourth  Sacral  Nerves  to  the  Pelvic  Plexus  ; 
1,  Ovarian  Artery  ;  2,  Uterine  Artery  ;  3,  Uterine  and  Vesical  Artery  ; 
4,  Branch  of  the  Internal  Pudic  Vein ;  5,  Ovarian  and  Uterine  Vein  ;  (3,  Left 
LTterine  Cornu. 

"When  the  gravid  uterus  increases  in  volume,  it  pushes  the  pelvic 
flexure  of  the  colon  before  it  as  it  advances  into  the  abdominal  cavity,  on 
to  the  floor  of  which  it  gradually  descends  and  rests  until  the  termina- 
tion of  pregnancy.  As  has  been  mentioned,  in  this  advance  and  descent 
it  carries  with  it  the  cervix  and  vagina,  which  is  considerably  length- 
ened, the  traction  being  extended  even  to  the  vulva,  this  appearing 
to  be  buried   between    the    ischiatic   tuberosities   toward   the   end  of 


pregnancy. 


Differences. 
Coic. 


The  uterus  of  the  Cow,  with  regard  to  its  general  disposition  in  the 
pelvic  and  abdominal  cavities,  does  not  offer  any  striking  differences 


IXTKIiXAL  oiiOAXS  (>F  (1  f^XRUArmx. 


V?i 


from  that  of  the  Mare,  except  that  the  body  is  short  (its  interior  space 
beinfT  also  much  less  than  in  the  Mare's  uterus),  and  it  does  not  extend 
so  far  into  the  latter  cavity.  If  the  uterus  were  perfectly  horizontal,  a 
transverse  line  drawn  across  the  abdomen,  in  front  of  the  external  aii^^e 
of  the  ilium,  would  be  exceeded  to  the  extent  of  some  one  and  a  half  to 
two  inches  by  the  extremities  of  the  cornua  ;  so  that  if  the  animal  were 
placed  on  its  back,  the  uterus  would  only  be  found  to  reach  to  the 
fourth  or  fifth  lumbar  vertebra. 

With  regard  to  shape,  however,  the  uterus  of  this  animal  offers  some 
noteworthy  features.  For  instance,  the  concave  curvatures  of  the 
cornua  look  downwards,  whereas  in  the  Mare  they  are  in  the  opposite 
direction  ;  though  in  both  the  broad  ligaments  are  attached  to  tliis  con- 
cavity. The  consequence  is,  that  in  the  Cow,  if  the  uterus  be  considered 
as  freely  suspended  in  the  cavity  of  the  abdomen,  the  extremity  of  the 
horn  is  twisted  outwards  and  upwards ;  while  its  base  near  the  body  of 


Aj\)/H' 


Fig.  23. 
A,  Utricular  (!Iand  of  a  i>regDant  (loat. 


Fig.  24. 
B,  Utricular  Oland  of  a  preLrnaiit  Cnw. 


the  organ,  although  drawn  in  the  same  direction  by  the  ligaments,  yet 
retains  its  position,  being  firmly  maintained  in  it  by  the  body  of  the 
uterus,  which  also  receives  the  insertion  of  the  broad  ligaments  on  its 
loiccr  plane.  This  insertion  causes  the  uterus  to  project  above  them  ; 
while  in  the  Mare,  in  which  the  ligaments  are  inserted  at  the  upper  part 
of  the  body,  the  uterus  projects  below  them.  In  tlie  Cow  these  liga- 
ments are  very  extensive,  particularly  at  their  anterior  border,  and 
widely  separated  from  one  another  in  front  near  their  lumbar  attach- 
ment, which  is  prolonged  as  far  as  the  flank.  The  ligaments,  taken  as 
a  whole,  may  be  compared  to  a  triangular  sheet,  one  angle  of  wiiich  is 
fixed  to  the  floor  of  the  pelvis,  and  the  other  two  to  the  tuberosities  of 
the  ilia  ;  on  this  sheet  rests  the  body  of  the  uterus  and  a  portion  of  the 
cornua.  This  peculiarity  in  the  suspensory  apparatus  of  the  uterus  of 
the  Cow  explains  the  occurrence  of  torsion  of  the  organ  during  preg- 
nancy— an  accident  to  which  reference  will  be  made  hereafter. 


44  OBSTETFJCAL  AX  ATOMY. 

The  cornua  are  thin  and  tapering  at  their  anterior  extremity,  and  the 
body  is  short  and  narrow  ;  while  the  interior  of  the  uterus  is  not  so 
ample  as  in  the  Mare.  Here  it  oii'ers  a  peculiarity  which  is  not  observed 
in  the  latter  animal,  the  Carnivora,  or  the  Pig,  in  the  presence  of 
rounded  smooth  prominences  named  caruncles  or  cotyledonal  processes 
{placenta  uterince),  which  increase  in  number  with  the  size  of  the 
species.  The  maternal  cotyledons  are  most  numerous  in  the  cornua, 
and  few  and  small  in  the  body  of  the  uterus  :  they  are  about  the  size  of 
a  pea  or  haricot-bean,  in  calves :  at  a  later  period  they  have  acquired 
the  dimensions  of  a  button,  and  they  increase  largely  and  assume 
variable  shapes  during  gestation.  In  the  Cow  they  are  flat  or  slightly 
convex  on  the  top,  but  concave  in  the  Sheep  and  Goat,  and  their 
colour  is  usually  pale ;  after  conception,  however,  they  become  red 
from  the  afflux  of  blood  to  them.  They  are  intended  for  the  reception 
of  similar  processes  on  one  of  the  foetal  membranes,  the  chorion, 
and  will  be  noticed  more  fully  hereafter.  It  may  be  sufficient  now  to 
mention  that  their  number  in  the  Calf  sometimes  amounts  to  thirty  or 


Fig.  25. 
HoRizosT.\L   Section  of  the  Upper   Surface  of  the   Micous   Membrane, 

NEAR    TO   A   COTTLEDON,  OF    THE    UTERUS  OF  A  NON-GRAVID  COW  :    ^IaGNIFIED 

ISO  Diameters. 

a,  Section  of   a  Utricular  Gland,  and  a'  its  Proper  Structure  ;  h,  h.  Mucous 
Glands  ;  c,  c,  Adenoid  Tissue. 

forty  ;  and  after  parturition  there  have  been  counted  as  many  as  from 
eighty  to  one  hundred  and  twenty.  They  are  disposed  in  linear  or 
longitudinal  series  which  are  all  the  more  numerous  as  the  cornu  is 
wide  ;  there  being  four  series  near  the  body  of  the  uterus  (which  has 
none),  two  at  the  anterior  extremity,  and  three  in  the  middle.  Each  is 
attached  to  the  mucous  membrane  by  a  narrow  pedicle,  and  in  removing 
the  foetal  placenta  after  parturition,  care  has  to  be  taken  not  to  tear 
them  off. 

The  cervix  uteri  of  the  Cow  is  from  2|  to  3^  inches  in  length  ;  it  is 
narrow,  almost  as  firm  as  cartilage  in  texture,  and  irregular  in  shape  ; 
the  mucous  membrane  is  more  finely  plicated  over  it,  around  the  os 
tinea,  than  in  the  Mare.  The  fibres  composing  the  cervix  are  divergent 
and  circular.  At  an  early  age  this  part  is  nearly  circular  in  shape,  and 
the  body  of  the  uterus  is  so  small  that  the  cervix  and  cornua  are  close 
together,  or  joined  to  each  other  at  their  origin  from  it.  Towards 
puberty,  however,  in  all  the  larger  domesticated  animals  it  becomes 
fusiform,  and  shows  two  lips,  about  two  inches  in  length — an  anterior 
and  posterior,  the  last  the  longest — which  are  pulpy  to  the  touch ;  these 


iNTEiiXAL  (>i;i:axs  of  i!KXtn:ATi(>y.  \:> 

lips  are  composed  of  flattened,  dense,  transverse  libres.  The  orifice,  or 
OS  uteri,  is  either  circular  or  elongated  transversely,  and  corresponds 
to  the  middle  of  the  posterior  part  of  the  vaginal  cavity.  During 
pregnancy  the  cervix  is  firm  and  tense,  and  appears  to  become  shortened 
in  animals  which  have  had  young  several  times.  The  folds  of  nmcous 
membrane  which  we  have  descril)L'd  as  existing  in  its  anterior  and 
around  tlie  os,  permit  its  dilatation  during  the  passage  of  the  fa-tus.  A 
knowledge  of  the  presence  of  the  two  lips  of  tlie  cervix,  and  also  their 


I'tkul-9,  Ovhhcts,  and  Ovaria  ok  thk  Shkki'. 

a,  Vagina  ;  h,  Os  Uteri  ;  r.  Transverse  Folds  of  Cervix  I'teri  ;  </,  Hody  of 
Utenus  ;  t,  f.  Caruncles  or  Cotyledonal  Processes  ;  f,  ConHiience  of  tho  ('ormia  ; 
7,  Intact  Cornu  ;  h,  h.  Oviducts  or  Fallopian  Tubes  ;  i,  i,  Finihriif  ;  /•,  /', 
Ovaries  ;  /.  Koiind  Ligament  ;  m.  m,  Broad  Ligaments  ;  ii,  n.  Cotyledons. 


position,  is  useful  when  explorations  by  hand  are  necessary  in  cases  of 
inversion  of  the  uterus.' 

The  utricular  glands  are  wider  than  in  the  Mare,  and  have  lateral 
diverticuli. 

The  muscular  tunic  altogether  is  thicker  in  the  Cow  than  in  the  Mare ; 
indeed,  the  walls  of  the  uterus  in  this  animal  are  more  dense  than  in  any 
of  the  domesticated  creatures,  the  muscles  having  a  red  tint,  and  being 
continued  well  into  the  broad  ligaments. 

'  Profe.«.«or  Violet  found  two  distinct  cervice.t  in  the  ateius  of  a  Cow,  both  projecting 
into  the  vagina,  but  the  canal  in  one  of  them  was  very  fhort,  and  terminated  in  a 
cul-dt-Mte. 


46  OBSTETRICAL  AXATOMV. 

SJieejJ  and  Goat. 

In  the  Sheep  and  Goat  the  disposition  of  the  uterus  is  similar  to  that 
of  the  Cow.  The  cornua  are  relatively  longer,  more  tortuous  and 
pendant,  and  expand  more  gradually  from  the  termination  of  the 
oviducts ;  while  the  longitudinal  rugte  in  the  body  and  cervix  are  dis- 
posed in  a  series  of  transverse  folds  in  the  latter,  which  gives  them  the 
appearance  of  so  many  ora  tinea.  The  cotyledons  we  have  mentioned 
already ;  they  are  concave,  or  cupuliform,  in  their  centre  in  these 
animals. 

Pig. 

In  the  Pig  the  uterine  cornua  are  long  and  tortuous,  and  float  among 
the  intestines,  which  they  resemble ;  the  body  of  the  uterus  is  very 
short,  and  the  numerous  irregular  ridges  on  the  inner  surface  of  the 
cornua  gradually  subside  towards  the  cervix,  where  they  form  two  or 
three  series  of  thick,  soft  rugte.  The  os  uteri  is  marked  by  a  series  of 
narrow,  close-set,  longitudinal  laminye,  but  there  is  no  labial  or  valvular 
projection  into  the  vagina ;  so  that  there  is  no  exact  limit  between  the 
two  cavities.  The  broad  ligaments  resemble  the  mesentery.  The 
utricular  glands  divide  repeatedly  in  the  deeper  parts  of  the  mucosa,  as 
in  the  Mare. 

Bitch  and  Cat. 

In  the  Bitch  and  Cat  the  cornua  are  also  very  long,  slender,  straight, 
and  slightly  compressed,  with  a  number  of  flat  eminences  on  their  inner 
surface.  They  extend  to  the  lumbar  region,  and  unite  externally  for 
nearly  two  inches  before  they  join  the  corjnis  uteri.  The  interior  of  the 
latter  shows  a  few  smooth  longitudinal  rugae,  and  the  os  uteri  is  a 
smooth,  thick,  and  even  prominence,  larger  almost  than  the  body  of  the 
uterus,  which  is  short.  It  projects  very  markedly  into  the  vagina.  The 
utricular  glands  are  pyrifomn ;  the  round  ligaments  escape  from  the 
abdomen  by  the  inguinal  rings. 

Development. 

In  the  foetus  and  the  adult  animal  which  has  not  been  fecundated, 
the  uterus  is  comparatively  small,  narrow,  and  insignificant ;  but  it 
increases  in  volume  with  age  after  the  venereal  desires  become  manifest. 
In  a  Calf  a  little  more  than  a  month  old,  the  total  length  from  the  vulva 
to  the  extremity  of  the  cornua  was  about  ten  inches,  of  which  the 
vagina  formed  about  five-eighths.  In  the  Lamb  the  uterus  and  vagina 
only  measure  about  six  inches  in  length.  From  this  period  until  the 
animal  is  capable  of  breeding,  the  uterus  receives  so  little  blood  that  it 
may  be  removed  without  much  risk. 

During  gestation  the  uterus  acquires  a  great  volume,  and  its  cavity, 
usually  less  than  that  of  the  vagina,  is  considerably  increased,  its  shape 
then  bearing  some  resemblance  to  one  of  the  large  intestines.  The 
cornua  vary  in  size,  according  to  the  dimensions  and  species  of  the 
difl'erent  animals.  In  those  which  are  uniparous  (one  foetus),  as  the 
Mare  and  Cow,  they  are  short ;  but  in  those  which  are  multiparous 
(more  than  one  foetus)^  they  are  long  in  proportion  to  the  number  of 

^  In  order  to  avoid  confusion  in  the  employment  of  terms,  and  also  on  the  score  of 
convenience,  it  may  be  as  well  to  ob-erve  here  that  Kniparoax  animals  are  those  which 
generally  produce  only  one  at  a  birth  ;  inultijiafoiis,  those  which  bring  forth  more  than 
<iiie  ;  primip%rouA,  those  which  produce  young  for  the  first  time  ;  and  pluri parous, 
those  which  have  bred  more  thaa  once. 


IXTHllXAL  onHAXS  OF  UKXEJlATKiX.  47 

young  they  bear,  while  the  body  is  diminished  in  length.  In  the  uni- 
parous  animal  the  fa'tus  is  usually  developed  in  the  body  of  the  uterus, 
and  its  posterior  extremities  only  are  sometimes  engaged  in  one  of  the 
cornua  ;  but  in  the  nuiltiparous  females  the  cornua  resemble  the  intes- 
tines, and  the  young  are  developed  in  them,  the  body  of  the  uterus 
seldom  containing  any.  In  the  Rabbit,  indeed, .there  is  no  corpus  uteri, 
the  cornua  opening  independently  and  directly  into  the  vagina. 

After  parturition  tlie  uterus  gradually  diminishes  in  size,  and  some  of 
its  supplementary  structures  disappear ;  but  it  never  resumes  its  previous 
volume. 

The  lujmncnts  of  the  uterus  suspend  it  loosely,  yet  securely  in  the 
abdominal  cavity ;  and  while  allowing  it  a  certain  range  of  movement, 
permit  its  full  development  during  gestation.  At  this  period  they  become 
developed  in  a  peculiar  manner,  and,  as  we  have  seen,  between  their 
lamina;  appears  a  layer  of  muscular  fibres  ;  in  the  Cow  these  fibres  are 
arranged  in  fasciculi,  one  of  which,  larger  than  the  others,  extends  from 
the  ovary  to  the  cervix  uteri.  These  ligaments  would  also  appear  to 
stretch  considerably  in  version  or  inversion  of  the  uterus  in  Herbi- 
vorous animals ;  even  in  the  Carnivora  they  accompany  the  uterus  when 
hernia  takes  place  ;  and  in  the  torsions  of  this  organ  which  sometimes 
occur  in  Ruminants — when  its  upper  face  becomes  the  lower,  or  even 
when  it  has  made  a  complete  turn  upon  itself — they  encircle  and  strangle 
the  uterus  at  the  cervix. 

SKCTIOX  III.-  FALLOPIAN  TUBES,  OR  OVIDUCTS. 

The  F.\LLOi'i.\N  TUKES,  or  oviDfCTs,  are  two  small,  cylindrical, 
tlexuous  canals,  about  ten  inches  long,  white  in  appearance,  one  of  which 
is  lodged  in  each  broad  ligament,  between  its  serous  layers,  and  near  its 
anterior  border.  Each  tube  connnences  at  the  extremity  of  the  uterine 
horn,  at  a  small  hard  tubercle  in  its  cul-de-sac  {ostium  uterinum).  This 
tubercle  is  its  opening  into  the  cornu,  and  from  this  it  proceeds,  more 
or  less  tortuously,  and  increasing  slightly  in  diameter,  towards  one  of 
the  ovaries,  upon  which  it  terminates  by  a  free,  widened  extremity 
{ostiu7n  ubdominale)  in  the  ^x/rj7/o;i  of  the  tube.  The  calibre  of  this 
canal  is  small,  and  scarcely  admits  a  thin  straw  at  its  middle  portion, 
and  it  is  still  smaller  towards  the  uterine  extremity  ;  as  it  approaches 
the  ovary,  however,  it  increases  in  width  until  it  ends  in  tlie  pavilion. 
The  uterine  extremity  of  the  canal  opens  through  the  small  liard  tubercle 
just  referred  to  as  existing  at  the  cul-de-sac  of  the  cornu.  The  ovarian 
extremity  oflfers,  in  all  the  mammalia,  a  peculiar  disposition.  It  opens 
into  the  peritoneal  cavity  of  the  abdomen  (the  only  instance  of  a  serous 
cavity  communicating  with  the  exterior),  near  the  ovarian  fissure,  in 
the  middle  of  the  pavilion,  which  is  also  named  the  fimhrite  tuharum,  or 
morsus  diaboli,  from  its  fringed  or  dentated  border.  This  pavilion  is 
fixed  to  the  external  side  of  the  ovary,  and  its  inner  surface  is  marked 
by  numerous  narrow,  close-set,  minutely  plicated  lamintc,  while  its  cir- 
cumference is  irregularly  disposed  into  a  number  of  unequal,  fringe-like 
prolongations  (timbrice)  which  hang  into  the  abdominal  cavity.  This 
arrangement  is  interesting,  from  the  fact  that  it  gives  us  a  unique  ex- 
ample of  a  breach  of  continuity  between  a  gland  (the  ovary)  and  its 
excretory  canal  (the  tube). 

Each  tube  is  composed  of  three  tunics  :  an  external  or  serous,  formed 
by  the  broad  ligament;  a  middle  or  muscular,  coi^stituted  by  longitu- 
dinal  and  circular  non-striated  fibres,  continued   from  those  of   the 


48  OBSTETRICAL  ANATOMY. 

uterus,  which  are  also  disseminated  in  the  pavihon  and  its  fimbriae ; 
and  an  internal  or  mucous,  which  exhibits  longitudinal  rugae  in  the 
tube,  and  radiated  in  the  pavilion ;  this  membrane  is  covered  by 
ciliated  epithelium,  and  its  villi  are  greatly  enlarged  after  impregnation. 
It  ceases  abruptly  at  the  margin  of  the  fimbriae,  where  it  meets  the 
peritoneum. 

The  bloodvessels  supplying  the  Fallopian  tubes  are  derived  from  the 
ovarian  arteries,  and  their  nerves  are  from  the  great  sympathetic. 

Their  function  is  to  convey  the  spermatozoa  of  the  male  to  the  ovary 
in  the  first  instance,  and  afterwards  to  transmit  the  impregnated  ovum 
to  the  uterus  or  its  horn  ;  in  this  respect  they  are  the  excretory  ducts 
of  the  ovaries.  When  the  Graafian  vesicle  of  the  ovary  ruptures,  the 
fimbriae  of  the  tube  grasp  the  ovary,  and  receive  the  ovum,  which  they 
carry  to  the  ovarian  extremity  of  the  canal ;  this  act,  together  with  the 
application  of  the  pavilion  to  the  ovary,  takes  place  either  through  the 
contraction  of  the  non-striated  muscular  fibres  which  this  part  contains, 
or  from  the  swelling  of  the  bulb  of  the  ovary.  At  times,  however,  the 
act  is  not  properly  accomplished,  and  the  fecundated  ovum,  instead  of 
passing  into  the  uterine  cavity,  escapes  the  fimbriae  and  falls  into  the 
abdomen,  where  it  constitutes  that  most  remarkable  form  of  gestation 
termed  extra-uterine. 

DiFFEKENCES. 

CoiLi,  Sheep,  and  Goat. 

In  the  Cow,  Sheep,  and  Goat,  the  fimbriated  extremity  of  each  tube 
is  expanded  upon  the  outer  margin  of  the  ovarian  capsule  ;  the  inner 
surface  of  the  pavilion  is  beset  with  numerous  fine  oblique  striae,  and  is 
further  increased  by  narrow  folds  or  laminae  converging  toward  the 
contracted  opening  of  the  duct.  The  duct  itself  forms  three  or  four 
wavy  folds,  and  is  then  continued  along  the  walls  of  the  wide  ovarian 
capsule  to  the  extremity  of  the  uterine  horn,  which  makes  an  abrupt 
curve  to  meet  it. 

Pig. 

In  the  Pig  the  oviduct  has  few  or  no  inflexions,  but  its  length 
is  proportionately  greater  than  in  the  other  species.  The  paviUon 
is  wide  and  deep,  and  the  margin  of  its  abdominal  opening  is  almost 
even  ;  its  inner  surface  is  augmented  by  many  loDg,  narrow,  and 
highly  vascular  folds,  which  radiate  from  the  commencement  of  the 
contracted  part  of  the  tube  upon  the  expanded  pavilion. 

Bitch. 

In  the  Bitch  the  fimbriated  commencement  of  the  oviduct  is  attached 
to  the  exterior  boundary  of  the  aperture,  opposite  the  ovarium  ;  while 
the  tube  itself,  long  and  fine,  passes  in  a  wavy  course  round  the 
anterior  aspect  of  the  latter  to  the  uterus.  The  length  of  the  tube  is 
from  two  and  a  half  to  three  and  a  half  inches. 

SECTION  IV.— THE  OVARIES. 

The  Ovaries  {testes  muliebres),  the  essential  organs  of  generation  in  the 
female,  and  analogous  to  the  testes  of  the  male,  are  two  ovoid  or  elongate 
reniform  bodies,  smaller  than  the  latter,  but  of  the  same  shape,  and 
situated  in  the  abdominal  cavity.     They  are  loosely  suspended  in  the 


IXTERXAL  ana  AN S  OF  GENERATIOX.  40 

sublumbar  region,  behind  the  Fallopian  tubes  and  the  kidneys,  among 
the  convolutions  of  the  intestines,  thouj^'h  sometimes  their  position  is 
altered.  In  four  instances  in  the  Pig  they  have  been  found  in  the 
perineal  region,  occupying  small  cavities  analogous  to  the  scrotum  of 
the  male. '  Smooth  externally,  each  ovary  shows  in  the  middle  of  its 
upper  portion  a  more  or  less  oblique,  but  deep  fissure,  resembling  the 
hilus  of  the  kidney,  and  which  gives  attachment  to  the  pavilion  of  the 
Fallopian  tube.  Each  ovary  is  suspended  at  the  anterior  border  of  the 
broad  ligament,  and  is  also  sustained  in  situ  by  the  vessels  passing  to 
and  from  it,  as  well  as  by  a  small  cord  of  non-striated  muscular  fibres 
called  the  li(jamcnticm  orarii,  which  connects  it  with  the  uterus. 

The  structure  o(  the  ovary  comprises  a  serous  and  fibrous  membrane, 
the  proper  tissue  of  the  ovary,  and  the  Graafian  vesicles  embedded  in  it. 
The  serous  membrane  is  continuous  with  the  broad  ligaments — is,  in 
fact,  a  peritoneal  tunic  which  entirely  envelops  it,  adhering  closely  to 
the  covering  beneatii.  This  is  the  tunica  albu(ji)iea—&  dense  resisting 
membrane  similar  to  the  structure  enveloping  the  testicle,  and  sending 
lamellar  prolongations  into  the  substance  of  the  ovary. 

The  proper  tissue  or  stroma  of  the  ovary  is  solid  and  hard,  and  has  a 
speckled-grey  tint.  It  is  divided  into  two  layers,  which  are  distinct  in 
appearance  and  structure.  The  medullary  layer  is  nearest  the  hilus, 
and  is  somewhat  red  and  spongy  ;  it  is  formed  by  the  intercrossing  of 
connective  tissue,  non-striated  muscular  fibres,  and  by  a  large  number 
of  vessels  which  radiate  fi'om  the  centre  towards  the  periphery  of  the 
organ  and  nerves.  The  cortical  layer  has  connective  tissue  for  its  basis ; 
it  is  not  very  vascular,  but  it  contains  in  its  substance  the  Graafian 
vesicles  or  follicles,  and  for  this  reason  is  named  the  oviijcnic  layer. 

These  Graafian  vesicles  are  generally  in  various  stages  of  develop- 
ment ;  the  smallest  are  situated  beneath  the  tunica  albuginea,  and  they 
descend  towards  the  deeper  layer,  increasing  in  volume  as  they  do  so. 
When  they  have  reached  their  period  of  full  growth,  they  are  filled  with 
a  transparent,  citron-coloured  fluid,  and  the  ovigenic  layer  being  in- 
capable of  containing  them,  they  form  a  more  or  less  considerable 
prominence  on  the  sui-face  of  the  ovary.  A  Graafian  vesicle,  when 
perfect,  is  composed  of  an  envelope  and  its  contents.  The  envelope 
comprises  two  tunics — a  fibrous  membrane  (tunic  of  the  ovisac),  which 
is  continued  externally  with  the  stroma  of  the  ovary,  and  internally  is 
rich  in  bloodvessels  ;  an  inner  (ovisac),  formed  by  a  smooth  membrane 
which  derives  its  bloodvessels  from  the  latter ;  it  is  lined  by  an  epithe- 
lial or  granular  membrane  (tunica  i/ranulosa),  composed  of  round  or 
polygonal  granular  cells.  At  the  bottom  of  the  vesicle  this  epithelium 
forms  an  aggregation  (the  cumulus,  or  discus  proliijcr),  in  the  centre  of 
which  exists  the  ovum  or  ovuluvi  of  mammalia.  The  contents  of  the 
vesicle  is  a  yellowish,  transparent,  albuminous  mass,  that  becomes 
reddened  by  an  admixture  of  blood  when  the  vesicle  ruptures. 

The  ovulum,  ovule,  or  ovum,  is  a  small  cell  imbedded  in  the  cumulus, 
and  surrounded  by  an  amorphous,  thick,  white  membrane,  which  has 
been  designated  the  zona pcllucida ;  within  this  membrane  is  a  granular 

'  A  remarkable,  if  not  unique,  cane  of  displacement  of  the  ovarie*  i<»  recorded  by 
M,  Dupmt,  in  the  Journal  df»  Vitirinair>t  <Ih  .}fi'li  for  1869.  In  four  female  I'ip«. 
fifteen  days  old,  beneath  the  vulva  were  observed  two  protulierances  exactly  like  the 
testicles  of  the  male,  and  which,  on  examination  after  death,  j>P>ved  t^)  be  the  ovarieo. 
The  other  organs  of  generation  were  normal.  The  same  Sow  which  produced  them,  had, 
in  a  previous  litter,  brought  forth  two  females  with  the  ovaries  similarly  misplaced. 

4 


50 


OBSTETRICAL  ANATOMY. 


layer,  the  vitcllus  or  yolh,  the  larger  granules  of  which  are  superficial 
and  compact,  while  internally  it  is  a  transparent  albuminous  fluid,  in 
which  are  but  few  granules.  Enclosed  in  this  vitellus,  though  nearer 
its  circumference  than  centre,  is  the  nucleus— the  germinal  vesicle,  or 


Fig.  27. 

Ovary  opened  Vertically. 

a,  a,  b,  h,  Graafian  Vesicles  at  different 
stages  of  development. 


Fig.  28. 

Portion  of  the  Ovary  of  a  Pig. 

a,  Point  at  which  a  ripe  Vesicle  is  about 
to  escape  ;  b,  Fissure  by  which  an 
Ovule  has  escaped. 


vesicle  of  Purhinje,  a  most  important  portion  of  the  ovum ;  it  has  the 
appearance  of  a  very  small  clear  ring,  measuring  about  l-60th  of  a  line 
in  diameter,  and  upon  its  surface  is  a  dark  spot,  the  inacnla  germinativa. 
This   is  always  observed  as  a  simple  rounded  body,  measuring  from 


Fig.  29. 

Graafian  Vesicle  in  Make's  Ovary. 

a,  Membrana  Propria  of  the  Graafian 
Follicle  ;  b,  Membrana  Granulosa ; 
b'.  Discus  Proligerus  ;  c,  Ovum. 
Magnified  5  Diameters. 


Fig.  30. 

OVULUM    OF    THE    MaRE. 

,  Zona  Pellucida  ;  b,  Vitellus,  con- 
taining the  Vesicula  Germinativa  ; 
c,  Cells  of  the  Discus  Proligerus. 


l-200th  to  l-300th  of  a  line  in  diameter ;  it  is  rarely  found  double  or 
as  an  aggregate  of  granules,  except  in  miniature  ova. 

The  large  flexuous  arteries  supplying  the  ovary  are  from  the  utero- 
ovarian  trunk;  they  spread  over  the  spaces  in  the  tunica  albuginea, 
before  entering  the  hilus  of  the  organ  to  be  distributed  in  its  interior. 


IMKRX.IL  <>/:i;A.\S  oF  dEyKllATlnX.  61 

The  veins  are  extremely  large,  and  form  a  very  close  plexus  around  the 
f;land  {bulb  of  the  ovarij),  emptying  themselves  into  the  vena  cava  near 
the  renal  veins.  The  lymphatics  pass  to  the  suhlumbar  ganglia,  and 
the  nerves  come  from  the  small  mesenteric  plexus. 

Differences. 

Coxv,  Sheep,  and  Chat. 

In  the  Cow  the  ovaries  are  relatively  smaller  than  in  the  Mare,  but 
their  form  and  structure  are  the  same.  Each  is  lodged  in  a  depression 
or  sacculus  of  the  broad  ligament,  which  is  more  or  less  deep,  and  the 
Ciraafian  vesicles  are  visible  through  the  tunica  albuginea.  The  same 
arrangement  is  observable  in  the  Sheep  and  Goat. 

Pi'J- 
In  the  Pig  the  ovaries  are  comparatively  large,  oblong  bodies,  with 
an  irregular,  tuberculated,  or  lobulatcd  aspect,  due  to  the  Graafian 
vesicles,  which,  when  well  developed,  project  beyond  the  surface  of  the 
organ,  instead  of  remaining  within  it.  When  these  ovisacs  enlarge, 
the  stroma  is  scanty  in  proportion.  Tiach  ovary  is  enclosed  within  a 
peritoneal  sac,  near  tlie  opening  of  which  it  has  a  pedunculate  attach- 
ment. The  posterior  wall  of  this  sac,  as  we  have  seen,  appears  to  be 
formed  l)y  the  wide  and  deep  pavilion  of  the  Fallopian  tube. 

Bitch  and  Cat. 
There  is  nothing  particular  to  indicate  in  the  ovaria  of  the  Bitch  and 
Cat,  except  that  the  ligaments  suspending  them  to  the  spine  are  very 
short,  and  they  are  contained  in  a  fold  of  peritoneum. 

Develoi'ment. 

The  development  of  the  ovaria  and  the  ova  is  very  interesting.  In 
the  Mare,  the  ovaria  of  the  fa'tus  are,  when  compared  with  the  uterus, 
of  an  immense  size,  and  at  six  months  are  almost  as  large  as  in  the 
adult.  In  aged  animals  they  become  atrophied,  and  it  is  not  unusual 
in  old  Mares  to  find  either  one  or  both  in  an  unhealthy  condition.  Not 
infrequently  they  are  hypertrophied,  and  their  fibrous  envelope  and 
stroma  are  much  thickened.  Sometimes  the  vesicles  are  greatly  en- 
larged, and  converted  into  cysts  which  contain  a  limpid,  sanguinolent, 
or  purulent  fluid,  secreted  from  their  walls.  Flandrin  cites  the  case  of 
a  ^lare,  one  of  whose  ovaria  weighed  26k  pounds,  and  measured 
14i  inches  in  its  long,  and  12  inches  in  its  short  diameter.  The 
texture  of  the  ovaries  is  also  liable  to  various  abnormal  alterations. 

The  Graafian  vesicles  are  present  in  the  ovary  of  the  fcetus,  but  they 
do  not  attain  their  full  development  mitil  puberty  ;  neither  are  they  all 
present  at  birth,  but  are  continually  being  developed  beneath  the  tunica 
albuginea.  The  first-formed  elements  in  the  fcttal  ovary  are  cells  and 
cell-nuclei ;  these  next  appear  in  somewhat  circular  groups,  which  are 
more  opaque  than  the  other  parts  of  the  regularly  uniform  mass  (Fig. 
31,  A).  A  kind  of  film  soon  condenses  round  these  groups  (B),  and  upon 
the  inner  surface  of  this  there  is  fixed  an  epithelial  precipitate  from  the 
fluid  and  granules  of  the  interspaces  of  the  contained  primary  cells. 
Within  the  ovisac  thus  formed,  a  large  nucleate  cell  becomes  visible : 
this  is  the  commencement  of  the  ovum  (C,  (j).  As  this  expands,  the 
proportion  of  fluid  to  the  formed  particles  increases,  and  the  latter 


52 


OBSTETRICAL  ANATOMY 


^^2r^- 


are  attracted  to  the  contiguous  surfaces :  some  to  that  of  the  ovisac, 
which  thus  becomes  lined  by  a  thicker  layer  of  ceils  ;  others  to  the 
ovum,  accumulating  round  it.  With  the  enlargement  of  the  ovisac,  the 
stroma  of  the  ovum  condenses  round  its  delicate  membrane  (Fig.  32,  h), 
to  form  what  has  been  called  the  "  theca  folliculi  "  of  Baer — the  fibrous 

tunic  already  noted ;  this  vascular 
tunic  (a),  with  the  other  (h),  consti- 
tuting the  vesicle;  while  the  stratum 
of  nucleate  cells  lining  this  double 
covering  is  the  membrana  granulosa, 
and  those  surrounding  the  ovum  itself 
form  the  ])roligcrous  disc  (e),  the  mass 
of  cells  adhering  thereto  being  the 
cu7mihis. 

The  hyalinion,  or  proper  tunic  of  the 
ovum,  thickens  into  the  clear  substance 
improperly  named  the  zona  pelhicida 
( /'),  which  in  reality  is  a  bag.  x\s  the 
cells  and  cell-nuclei  of  the  ovum  become 
developed,  they  are  pushed  deeper  into 
the  stroma  by  those  of  more  recent 
formation  ;  while,  as  the  ovum  ripens, 
the  cells  immediately  around  it  become 
elongated  and  pyriform,  the  tapering 
extremity  being  attached  to  the  zona  : 
those  of  the  cumulus  diverge  irregularly 
into  the  fluid  intervening  between  them 
and  the  membrana  granulosa  of  the 
ovisac.  What  have  been  termed  reti- 
nacnlce  (d)  have  been  described  by  some 
authorities ;  they  are  four  processes 
formed  by  the  cells  of  the  cumulus, 
and  may  be  merely  exceptional  diver- 
gences. 

Until  puberty  there  is  no  great  ac- 
tivity apparent  in  the  vesicles ;  but  at 
this  time  the  ovary  becomes  more  vas- 
cular, and  certain  vesicles  increase  in 
volume.  At  the  period  of  "rut"  or 
"  heat,"  one  or  more  vesicles,  accord- 
ing to  the  species  of  animal,  show 
evidence  of  increased  vascularity  and 
become  distended  ;  the  ovisac  thins  at 
the  most  prominent  part  to  which  the 
ovum  tends,  and  blood  is  extravasated  into  it ;  then,  partly  by  absorp- 
tion and  partly  by  pressure,  the  coverings  give  way,  the  proligerous  disc 
and  o^Tim  escape  outwards,  and  are  either  received  into  the  Fallopian 
tube  for  conveyance  to  the  uterus,  or,  which  is  very  rare,  fall  into  the 
cavity  of  the  abdomen. 

The  size  of  the  mature  ovum  in  the  Cow  is  -^Ijj,  Pig  -^Ijj,  Cat  ^i^, 


Fig.  31. 

FOBMATIOX   OF   THE   OviSAC    IN   THE 

Bitch's  Ovaky. 


Bitch 


ie(T> 


Rabbit 


of  an  inch. 


After  the  rupture  of  a  Graafian  vesicle  and  the  escape  of  the  ovum,  the 
cavity  of  the  ovisac  is  filled  with  a  clot  of  blood,  while  its  walls  are 
thickened  and  altered  in  colour,  being  in  most  animals  partially  everted 


IXTHnXAL  nnnAXS  nf  C t:.\ HIIAT K >\. 


53 


at  the  rupturetl  orifice.  In  the  Cow  and  Sheep  the  folUele  has  a  brick- 
red  colour,  and  in  the  Pig  it  is  yellowish-brown — it  is  then  designated 
in  the  human  subject,  from  its  colour,  the  corpus  lutcum  ;  but  gradually 
the  clot  shrinks,  loses  its  tint,  and  the  cavity  contracts  ;  at  the  same 
time  the  walls  are  hypertrophied,  and  the  tunica  granulosa  becomes 
wrinkled  and  transformed  into  cylindrical  epithelium.    By  the  time  the 


Fig.  32. 
Graafian  Vesicle  and  Ovum. 

succeeding  ovisac  with  the  ripening  ovum  has  begun  to  protrude  from 
the  surface  of  the  ovary,  the  old  ovisac  has  lost  its  colour,  with  much 
of  its  dimensions,  and  fallen  inwards  ;  the  cylindrical  epithelium  becomes 
infiltrated  with  fat  and  is  gradually  absorbed.  This  change,  with  col- 
lapse of  the  wall,  depresses  the  cicatrix  of  the  aperture  ;  and  these  suc- 


Fig.  33. 
KscAPE  OK  Ovum  kuom  Ovisac. 


cessive  shrinkings  and  cicatrisations  of  the  ruptured  ovisacs  give  the 
ovary  a  pitted  and  furrowed  appearance  in  advanced  life. 

If  the  expelled  ovum  be  not  impregnated,  the  changes  of  the  ovisac 
into  the  yellow  convolute  cavity,  then  into  the  depressed  stellate  cicatrix, 
occur  somewhat  rapidly  ;  but  if  impregnation  takes  place,  the  matura- 
tion of  successional  ova  is  delayed,  and  the  first  change  in  the  ruptured 
ovisac  goes  on  to  a  greater  extent,  the  corpus  lutcum  not  becoming 
obliterated  for  a  comparatively  long  time.  In  this  period  the  inner  coat, 
or  original  ovisac,  is  much  thickened  by  a  larger  de^wsit  of  yellow  oil- 
granules  ;  it  becomes  more  deeply  plicated,  is  impacted  into  a  yellowish 


54 


OBSTETRICAL  AX  A  TOMY. 


mass,  and  gains  an  adventitious  white  lining  membrane,  and  it  rarely 
happens  that  the  cavity  is  obliterated  before  full  gestation.  It  is 
then,  in  the  human  species,  represented  by  a  stellate  hnear  figure 
surrounded  by  the  corpus  luteum,  which  is  ultimately  absorbed,  but 
usually  not  before  some  weeks  after  parturition. 

It  is  this  difference  between  the  impregnated  and  unimpregnated 
condition  which  enables  us  to  distinguish,  in  these  ruptured  vesicles, 
the  true  and  false  corpora  lutea. 

In  the  Mare  the  retrocession  of  the  true  corpus  luteum  is  more  rapid 
than  in  the  other  domesticated  animals,  and  it  has  not  that  deep  yellow 
colour  observed  in  the  Cow ;  but  it  is  of  a  darker,  dull  reddish-brown 


Fig.  34. 

Successive  Stages    in    the    roRiiATiox    of    the  Corpus  Ldteuii   in  the 
Graafian  Follicle  of  a  Sow  :  Vertical  Section. 

a,  Follicle  immediately  after  the  expulsion  of  the  Ovum,  its  cavity  being  filled 
with  blood,  and  no  ostensible  increase  of  its  epithelial  lining  having  yet 
taken  place  ;  at  6  a  thickening  of  this  lining  has  become  apparent  ;  at  c  it 
begins  to  present  folds,  which  are  deepened  at  d,  and  the  clot  of  blood  is 
being  absorbed  and  decolorised ;  a  continuation  of  the  same  process,  as 
shown  at  e,f,  <j,  h,  forms  the  Corpses  lutevm,  with  its  stellate  cicatrix. 


hue,  and  on  section  presents  convolutions  resembling  those  of  the 
brain.  When  recent,  the  corpus  luteum  of  the  Mare  is  voluminous, 
and  drawn  towards  the  hilus  of  the  ovary  ;  it  has  two  layers,  the 
internal  being  constituted  by  a  clot  of  blood  the  size  of  a  small  nut. 

Franck  has  convinced  himself,  hy  post-mortem  examination  of  Mares, 
of  the  possibility  of  ova  being  thrown  off  from  the  ovary  during  preg- 
nancy. 

It  is  to  be  remarked  that  the  number  of  ovisacs  and  ova  which 
became  matured  at  each  "  rut "  or  "heat,"  depends  upon  the  multiparity 
or  uniparity  of  the  species  ;  in  the  Mare  and  Cow  there  is  usually  only 
one,  in  the  Sheep  and  Goat  one  or  two,  in  the  Pig  from  four  to  a  dozen, 
and  in  the  Bitch  a  variable  number. 


ItKI'Unin'CTinX.  65 

BOOK  II. 

OBSTETRICAL  PHYSIOLOGY. 

REPRODUCTION. 

Having  described  the  situation,  structure,  and  peculiarities  of  the 
external  and  internal  orfj;ans  of  the  female  domesticated  animals,  we 
have  now  to  inquire  into  their  functions.  Some  of  these  functions  have 
for  their  end  the  conception,  development,  and  preservation  of  the  young 
animal  for  a  certain  period,  until  it  can  maintain  a  more  or  less  inde- 
pendent existence,  when  others  of  them  are  brought  into  play  in  order 
to  place  it  in  direct  relation  with  the  external  world  in  the  act  of 
parturition,  while  others  cease.  But  in  order  that  generation  should 
take  place  in  the  higher  classes  of  animals,  it  is  necessary  that  the  two 
sexes  be  placed  in  favourable  relations  with  each  other.  This  pre- 
liminary condition  is  indispensable,  as  the  essential  of  reproduction  is 
the  contact  with,  and  action  of  the  male  fecundating  fluid  on,  the  ovum 
of  the  female.  Nature  has  ordained  that  this  creative  act  should  be 
accomplished  by  engendering  in  these  animals  an  instinctive,  copulative, 
and  irresistible  desire  at  a  certain  stage  of  existence  ;  which  desire, 
continuing  only  for  a  brief  period,  is  renewed  after  particular  intervals, 
until  the  faculty  of  reproduction  ultimately  ceases. 

The  advent  of  the  power  of  reproduction  in  the  male  and  female  sex 
of  animals  is  very  unequal  among  the  various  species,  and  is  generally 
in  relation  to  the  duration  of  their  existence — the  creatures  which  are 
short-lived  being  capable  of  bringing  forth  young  at  an  earlier  period  of 
life  than  those  which  enjoy  a  longer  term. 

The  Elephant  only  brings  forth  one  at  birth,  and  this  occurs  but  once 
in  three  or  four  years  ;  while  the  descendants  of  the  Kabbit  in  tlie  same 
space  of  time  may  be  reckoned  at  more  than  a  million.  This  great 
disparity  has  nothing  of  chance  or  accident  in  it,  but  is  in  admirable 
harmony  witli  the  designs  of  Nature.  The  individuals  of  every  species 
produce,  as  has  been  justly  remarked  by  Verheyen,  a  total  number  of 
germs  which  amply  covers  the  losses  caused  by  death  ;  and  the  prema- 
ture destruction  of  many  of  these  germs  is  likewise  a  providential  safe- 
guard against  their  too  numerous  multiplication. 

Two  factors  regulate  fecundity  ;  these  comprise  the  nutritive  excess 
which  the  maintenance  of  the  individual  renders  disposable,  and  the 
sum  total  of  the  materials  necessary  for  the  embryonic  evolution  ;  but 
tlie  divergences  of  these  two  factors  are  as  extensive  as  those  of  fecun- 
dity itself. 

If  we  take  the  weight  of  the  foetus  at  birth  as  the  equivalent  to  the 
nutritive  matter  that  the  parent  has  endowed  it  with,  and  multi])ly  this 
weight  by  the  number  of  young  annually  produced,  we  shall  obtain  the 
total  amount  of  the  materials  which  have  been  derived  from  the 
maternal  organism.  Theti  weighing  the  mother,  and  comparing  her 
weight  with  that  of  the  foetus,  we  shall  arrive  at  tlie  disposable  nutritive 
excess;  and  from  this,  according  to  Leuckart,  be  able  to  calculate  the 
fertility  of  a  species.  Although  this  calculation  is  only  approximate,  it 
none  the  less  demonstrates,  in  principle,  the  relations  between  fecundity 
and  the  two  before-mentioned  factors.  This  is  shown  in  the  following 
table,  drawn  up  by  Leuckart,  with  reference  to  the  domesticated 
animals. 


56 


OBSTETRICAL  PHYSIOLOGY. 


Species. 

Weight  of 
Body. 

Annual 

Number  of 

Young. 

Weight  of 

each  Young 

Animal. 

Annual  nu-       R^i^^^ion  between 

ce^l  of  the  t'^«'  1*^^"^  ^^^S*^*  °^ 
Mof  l„„i  tlie  Mother  and  that 
Maternal              ,  t.\.    x- 

Organism.    ,        of  the  \oung. 

Nutritive  Matter' 

yielded  to  the 

Foetus. 

Horse 

Cow 

Sheep 

Pig 

Dog 

Fowl 

Grammes. 

325,000 

175,000 

50,000 

90,000 

22,000 

0,900 

1 

2 

20 

18 

100 

Grammes. 

50,000 
35,000 
4,500 
2,400 
0,440 
0,044 

Grammes.    ] 

25,000            100:       7,7 

35,000            100 :     20,0 

9,000     1       100:     18,0 

48,000     ^        100:     53,0 

7,950     '       100:     36,0 

4,400     ■       100:  500,0 

Per  cent,  of  the  | 

living  Maternal 

Weight. 

14 

20 

9 

3 

•2 

5 

The  nutritive  reserve  of  the  Horse,  compared  with  that  of  the  other 
animals,  is  here  seen  to  be  very  limited ;  while,  on  the  contrary,  the 
Fowl  yields  in  reproductive  material  a  sum  equivalent  to  five  times  the 
weight  of  its  own  body.  When  a  balance  is  struck  between  the  profits 
and  losses  in  the  animal  economy,  it  is  found  that  the  great  difference 
existing  has  its  own  reasonable  explanation.  The  function  which 
makes  the  greatest  demand  upon  the  nutritive  capital,  is  doubtless  that 
with  which  the  muscles  are  charged,  and  their  maintenance  in  power 
exacts  the  heaviest  compensation  ;  as  they  consume  material  in  pi-opor- 
tion  to  the  weight  of  the  body,  and  the  energy,  extent,  and  frequency 
of  the  movements.  In  proportion  as  the  height  increases,  the  cubical 
weight  augments  at  the  expense  of  the  motive  power ;  while  the  latter, 
equal  to  the  square  of  the  transverse  section  of  the  muscles,  follows  an 
arithmetical,  and  not  a  geometrical,  progression. 

The  nutritive  maintenance,  then,  demands  in  an  absolute  manner  an 
expenditure  much  more  considerable  in  the  larger  than  the  smaller 
animals ;  so  that  the  latter  are  more  fruitful  than  the  former,  and  their 
economy  renders  them  more  apt  to  hold  in  reserve  a  much  greater 
nutritive  capital. 

A  rich  and  abundant  aliment,  given  regularly,  increases  reproductive- 
ness ;  as  is  evidenced  in  the  case  of  our  domesticated  animals,  if  com- 
pared with  the  wild  creatures  of  the  same  species ;  and  their  fecundity 
increases  or  declines  as  their  food  is  plentiful  and  good,  or  scarce  and 
bad.  But  this  influence  of  alimentation  on  fecundity,  and  the  faculty 
of  living  beings  to  maintain  a  nutritive  reserve,  has  its  limit ;  for  the 
intestinal  absorption  goes  on  in  direct  proportion  to  the  superficies  of 
the  mucous  membrane  lining  it,  and  this  is  definite. 

The  sum  of  materials  necessary  for  embryonic  evolution  is  also 
founded  on  the  nutritive  reserve.  In  proportion  as  the  organisation  is 
simplified  and  the  various  apparatus  decrease  in  number,  so  does  the 
maturity  of  the  embryo  gain  in  precocity,  and  the  nutritive  matter  serve 
for  a  larger  number  of  germs.  Thus,  as  has  been  aptly  said,  what  would 
be  required  to  maintain  the  single  foetus  of  a  large  mammal,  whose 
organisation  is  complete  at  its  birth,  would  suffice  for  the  evolution  of 
many  million  of  frogs.  Besides,  the  parent  having  once  evacuated  the 
product  of  her  fecundation,  has  done  with  it — the  tadpoles  issuing  from 
the  ova  find  their  nourishment  in  the  outer  world;  but  the  young 
mammal  derives  its  sustenance  from  the  mammte  of  the  mother,  at 
whose  expense  it  continues,  for  a  more  or  less  protracted  period,  to  live 
as  a  parasite  (as  it  really  was  in  utero).     With  the  higher  animals, 


I'UiiKKTV.  :•: 

wliich  give  birth  to  an  incomplete  being,  tliere  is  observed  an  increase 
in  fecundity  :  the  Bitch  only  yields  two  per  cent,  of  its  weight,  but  the 
Calf  absorbs  twenty  per  cent,  of  its  parent's  weight. 

This  unequal  distribution  of  fecundity  among  the  animal  species  is  a 
conservative  element  in  the  scheme  of  organic  nature.  The  reproduc- 
tivencss  and  the  numerous  chances  of  destruction  surrounding  the  germs, 
are  compensated  for  in  just  proportion  ;  for  out  of  many  thousands 
of  ova  furnished  by  the  most  prolific  species,  a  comparatively  limited 
number  only  find  all  the  conditions  favourable  for  their  development. 


CHAPTER  I. 

Generation. 

The  processes  by  which  generation  is  accomplished  are  four  ;  these  ai'e 
<x>pulation,  fecundation,  (jcstation,  and  jnirturition  ;  but  it  is  only  on  tlie 
attainment  of  a  certain  age — that  of  pid^crty — that  these  sexual  acts  are 
in  activity,  and  they  continue  so  for  a  variable  period,  according  to  the 
species.  During  this  time,  ova  from  the  ovaries,  fecundated  by  the 
male  seminal  fluid,  are  received  into  the  uterus,  and  remain  there  for  a. 
regulated  period,  until  they  have  become  transformed  into  young  crea- 
tures possessing  certain  physical  attributes  and  resemblances  to  their 
parents.  This  is  the  gestation  period,  and  is  followed  by  that  of 
jiarturition,  when  the  young  are  born. 

SECTION  I.— PUBERTY. 

The  generative  organs  of  the  domesticated  female  animals  are,  like 
those  of  the  human  female,  only  in  a  state  of  greatest  activity  during 
the  prime  of  life  ;  and  the  most  notable  characteristic  of  their  functions, 
as  in  woman,  is  their  periodicity.  These  functions  lie  dormant  from 
birth  until  puberty,  when,  somewhat  suddenly,  certain  very  marked 
modifications  occur  throughout  the  whole  organism,  but  particularly  in 
the  generative  organs  of  the  male  and  female  animals.  In  the  first  the 
testicles  become  more  voluminous,  and  in  some  species  they  leave  the 
abdominal  cavity  to  be  lodged  in  the  scrotum  ;  they  also  begin  to  secrete 
an  abundance  of  a  special  fluid — the  "spermatic"  or  "seminal,"  in 
^vhich  particles  of  a  definite  shape — spermatozoa — and  endowed  with 
motion,  appear.  This  fiuid  is  stored  up  in  the  vesicnUe  seminalcs, 
which,  until  this  period,  were  small  and  wasted-looking.  The  organ  for 
the  conveyance  of  this  spermatic  fluid  to  the  female  becomes  more 
developed,  and  is  capable  of  complete  and  frequent  erection.  In  the 
female  the  mammie  enlarge,  the  ovaries  are  more  vascular  and  turgid- 
looking  than  before,  and  the  Graafian  vesicles  are  more  or  less  developed. 
The  periodic  ovipont  then  begins  to  be  carried  on,  with  all  tlie 
distinctive  peculiarities  that  attend  it,  and  which  it  is  to  bear  during 
the  prolific  period  of  life. 

The  age  at  which  animals  arrive  at  pnhcrt]i  or  sexual  maturity,  is  not 
only  dilTerent  in  different  species,  but  is  influenced  to  some  extent  by 
the  rapidity  of  their  growth  and  the  duration  of  their  life.  Domestica- 
tion has  more  particularly  brought  about  changes  in  this  respect,  and 
by  inducing  a  more  rapid  development  of  the  organism,  has  hastened 
the  advent  of  this  period.  And  it  may  be  said  that  puberty  is  sooner 
attained  in  the  female  than  the  male,  and  also  that  domesticity   has 


VXS&  i  aK  aJboos  two  OBOBths  mhl  i 


•n:. 


3»: 


60  OBSTETRICAL  PHYSIOLOGV. 

In  other  animals  this  ejection  sometimes  consists  of  a  viscid,  red- 
tinted,  or  sangtiinolent  fluid.  In  all  it  has  a  special  and  powerful  odour, 
which  attracts  the  males,  and  enables  them  to  distinguish  between  the 
females  which  are  in  "  rut  "  or  "  heat,"  and  those  which  are  not,  as  well 
as  exciting  in  them  the  most  ardent  amatory  desires. 

The  uterine  mucous  membrane  is  also  very  congested,  and  there  is 
poured  out  on  its  surface  a  fluid  containing  epithelial  debris,  mucus 
corpuscles  and  blood  globules. 

The  existence  in  the  lower  animals  of  what  is  analogous  to  the 
menstrual  discharge  in  the  human  female,  has  frequently  been  denied, 
but  without  any  reason  or  proof.  A  discharge  of  blood  from  the  sexual 
organs  of  woman  announces  the  advent  of  puberty  ;  and  its  coincidence 
with  the  maturity  and  escape  of  the  ovarian  o^nile,  as  well  as  its 
periodical  appearance  until  the  termination  of  fertility,  establishes 
between  this  phenomenon  and  the  "heat "  or  "  rut"  (cestrum)  of  animals 
a  very  close  analogy.  And  this  analogy  is  rendered  complete  by  the 
fact  that  animals  also  at  this  period  have  more  or  less  evident  sanguine 
emissions.  Kahleis,  Fuchs,  Spinola,  Numann,  and  others  have  observed 
this  in  the  Cow,  and  have  also  noted  that  the  discharge  occurs  regularly 
at  intervals  of  nineteen  or  twenty  days,  when  the  animal  is  not  giving 
milk  or  in  calf.  The  haemorrhagic  flow  appears  two  or  three  days  after 
the  commencement  of  "  rutting,"  and  when  this  is  most  intense.  The 
amount  of  blood  does  not  exceed  one  or  two  ounces,  and  the  coagulated 
clot  remains  in  the  vagina  until  it  is  expelled  with  the  urine.  There 
can  be  no  doubt  as  to  its  source.  If,  at  the  moment  when  traces  of  it 
are  perceived  externally,  the  Cow  is  killed  and  the  inner  surface 
of  the  uterus  examined,  blood  will  be  seen  exuding  from  the  cotyledons. 
And  this  phenomenon  has  been  proved  to  extend  bej'ond  the  Bovine 
species,  for  it  has  been  witnessed  in  the  Mare,  Bitch,  Cat,  Eabbit,  etc.; 
and  in  the  red-coloured  mucus  of  the  vagina  and  uterus,  multitudes  of 
blood-corpuscles  have  been  found. 

Not  only  is  the  existence  of  a  menstrual  discharge  in  animals  a  well- 
ascertained  fact,  but  the  ill  effects  of  its  retention  in  cases  of  uterine 
obstruction  or  occluded  vagina,  have  been  recorded  as  occurring  in  both 
the  Bovine  and  Equine  species. 

The  cause  of  menstruation  or  periodical  discharges  of  blood  in  female 
animals,  has  received  a  satisfactory  explanation  from  the  researches  of 
Eouget,  who  has  established  the  fact  that  the  utero-ovarian  artery,  on 
arriving  at  the  body  of  the  uterus,  near  the  Fallopian  tube,  divides  into 
curs^ed  or  spiral  bouquets  of  vessels  which  open  into  veins,  like  the 
helicine  arteries  of  the  male  cavernous  sinus.  Along  the  inferior  border 
of  the  ovarj",  this  artery  forms  a  series  of  branches  that  wind  and  twist 
exactly  like  the  arterial  ramifications  at  the  root  of  the  corpus  cavern- 
osuin,  penetrating  the  stroma  of  the  ovary,  and  giving  rise  to  spiral  con- 
volutions. The  venous  system  composes  the  uterine  sinuses — contorted 
venous  canals  not  unfrequently  spiral,  like  the  arteries. 

The  uterus  is,  therefore,  an  erectile  organ  like  the  penis,  and  its 
erection  is  connected  with  the  periodic  haemorrhage  from  its  inner 
surface.  The  venous  sinuses  in  the  meshes  of  the  muscular  tissue, 
crossing  each  other  at  the  hilus  of  the  ovary,  are  partially  compressed,  and 

twent3'-four  years  of  age,  which  every  three  weeks  had  a  sanguineous  emission  from  the 
vulva ;  this  discharge  ceased  towards  the  middle  of  pregnancy,  but  returned  after 
parturition.  I  have  frequently  witnessed  the  periodic  discharge  from  Mares  either 
streaked  with  blood,  or  blood-tinted. 


a'STJ.-CM.  61 

the  immediate  result  is  the  distending  and  erection  of  the  bulb  of  the  ovary. 
This  modification  in  the  ovarian  circulation  extends  to  tlie  uterus,  so 
that  both  are  in  a  state  analogous  to  erection  ;  the  prolonged  tension  is 
communicated  to  the  vessels  and  capillaries  of  the  mucous  niemhranc  ; 
the  epithelium  is  shed,  leaving  the  tunic  of  the  capillaries  exposed,  and 
this  soon  gives  way,  whence  results  the  haemorrhage,  which  })crsists  as 
long  as  the  erection  and  obstruction  to  the  free  How  of  blood  tln-ou"li 
the  veins  continues.  This  is  the  case  in  the  human  female,  but  it  nmst 
be  admitted  that,  in  several  animals,  the  erectile  formations  are  either 
in  a  rudimentary  condition  or  entirely  absent. 

In  the  Bitch  the  bulb  of  the  ovary  is  moderately  developed  ;  but  the 
arteries  of  the  uterus,  although  contorted  in  a  spiral  form,  are  not  such 
avascular  mass  of  vessels  as  to  constitute  a  real  erectile  organ.  In 
Ruminants,  small  vascular  masses  or  formations  are  observed  near  the 
cotyledons,  which  may  be  taken  to  represent  the  spongy  texture  of  the 
human  uterus. 

That  the  menstrual  flow  is  independent  of  the  influence  of  the  ovaries, 
and  even  nearly  all  of  the  uterus  and  its  ajjpendages,  would  appear  to 
be  established  by  several  important  facts  connected  with  the  subject  of 
ovariotomy  or  "spaying."  There  is  a  tradition  among  those  who 
practise  this  operation  on  Sows,  Bitches  and  Cats  more  particularly, 
that  it  does  not  prevent  their  showing  signs  of  oestrum  unless  they  are 
operated  upon  when  pregnant ;  this  is  more  especially  the  case  with 
animals  which  have  already  produced  young,  but  it  is  nevertheless  the  case 
also  sometimes  with  young  animals  which  have  never  been  bred  from.' 

With  regard  to  the  season  at  which  this  "  heat"  takes  place,  it  has 
been  observed  that  it  is  usually  the  spring-time,  when  food  becomes 
plentiful,  especially  with  Herbivorous  animals.  The  Carnivora  are  in 
heat  during  winter.  The  Mare  is  usually  in  heat  from  April  to  June,  or 
later.  \Vith  the  Cow  whose  Calf  is  sold  at  from  one  to  two  months  old, 
with  a  view  to  utilising  the  milk,  the  season  of  course  is  varied,  as  care 
is  taken  to  induce  conception  again  as  soon  as  the  lacteal  secretion 
begins  to  diminish  ;  but  it  has  been  observed  that  midsunnner  is  more 
particularly  the  rutting  period.  And  the  "  heat ''  in  Sheep,  though 
naturally  present  in  September,  is  usually  only  shown  during  summer, 
because  the  Ewes  are  kept  apart  from  the  Ram  at  the  natural  time,  in 
order  that  the  Lambs  may  be  born  at  a  favourable  season — the  spring  ; 
and  the  period  of  suckling  over  (four  or  five  weeks),  they  may  be  weaned 
when  the  herbage  is  tender  and  nutritious.  .\nd  in  other  circum- 
stances, particularly  with  animals  bred  for  tlie  butcher,  tlie  rut  is 
induced  sooner  by  putting  the  Ewes  in  contact  with  the  Kam  at  an 
earlier  period,  so  as  to  obtain  two  or  three  lambings  in  the  year. 

The  Bitch  is  in  heat  from  December  to  February,  or  in  the  autumn 
and  spring-time. 

'  A  strikinjf  in.ttance  of  this  h.oa  been  given  recently  by  Barthelniy,  in  tlie  Journal  dc. 
Medeciii''  I'etcrinaire,  who  a.-<.serta  that  the  (pstnim  or  "  nit ''  can  occur  in  Piijs  after  com- 
plete removal  of  the  ovaries.  A  professional  spayer  operated  on  thirty-ei^jht  young  Pigi 
under  sixty  days  old,  yet  these  animals  showed  the  symptoms  of  "  rtit "  at  from  three  to 
eight  months,  and  monthly  after  that  a^e,  as  thou^;h  they  had  not  l)een  spayed.  .\n  action 
was  brought  against  him,  after  M.  liarthelmy  had  given  his  opinion  that  the  a-strum 
indicated  incomplete  removal  of  the  ovaries.  The  defendant  declared  that  he  had  seen 
ivstnim  in  pigs  which  had  l>een  properly  si)aytd.  The  court  ordered  that  five  of  the 
Figs  which  showed  all  the  phenomeii.'t  of  rrstruin  to  the  greatest  extent,  shouM  be  killed 
and  examined  by  a  competent  veterin.iry  surgeon.  This  was  done,  and  it  w.-vs  found  that 
in  each  case  the  operation  had  been  well  performed — the  ovaries,  tubes,  and  almost  the 
entire  cornua  of  the  uterus  having  been  removed. 


62  OBSTETRICAL  FHYSIOLOGY. 

The  Cat  is  in  this  state  in  January  and  February,  and  also  in  the 
spring  and  autumn  ;  sometimes  the  heat  appears  three  or  four  times 
a,  year,  and  the  animal  may  produce  young  as  frequently  ;  though  in  the 
wild  state  it  seldom  does  so  more  than  twice  a  year. 

The  Pig  manifests  rutting  in  October  or  November — at  least  that  is 
the  period  when  it  is  usually  put  to  the  male  ;  and  it  may  be  put  a 
second  time  towards  the  end  of  spring,  in  order  to  have  two  litters 
within  the  twelvemonth. 

ThQ  frequency  and  duration  of  the  period  of  "rutting"  or  "heat" 
•depend  upon  age,  species,  and  other  circumstances ;  but  it  may  be 
said  to  persist  in  the  domesticated  animals  from  one  to  fifteen  days  at 
the  most.  The  shortest  period  is  witnessed  in  the  Cow  and  Sheep,  and 
the  longest  in  the  Bitch.  It  is  sometimes  only  present  from  twelve  to 
twenty-four  hours  in  some  non-fecundated  animals.  With  impregna- 
tion, however,  it  ordinarily  ceases  until  after  parturition ;  and  if 
impregnation  does  not  occur,  it  gradually  disappears  until  the  next 
period,  which  is  somewhat  variable.  Its  re-appearance  in  the  Cow 
has  been  noted  every  month  or  three  weeks,  and  sometimes  at  closer 
intervals  ;  and  in  the  Sheep  and  Pig  it  lasts  for  one  or  two  days,  and 
again  appears  from  the  fifteenth  to  the  thirtieth  day,  but  usually  every 
month.  When  removed  from  artificial  conditions,  it  is  stated  that 
the  Ovine  species  is  in  rut  in  September,  that  this  persists  only  for  a 
day,  but  re-appears  every  fourteen  days  until  the  end  of  December. 
From  the  spring  until  the  end  of  summer,  it  may  be  said  the  Mare 
manifests  a  desire  for  the  Horse  every  three  or  four  weeks,  and  the 
objective  phenomena  which  announce  it  continue  from  two  to  four  days. 
In  the  Bitch  they  last  for  nine  or  ten  days,  and,  as  has  been  stated, 
only  ajjpear  in  the  spring  and  autumn. 

This  periodicity  is  regulated  by  Nature,  with  a  view  to  the  preserva- 
tion of  species  ;  and  in  animals  not  influenced  by  artificial  conditions, 
it  is  so  arranged  that  the  young  creatures  may  arrive  during  the  season 
when  their  maintenance  will  be  best  assured. 

With  the  subsidence  of  venereal  excitement  in  unimpregnated  animals, 
there  succeeds  a  period  of  calm,  which  is  almost  equivalent  to  that  of 
gestation  in  impregnated  creatures.  And,  strange  to  say,  with  Bitches 
at  the  end  of  this  interval — from  the  fortieth  to  the  sixtieth  day — there 
sometimes  appear  phenomena  allied  to  the  parturient  period  ;  these 
are  :  tumefaction  of  the  mammary  glands,  followed  by  swelling  and 
increase  of  the  opening  of  the  vulva,  with  reddening  of  the  vaginal 
mucous  membrane  and  the  escape  of  a  viscid  fluid.  The  animal  also 
acts  as  if  about  to  bring  forth — making  a  bed  for  her  young  ;  moving 
about  uneasily  ;  neglecting  her  food  for  three  or  four  days,  during 
which  the  mammae  become  still  more  developed,  firm,  and  elastic,  the 
teats  elongated,  and  the  lactiferous  sinuses  filled  with  an  abundance  of 
good  milk,  which  is  easily  obtained  by  slight  pressure.  If  a  Bitch  in 
this  state  is  presented  with  a  young  Puppy,  she  will  take  to  it  as  if  it 
were  her  own,  and  rear  it  most  aflectionately.  This  strange  condition 
has  been  observed,  though  more  rarely,  in  the  Cat ;  and  Chauveau  has 
also  noticed  it  in  a  Mare  which  had  been  put  to  the  Horse,  but  did  not 
prove  in  foal. 

The  years  during  which  tt'strum  continues  varies  with  species,  and 
particularly  with  regard  to  the  age  they  attain  ;  but  it  always  disappears 
towards  the  decline  of  life. 

Climate,  inseparable  from  the  conditions  of  alimentation,  exercises  a 


MATURATIOX  OF  THE  <iRAAFIAX  VESICLES.  63 

marked  influence  on  the  "rut,"  in  hastening  its  development  and  its 
periodicity ;  but  the  economical  law  to  which  it  is  subordinate  does 
not  vary.  With  many  species,  the  rut  only  appears  once  a  year  ;  while 
in  others  wliich  are  favourably  placed  with  rof^ard  to  alimentation,  it 
persists  in  every  season,  or  at  least  during  a  large  part  of  the  year. 
Domesticity,  iu  assuring  animals  food  and  shelter,  and  removing  them 
from  the  risks  and  alternations  of  an  erratic  life,  multiplies  the  periodical 
returns  of  this  condition.  Fowls,  Pigeons,  etc.,  lay  despite  the  rigours 
of  winter,  and  the  domesticated  mammals  are  in  heat  at  short  intervals. 

Though,  as  a  rule,  oestrum  does  not  appear  until  after  parturition  is 
achieved,  and  lactation  has  nearly  or  quite  ceased,  yet  it  is  not  rare  to 
find  some  animals — as  the  Mare  and  Pig — manifest  a  desire  for  the  male, 
and  even  copulate  ;  and  it  is  no  less  a  fact  that  rutting  and  impregna- 
tion may  and  does  occur  soon  after  parturition.  The  Cow,  Ass,  and 
Sheep,  and,  it  is  believed,  the  Mare,  will  copulate  with  gi-eater  certainty 
of  success  on  the  ninth  day  after  parturition  than  at  any  other  time. 

As  has  been  just  stated,  various  conditions  intluence  the  appearance  of 
this  state,  and  more  or  less  change  the  period  and  the  intervals  of  its 
advent.  Warmth,  shelter  from  vicissitudes  of  weather,  an  abun- 
dance of  nourishment,  especially  that  of  a  stimulating  nature,  and  easy 
labour,  favour  its  more  frequent  and  early  appearance,  and  especially  a 
judicious  bringing  together  of  the  male  and  female.  It  has  also  been 
induced  by  the  injection  of  certain  substances  into  the  vagina. 

The  persistence  of  this  condition  for  longer  than  the  natural  period 
is  a  symptom  of  uterine  or  ovarian  derangement,  and  therefore  un- 
favourable. It  renders  Mares  and  Cows  less  serviceable,  and  even 
dangerous,  constituting  the  disturbance  designated  "  nymphomania." 
Repeated  intercourse  with  the  male  will  not  allay  the  abnormal  con- 
dition, but  frequently  aggravates  it.  Such  animals  will  not  breed. 
Ovariotomy  is  often  practised  for  "  nymphomania,"  and  in  the  Cow  the 
operation  is  frequently  followed  by  subsidence  of  the  troublesome 
symptoms  for  a  time  ;  in  the  Mare  it  is  much  less  successful. 

SECTION  III.— MATURATIOX  OF  THE  (IKAAFIAN  VESICLES. 

The  spontaneous  and  periodic  ripening  and  dehiscence,  or  discharge, 
of  the  ovarian  vesicle  that  marks  the  period  of  cestrum  in  the  domesti- 
cated animals,  though  independent  of  fecundation,  yet  is  doubtless 
intended  to  conmience  the  act  of  generation.  The  peculiar  condition 
which  accompanies  the  maturation  of  the  ovum,  the  intense  desire  of 
the  female  for  the  male,  and  the  excitation  produced  in  the  latter  at 
this  period,  with  its  aptitude  for  procreation,  conclusively  demonstrates 
this.  At  this  time,  as  we  have  seen,  particular  changes  occur  in  tlie 
ovaries.  A  certain  Ciraatian  vesicle  or  vesicles,  according  to  the  species 
and  whether  the  animal  is  uniparous  or  multiparous,  becomes  more 
voluminous  than  the  others,  raising  the  enveloping  membrane  of  that 
body,  and  makes  a  more  or  less  salient  projection  on  its  surface,  as  is 
witnessed  in  the  ovary  of  the  Pig.  Around  this  vesicle  the  bloodvessels 
enlarge,  and  the  stroma  is  congested ;  while  in  its  interior  an  effusion 
of  blood  takes  place  ;  the  capsule  becomes  greatly  distended  and  injected, 
and  at  a  particular  point  gives  way,  leaving  an  irregular  gap  through 
which  the  ovum  (Fig.  28,  a)  escapes.  In  the  Pig,  during  the  evolution 
of  the  vesicle,  the  corpus  luteum  is  red,  deep  red,  blue,  or  nearly  black. 
It  is  probable  that  the  Graafian  vesicles  open  at  any  part  of  the  surface 


64  OBSTETRICAL  PHYSIOLOGY. 

of  the  ovary,  in  those  animals  in  which  the  pavilion  of  the  Fallopian 
tube  is  large  enough  to  envelop  it  more  or  less  completely.  But  in 
those  creatures,  such  as  the  Mare,  in  which  the  ovary  is  so  voluminous, 
the  pavilion  cannot  cover  it ;  and  it  is  not  at  all  unlikely  that  in  this 
case  the  rupture  of  the  vesicles  occurs  at  the  hilus  of  the  ovary,  as  the 
corpora  lutea  have  only  been  observed  at  this  part.  In  multiparous 
animals,  the  rupture  of  the  vesicles  at  one  period  of  rutting  does  not 
appear  to  take  place  simultaneously,  but  successively. 

The  number  of  Graafian  vesicles  which  come  to  maturity  and  rupture 
at  each  period  of  oestrum,  depends,  with  some  exceptions,  upon  the 
number  of  young  each  female  brings  forth  at  a  birth.  The  Mare,  Cow, 
and  Sheep,  having  usually  only  one  offspring  at  a  time,  only  one  vesicle 
ripens  during  oestrum  ;  the  Goat  has  most  frequently  two  young,  and 
in  this  case  a  vesicle  ruptures  in  each  ovary ;  while  the  Pig  and 
Carnivora  having  several  at  a  birth,  a  corresponding  number  of  vesicles 
open,  and  their  contents  occupy' each  cornu  of  the  uterus. 

The  ovum  liberated  by  the  bursting  of  the  vesicle  is  seized  by  the 
pavilion  of  the  oviduct,  which  is  applied  somewhat  closely  to  the 
surface  of  the  organ,  and  is  carried  down  the  tube  to  the  uterus,  where, 
if  fecundation  does  not  ensue,  it  remains  only  a  brief  period  before  it  is 
expelled  or  perishes.  The  seizure  of  the  ovum,  as  has  been  stated,  is 
all  the  more  certain  in  proportion  as  the  pavilion  is  large  enough  to 
grasp  a  large  surface  of  the  ovary ;  this  condition  is  found  most 
developed  in  the  Carnivora. 


CHAPTER    II. 
Fecundation. 

The  effective  intercourse  of  the  male  with  the  female  is  followed  by 
certain  remarkable  changes  in  the  ovum  and  generative  apparatus  of 
the  latter,  which,  at  first  known  as  fecundation,  conception,  or  inipreg- 
iiation,  ultimately  results  in  the  formation  of  a  new  creature  possessed, 
to  a  certain  degree,  of  individual  or  independent  life.  The  intercourse, 
to  be  effective,  depends  upon  the  presence  of  a  healthy  ovum  in  the 
generative  apparatus  of  the  female,  and  the  introduction  into  this 
apparatus  of  the  seminal  fluid  by  the  special  organ  of  the  male.  This 
fluid  contains  the  essential  elements  known  as  "  spermatozoa  " — organic 
particles  of  a  particular  shape,  and  endowed  with  motion.  For  con- 
ception, it  is  absolutely  necessary  that  the  ovum  of  the  female  should 
be  brought  into  contact  with  these  particles  ;  though  whether  this  con- 
tact can  occur  in  the  ovisac,  prior  to  its  escape,  has  not  yet  been  defi- 
nitely ascertained.  It  is  certain  that,  by  reason  of  their  particular 
movements,  and  also  doubtless  through  the  aid  they  receive  from  the 
special  motion  of  the  ciliated  epithelium  covering  certain  portions  of 
the  lining  membrane  of  the  uterus,  these  spermatozoa,  when  the  uterine 
opening  is  patent,  are  diffused  soon  after  coit^is  to  the  most  distant  parts 
of  that  cavity,  and  high  up  in  the  Fallopian  tubes  ;  though  they  have 
never  been  traced  so  far  as  the  ovisac.  Nevertheless,  a  very  strong 
argument  in  favour  of  their  attaining  this  region,  and  producing  what  is 
called  "ovarian"  or  "  tubal  impregnation,"  is  afforded  in  the  occurrence 
of  extra-uterine — ovarian  or  tubal — gestation ;  for  in  this  case  the 
spermatozoa  must  have  reached  both  oviduct  and  ovary. 

Before  the  ovum  leaves  the  ovary,  changes  occur  in  it  which  may  be 


STEIULITV.  65 

noted  here.  The  germinal  spot,  })reviously  at  the  inner  surface,  passes 
to  the  centre  of  the  genninal  vesicles  ;  and  this,  which  was  before  at 
the  surface,  goes  to  the  centre  of  the  yolk  or  vitellns ;  while  the  mem- 
brane investing  the  latter,  from  being  thin,  suddenly  thickens.  When 
the  ovum  is  discharged,  the  tunica  (jraiiulosa  and  rctinacnla  accompany 
it  through  the  small  opening  in  the  vesicle  ;  the  whole  being  received 
into  the  pavilion  or  infundibulum  of  the  Fallopian  tube,  which  at  this 
time  is  tirndy  applied  against  the  ovary.  Arrived  at  this  part,  the 
ovum  is  carried  along  by  the  slow  vermicular  motion  or  contraction 
of  the  tube,  as  well  as  by  the  ciliary  movement  of  the  cells  covering 
the  nmcous  membrane  lining  this  duct,  until  at  last  it  reaches  the 
uterus. 


CHAPTER  III. 
Sterility. 


Hitherto  we  have  been  treating  of  fecundation  as  if  it  were  always 
a  sure  result  of  the  coupling  of  the  male  and  feniale  sexes  at  a 
certain  period.  Successful  fecundation,  however,  is  not  always  the  case, 
and  in  some  species — particularly  the  Equine — sterility,  temporary  or 
permanent,  in  the  female  is  far  from  being  uncommon,  and  is  some- 
times serious.  Sterility,  barrenness,  or  infecundity  depends  on  numerous 
causes,  to  some  of  which  we  must  allude,  as  in  distinguishing  their 
presence  we  may  be  able  to  remove  or  counteract  them. 

It  is  difhcult  to  ascertain  the  extent  to  which  it  prevails,  especially  in 
the  larger  and  more  important  animals.  In  the  Stud  Book,  it  is  shown 
that  among  thoroughbred  Mares  the  percentage  of  those  which  carry 
foal  is  73"8G,  and  those  which  abort  or  are  infecund  26"64.  In  the 
studs  of  France  the  fruitful  Mares  are  o9-o7,  and  the  unfruitful  ones 
4043  per  cent.  The  Due  de  Guiche  gives  68  per  cent,  of  fecund 
Mares.  At  the  haras  of  Pin,  during  a  period  of  twenty  years,  there 
was  a  percentage  of  68- 27  fecund  Mares,  abortions  5-06,  non-fecund 
26G7  ;  while  at  the  Pompadour  haras,  where  Oriental  horses  were 
chieHy  bred,  the  births  in  three  years  were  79'55,  abortions  2*27,  and 
non-fecunds  2045. 

In  the  Cow,  the  fecundations  appear  to  average  about  79  per  cent. 

With  the  Sheep,  sterility  or  infecundity  is  not  so  common.  RuefT,  at 
Hohenheim,  found  among 8,500  sheep,  only  740,  or  8  per  cent., unfruitful. 

Sterility  may  depend  upon  organic  or  pliysical  causes,  and  may 
amount  to  permanent  impotence,  more  particularly  when  congenital 
and  located  in  the  generative  apparatus.  Monstrosities,  hermaphro- 
dites, animals  in  which  one  or  more  important  organs  of  the  sexual 
apparatus  are  absent,  and  hybrids,  are  generally  permanently  sterile.' 

Prolonged  continence  and  old  age  are  not  infrequent  causes  of  in- 
fecundity, as  is  witnessed  in  Mares  which  liave  worked  for  many  years 
in  towns,  and  then  been  transferred  for  breeding  purposes. 

Change  of  climate  has  in  many  cases  a  marked  influence  on  fecundity 
— sometimes  putting  it  altogether  in  abeyance,  and  at  others  rendering 
the  animals  infecund  for  only  a  longer  or  shorter  period.  It  may  also 
be  impaired,  or  suspended  ten)porarily  or  permanently,  by  abuse  of 
the  generative  functions,  bad  hygiene,  etc. 

'  There  are  exceptions  to  this  rule.  Several  well  authenticated  instancea  are  recorded 
in  which  the  suliped  mule  haa  bred,  as  well  aa  other  hybrids. 

5 


66  OBSTETRICAL  PHYSIOLOGY. 

It  may  likewise  be  due,  though  temporarily,  to  premature  or  tardy 
coition  when  the  generative  organs  are  not  in  a  physiological  condition 
for  conception,  or  when  they  are  in  an  irritable,  abnormal  state.  Under- 
fed or  over-fed  animals  generally  do  not  breed  so  readily  as  those  which 
are  in  moderate  condition ;  fat  animals  are  especially  unfruitful. 
Excitable,  vicious  Mares  are  less  likely  to  procreate  than  those  w^hich 
are  of  an  equable  and  gentle  disposition.  The  latter  are  often  impreg- 
nated at  one  attempt ;  and  it  has  been  observed  that  with  Mares 
accustomed  to  work,  active  exertion,  even  to  produce  fatigue,  before 
being  put  to  the  horse,  is  favourable  to  conception.  So  it  is  that  the 
Arab  submits  his  Mare  to  a  severe  gallop,  and  brings  her  almost  breath- 
less before  the  Stallion,  when,  the  act  being  accomplished,  he  leaves  her 
quietly  at  rest  for  some  hours. 

Various  diseased  conditions  of  the  generative  or  other  organs,  as  well 
as  general  derangements,  may  also  prove  antagonistic  to  fecundity. 
There  may  be  disease  or  alterations  in  the  ovaries.  Fallopian  tubes, 
uterus,  or  vagina,  which  will  hinder  conception  ;  and  if  any  material 
obstacle  to  the  contact  of  the  spermatic  fluid  with  the  ovum  be  present  in 
these  parts,  fecundation  cannot  take  place.  Tumours  of  various  kinds  in 
this  region  are  not  an  infrequent  cause  of  sterility. 

Eueff  and  others  have  observed  an  imperforate,  dense,  and  tough 
hymen  to  be  a  cause  of  infecundity  in  the  Mare. 

The  fault  may  rest  with  the  male,  and  be  due  to  imperfection  in  his 
generative  organs,  the  absence  of  spermatozoa  in  the  seminal  fluid,  or 
general  or  sexual  debility  of  a  temporary  or  permanent  character.  Or 
the  spermatozoa,  when  introduced  into  the  genital  canal,  may  have 
their  vitality  destroyed  by  the  secretions  they  meet  with ;  or  the  im- 
pregnated ovum  may  be  unable  to  fix  itself  on  the  mucous  membrane 
of  the  uterus  because  of  disease  existing  there,  such  as  endometritis. 

In  all  these  conditions  a  careful  examination  should  be  made,  as 
removal  of  the  obstacle  to  generation  may,  in  many  instances,  be  quite 
within  the  scope  of  surgical  or  medical  measures.  More  particularly  is 
this  the  case  when  the  obstacle  is  related  to  some  abnormal  condition 
of  the  cervix  uteri — a  circumstance  more  common  than  is  generally 
supposed. 

Occlusion  of  the  canal  leading  to  the  cavity  of  the  uterus — the  os — 
has  been  known  as  a  cause  of  sterilitj^  in  the  Mare  and  Cow  from  the 
earliest  times.  This  occlusion  may  be  complete  during  coition,  and 
prove  fatal  to  conception ;  or  it  may  be  due  merely  to  a  spasmodic  con- 
dition of  the  muscles  of  the  cervix.  The  oiled  hand  should  be  intro- 
duced into  the  vagina  to  ascertain  the  state  of  the  part ;  when,  if  the 
closure  is  suspected  to  be  owing  to  muscular  defect,  the  cervix  may  be 
smeared  with  extract  of  belladonna.  If,  however,  this  does  not  succeed, 
or  if  there  be  hypertrophy,  disorganization,  or  rigidity,  then  an  opera- 
tion will  be  necessarj'.  Hypertrophy  from  plastic  exudation  and  the 
formation  of  false  membranes,  is  a  frequent  cause  of  sterility,  and  usually 
occurs  during  or  after  the  first  birth,  particularly  in  the  Cow.  In  many 
cases  the  morbid  closure  of  the  os  can  be  remedied  in  a  very  safe  and 
simple  manner.  The  animal  is  secured — if  a  mare  by  the  "  side-line," 
if  a  Cow  by  fastening  the  two  hind-legs  together,  though  not  too  close 
— and  the  oiled  hand,  in  the  form  of  a  cone,  passed  up  the  vagina  to 
the  cervix  in  a  half-rotary  or  screwing  manner ;  on  reaching  this,  the 
tips  of  the  fingers  are  to  be  gently  insinuated  by  the  same  movement 
into  the  os,  and  pushed  on  until  the  cavity  of  the  uterus  is  reached.     A 


STERILITY.  67 

simple  sound,  the  size  of  an  ordinary  catheter,  well  j^reased,  may  be 
employed  with  the  same  object  as  the  lingers,  and  appears  to  answer 
(juite  as  well.  Various  instruments  have  been  devised  to  dilate  the 
cervix,  but  nothing  is  equal  to  the  lingers  or  the  sound.  The  animal 
may  be  put  to  the  male  on  the  same  or  the  following  day.  This  simple 
operation  for  the  cure  of  sterility  has  been  very  often  practised,  and  is 
well  known  to  the  Arabs  of  the  Sahara,  who  treat  their  barren  Mares  in 
this  manner,  and  in  the  majority  of  cases  with  success. 

In  the  United  States  of  America,  Lyford's  method  of  ensuring  fertility 
when  the  cen'ix  is  at  fault,  has  been  extensively  practised,  with  excellent 
results.  Use  is  made  of  what  he  terms  irapregnators  and  dilators.  The 
former  consist  of  a  hollow  tube  or  cone,  composed  of  soft  rubber  of 
suilicient  thickness  and  tirnmess  to  retain  its  shape  and  resist  the 
pressure  of  the  cen'ix.  Somewhat  constricted  at  the  disc  portion,  in 
order  that  it  may  be  self-retaining  (Fig.  35,  a),  the  posterior  surface  of 
the  disc  is  somewhat  concave,  to  admit  the  urethral  sinus  of  the  glans 
penis  ;  while  the  canal  in  the  body  is  sufficiently  wide  to  allow  the 
semen  an  easy  passage  through  the  tube  to  the  end  {h)  which  projects 


Fig.  .Jo.  Fig.  36. 

ImI'REGNWTI.NG    TlBH.  SkcTIOS    OI-    ImPRKCNATINC    TlBE. 

a.  Disc  ;  h,  Bulb.  a,  Disc  ;  /<,  F.ullj. 


t^Tr—    jf^- 


-% =-^^ =^ 

Fig.  \M. 
Dilator  ok  thk  Cervix. 

into  the  uterus.  These  imprcgnators  are  in  three  or  four  sizes,  to 
lit  different-sized  cervices ;  and  to  render  them  less  objectionable  to  the 
Stallion  and  Marc,  the  disc  (Fig.  3G,  </),  as  well  as  the  bulb  {}>),  is  hollow 
and  very  elastic,  so  that  connection  between  male  and  female  takes  place 
almost  as  if  no  foreign  body  intervened.  The  advantages  claimed  for 
these  articles  are  :  close  approximation  to  the  normal  condition  of  the 
cen'ix  during  copulation,  and  so  rendering  the  communication  between 
the  cavity  of  the  uterus  complete,  thus  assuring  easy  access  for  the 
semen  ;  they  are  easily  inserted  ;  are  ready  for  immediate  use  ;  and  they 
are  cheap  and  durable.  The  dilator  (Fig.  37)  greatly  facilitates  the 
introduction  of  the  tube,  by  dilating  the  os  uteri  and  displacing  any 
obstruction  that  may  exist,  thus  allowing  the  cervix  to  envelop  the 
impregnator  easily  and  closely,  as  well  as  saving  much  time  in  inserting 
it.  This  is  accomplished  by  the  left  hand  in  the  vagina  placing  the 
tube — in  which  is  the  dilator — at  the  entrance  to  the  os,  while  the  right 
hand  makes  the  necessar}'  pressure  on  the  handle  of  the  dilator  to  push 
it  into  the  canal ;  the  left  hand  retains  it  there  until  the  dilator  is  with- 


68  OBSTETRICAL  PHYSIOLOGY. 

drawn.  The  Stallion  is  then  allowed  access  to  the  Mare,  and  within 
five  minutes  after  copulation  the  tube  is  extracted  by  means  of  a  tape 
attached  to  it,  the  end  of  which  has  a  ring,  and  hangs  outside  the 
vulva. 

Moderate  rigidity  of  the  cervix,  which  cannot  be  overcome  by  prompt 
manipulation,  may  be  combated  by  means  of  sponge  tents  introduced 
into  the  os.  These  are  made  by  soaking  a  sponge  of  the  necessary  size, 
and  to  which  a  long  string  is  securely  tied,  in  a  strong  solution  of  gum 
arable  ;  it  is  then  closely  wound  round  with  a  thread,  so  as  to  form  an 
elongated,  pointed  mass  four  or  five  inches  long.  When  dry  the  thread 
is  removed,  and  the  sponge,  being  slightly  smeared  with  grease  or 
glycerine,  is  passed  into  the  os,  where  it  is  left  to  soften  and  expand,  in 
doing  which  it  widens  the  canal.  In  some  instances  it  may  be  neces- 
sary to  assist  the  dilatation  by  making  some  slight  incisions  through 
the  cervix. 

In  rare  instances  complete  dilatation  may  require  to  be  effected  by 
a  cutting  instrument,  but  this  should  never  be  resorted  to  until  the 
simpler  and  safer  means  have  failed. 

Disease  of  the  mucous  membranes,  with  altered  secretions,  must  be 
treated  according  to  the  indications. 


CHAPTEK  IV. 
Changes  in  the  Ovum. 

During  the  progress  of  the  ovum  towards  the  uterus,  and  soon  after  its 
reception  into  that  cavity,  some  remarkable  alterations  occur.  The 
ovum  has  encountered  the  fructifying  element  of  the  male  semen — the 
spermatozoa ;  at  least,  this  has  been  established  in  the  Rabbit,  in  whose 
oviducal  ovum  they  were  found  to  have  passed  through  the  zona pelliicida, 
though  no  opening  has  yet  been  discovered  in  that  extremely  fine 
evanescent  film.  The  germinal  vesicle  disappears,  or  has  changed  its 
character,  and  a  somewhat  more  opaque  cmhrijonal  cell  succeeds,  which 
may  be,  or  includes,  a  combination  of  the  nuclear  matter  of  the  sperm- 
cell  with  that  of  the  germ-cell.  Then  the  vitellus,  escaped  from  its 
enveloping  membrane,  becomes  depressed  in  a  circular  manner,  and 
breaks  up  into  independent  masses. 

This  change,  and  others  to  be  described,  takes  place  during  the  course 
of  the  impregnated  ovum  through  the  Fallopian  tube.  It  may  chance, 
however,  that  impregnation  takes  place  in  the  uterus ;  for  it  is  probable 
that  the  ovum  may  be  retained  there  for  a  certain  time  previous  to 
perishing  or  being  ejected,  and  that,  should  it  meet  the  spermatic  fluid, 
impregnation  will  ensue  and  the  usual  results  follow.^     But  it  is  more 

^  It  may  be  remarked  that,  with  multiparous  animals,  the  number  of  young  in  the 
cornua  are  not  in  proportion  to  the  corpora  lutea  of  the  same  period.  Franck  mentions 
an  instance  in  which  there  were  eleven  corpora  lutea  and  only  five  foetuses  ;  from  which 
it  might  be  inferred  that  six  ova  had  perished,  or,  if  they  had  been  impregnated,  that 
the  fcBtuses  must  have  died  at  a  very  early  period,  and  been  absorbed.  It  has  also  been 
stated  that  an  ovum  from  the  right  ovary  (which  bore  recent  traces  of  the  rupture  of  a 
Graafian  vesicle),  has  been  found  in  the  left  cornu,  whither  it  must  have  wandered. 
This  has  been  observed  in  woman,  in  the  Bitch,  the  Guinea-pig,  and  also  in  the  Sheep. 
Kehrer,  in  the  MonaUachrift  filr  iJeburtshnnde  (vol.  xxii.,  p.  225),  mentions  finding  a 
fcetus  in  each  horn  of  the  uterus,  and  in  the  right  ovary  two  true  corpora  lutea.  One 
ovum  had  migrated  to  the  left  cornu  by  means,  probably,  of  the  uterine  contractions. 


ril.iXdHS  IX  THE  OITM. 


69 


likely  that  the  initial  changes  are,  in  the  majority  of  instances,  accom- 
plished in  the  tube.  There,  the  ovum  is  bathed  and  moved  about  in 
the  clear  fluid  containing  the  spermatozoa,  by  the  peristaltic  action 
of  the  walls  of  the  duct,  in  order  to  enable  the  largest  number  of  the 
fertilising  particles  to  obtain  access  to  the  yolk,  and  thus  ensure 
fecundity. 

With  the  formation  of  the  embryo-cell,  the  vitellus  becomes  separated 
or  retracted  by  fluid  from  the  zona  pellucida,  and  begins  to  rotate 
therein  ;  while  one  or  two  minute  granular  or  oil-like  bodies  may  appear 
in  the  surrounding  fluid  (Fig.  38). 

A  division  or  segvicntation  of  this  primary  embryo-cell  into  two  portions 
(Fig.  39),  each  provided  with  a  nucleus,  is  the  next  step ;  then  there  is 
mutual  repulsion  of  these  secondary  globes,  and  further  cleavage  of  each 
into  two  portions  (Fig.  40),  and  these  again  into  other  binary  divisions 
(Fig.  41)  of  the  germ  yolk,  through  attraction  round  each  cell  of  the 
particles  contiguous  thereto,  until  the  whole  is  worked  up  into  a  mass 
of  finely  nucleated  corpuscles  —  the  ultimate  segmentations  of  the 
impregnated  parent  embryo-cell.  Each  of  these  corpuscles  contains  a 
colourless  pellucid  nucleus,  and  each  of  these  again  a  nucleolus.     The 


Fig.  38. 
Ovum   kkom  OvmrrT  nr  Rabbit, 

PKNETKATKD   HY  Si'KRMATOZOA    IN 
ITS  VlTKLLINK  LaVKR. 


Fig.  39. 

An  Ovum  more  auvan<ei)  in 
THB  OvinufT. 


eight-fold  cleavage  of  the  yolk  has  been  observed  three  days  after 
impregnation  in  the  Rabbit,  four  days  in  the  Guinea-pig,  and  ten  days 
in  the  Bitch  ;  and  always  in  the  ova  found  towards  the  uterine  extremity 
of  the  oviduct.  In  the  latter  animal  the  smooth  surface  of  the  zona 
pellucida  becomes  irregularly  flocculent,  as  if  a  granulo-mucous  substance 
had  been  deposited  thereon ;  in  the  Rabbit  the  ovum  acquires  a  thick 
adventitious  layer  of  albumin  before  entering  the  uterus  (Fig.  42,  n) ;  in 
the  Guinea-pig  the  zona  continues  smooth.  After  entering  the  uterus, 
on  the  fourth  day  the  zona  becomes  fainter,  as  the  final  segmentation 
or  rnulben-y  state  of  the  yolk  is  attained,  and  it  disappears  altogether 
when  the  germ-mass  is  completed.  The  act  of  impregnation  is  thus 
consummated,  and  a  series  of  new  changes  begin,  which  are  replete 
with  interest  and  importance. 

When  arrived  in  the  uterus,  a  layer  of  very  small  vesicles  makes  its 
appearance  on  the  whole  of  the  inner  surface  of  the  membrane  now 
investing  the  yolk.  The  viulbcrri/  structure  then  passes  from  the  centre 
to  a  certain  part  of  that  layer,  the  vessels  of  the  latter  coalescing  with 
those  of  the  former,  where  the  two  sets  are  in  contact,  to  form  a  mem- 
brane— the  future  amnion  ;  while  the  interior  of  the  mulbeny-like  body 


70 


OBSTMTHmAL  PMrSI^M^iV, 


is  now  seen  to  bo  occupied  by  a  large  vesicle,  coafeainiug  a  fluid  and 
dark  granules.  In  the  centre  of  this  fluid  is  a  spherical  body,  composed 
of  a  substance  having  a  finely  granular  appearance,  and  containing  a 
cavity  flUed  with  a  colourless  and  pellucid  fluid;  this  hollow  and 
spherical  body  seems  to  be  the  true  germ.  The  vesicle  oontaining  it 
disappears,  and  in  its  place  is  seen  an  elliptical  depression,  filled  with  a 
clear  fluid,  and  in  the  centre  of  this  is  the  "  germ,"  still  presenting  the 
appearance  of  a  hollow  sphere. 

The  fluid  presses  the  nucleate  corpuscles  of  the  yolk  outwards  against 
the  inner  face  of  the  enveloping  membrane,  and  as  it  increases  the  pres- 
sure from  within  flattens  these  corpuscles,  until  they  resemble  pavement 
epithelium :  and,  finally,  they  all  coalesce  to  compose  a  membrane 
lining  the  zona,  which  has  been  named  the  blastoderm.  This  blasto- 
dermic vesicle  divides  into  two  layers — an  external  and  internal — the 
first  of  which  is  pale  and  only  slightly  granular,  while  the  cells  of  the 
second  are  filled  with  fat  granules  ;  it  is  consequently  of  a  deeper  tint. 


Fig.  40. 
Ovxm  v«om  the  UTEBrerii:  ealji'  ov 

OrtDUGT. 


r  ig.  41. 

OvTM  ritOM  THE  Ul'EEIXE  BSD  Off  THE 
OvLUrCT,  WITH  A>"  AUPmOBtil 
LATER   OF   ALBCMtS. 


Though  the  foregoing  changes  in  the  impregnated  ovum  have  been 
chiefly  observed  in  the  Rabbit  and  Guiuea-pig,  yet  there  can  be  little 
doubt  that  they  are  of  the  same  character  in  the  domestic  creatures 
whose  embryology  we  are  now  studying. 

It  is  only  to  be  remarked  that,  in  hoofed  animals,  no  envelope  of  the 
ovum  is  superadded  to  the  zona  pellucida  before  it  enters  the  utems ; 
impregnation  of  the  ovum  taking  place  in  the  Fallopian  tube,  where  it 
meets  the  spermatozoa,  the  first  stages  of  cleavage  in  its  interior  go  on 
there,  but  the  germ-mass  is  completed  in  the  uterus.  In  this  proce^ 
the  zona  thins  away  and  fixially  disappears,  and  a  mass  of  albuminoiel 
matter  accumulates  arouud  the  ovum,  which  affords  material  for  imbibi- 
tion. The  germ-mass  becomes  fluid  at  the  centre,  and  expands  into  a 
hoEow  sphere,  the  hollow  wall  of  which  ofl:ers  two  layers  :  both  consist- 
ing of  coherent  cells,  and  only  differing,  as  just  remarked,  in  the  size 
and  proportion  of  the  oil-globules. 


DKrEI.iiI'MKXr  OF  THE  KMIinVO.  71 


SECTION  I.— DEVKLOPMENT  OF  THE  EMBRYO. 

The  ovum  having  been  lodged  in  the  uterus,  and  the  f/erm-mcmhraTie 
or  blastoderm  having  divided  into  two  layers — an  upper  or  seroics,  and  a 
lower  or  mucous — and  between  which,  at  a  later  period,  a  vascular  layer 
is  developed,  another  modification  occurs  by  which  the  outline  of  the 
embryo  becomes  evident. 

In  the  centre  of  the  blastoderm,  where  it  is  supposed  to  divide  into 
these  layers,  there  is  observed  a  clear  space  which  has  been  designated 
the  area  jtrolujera  or  pcllucula,  in  the  centre  of  which,  and  in  the  trans- 
verse axis  of  the  vitellus,  there  is  going  on  a  multiplication  of  loosely 
connected  cells  in  a  small  rounded  mass,  which  forms  the  rjerminative 
area,  primitive  streak,  or  trace  of  Von  Baer  ;  while  around  this  another 
space — the  area  vasculosa — is  developed.  The  •'  primitive  streak  "  is 
the  centre  where  the  blastoderm  commences  to  be  separated  into  the 
external  and  internal  layers  ;  the  middle  layer,  which  is  to  form  the 
foetal  organs,  not  extending  beyond  the  "germinative  area"  or  "streak." 


Fig.  42. 

Blastodkbm  and  Pkimitivk  Thack. 

a.  Vitelline  Membrane  with  iti)  <X)iiiiiiencing  VilloBities  ;  h,  External  (or  Serous) 
Layer  of  the  Bl*«t<xierui  ;  r.  Internal  (or  Mucouh)  Layer  ;  d,  liody  of  the 
Embryo ;  //,  b'.  Earliest  Cephalic  and  Caudal  Elevation  of  the  External 
Layer. 

By  a  proliferation  of  the  elements  of  the  outer  and  middle  layers  of 
the  blastoderm,  the  primitive  trace  increases  in  surface  and  thickness, 
becoming  clearly  defined  and  prominent,  in  the  form  of  a  shield,  and  is 
named  the  opaque  area,  which,  when  it  grows  transparent  in  its  centre, 
is  named  the  transparent  or  pellucid  area  ;  the  clear  spot,  narrowing  or 
constricting  in  its  middle  part,  is  named  the  area  vasculosa  or  einhnjonic. 
In  the  middle  of  this  embryonic  area  appears  a  dark  line,  or  median 
furrow,  duo  to  changes  occurring  in  the  primitive  streak  ;  and  below  it  a 
round  cord — the  chorda  dorsalis — the  axis  of  the  future  embryo,  and 
which  is  to  develop  the  spine  ;  on  each  side  of  the  streak  is  the  lamina 
dorsalis,  and  the  portion  of  fluid  separating  them  from  the  chorda  dor- 
salis is  the  future  spinal  cord  and  brain.  The  inner  layer  of  the 
blastoderm,  at  the  points  corresponding  to  the  embryo,  becomes  doubled, 
so  as  to  form  a   new   layer — the  middle  layer.     The  chorda  dorsalis 


72  OBSTETRICAL  PHYSIOLOGY. 

thickens  at  the  front  part,  to  form  the  first  appearance  of  the  skull,  and 
the  fluid  between  the  dorsal  laminae  is  in  larger  quantity,  in  corre- 
spondence with  it ;  so  that  the  central  parts  of  the  nervous  system  and 
their  coverings  are  laid  down  at  the  same  time  and  grow  simultane- 
ously. The  separation  between  the  spinal  cord  and  brain  takes  place 
early,  being  coincident  with  a  curving  downwax'ds,  towards  the  yolk,  of 
the  anterior  part  of  the  laminae  dorsalis,  which  defines  the  limit  between 
the  skull  and  spine,  brain  and  cord. 

Next  follows  the  closing  of  the  dorsal  laminae  over  the  fluid  which  is 
to  constitute  the  brain  and  cord.  Two  other  laminge  are  in  the  mean- 
time proceeding  from  the  axis  of  the  embryo,  one  on  each  side.  They 
grow  out  laterally,  and  tend  to  converge  in  the  median  line,  as  did  the 
dorsal  laminae  ;  but  they  form  a  larger  curve,  and  follow  a  diiferent 
direction,  converging  to  meet  heloic  the  axis,  where  they  join,  except 
at  the  umbilicus. 

After  the  rudiments  of  organic  life  have  been  commenced  in  the 
central  portion  of  the  serous  layer,  a  fold  of  its  peripheral  portion 
arches  over  the  dorsal  surface  of  the  embryo,  so  as  to  represent  a  sac 
whose  opening  is  at  the  edge  of  the  fold.  The  opening  gradually 
decreases  until  the  opposing  folds  of  membrane  are  in  contact ;  it  then 
disappears,  leaving  the  fcetus  surrounded  by  two  membranes.  The  one 
next  the  foetus  is  the  amnion,  and  the  other  is  gradually  separated  from 
the  amnion,  and  joins  the  serous  lamina  of  the  blastoderm,  forming  the 
"  false  amnion  "  of  Pander,  or  the  "  serous  covering"  of  Von  Baer.  The 
membrane  surrounding  the  vitellus  or  yolk  is  very  vascular ;  it  becomes 
oval  in  shape,  and  more  pointed  when  it  is  in  contact  with  the  embryo, 
until  at  length  it  contracts  into  a  narrow  duct,  constituting  the  vesicula 
alba  and  duct.  Thus,  then,  we  have  seen  the  embryo  developed  in 
the  layers  of  the  blastoderm,  and  formed  by  a  gradual  closing  in  of  the 
laminae  towards  the  median  line  ;  the  brain  and  spinal  marrow,  which 
are  its  earliest  rudiments,  are  covered  in,  and  the  parts  anterior  to  the 
spine — the  thorax,  abdomen,  etc. — are  formed. 

We  will  now  direct  our  attention  to  changes  occurring  elsewhere,  and 
return  to  the  development  of  the  embryo  again. 

Towards  the  twelfth  day,  in  the  higher  orders  of  animals,  the  chief 
modifications  which  have  just  been  described  as  occurring  in  the  con- 
dition of  the  ovum  after  fecundation,  are  accomplished.  The  ovum 
then  measures  from  one-third  to  one-fourth  of  an  inch  in  diameter,  and 
is  composed  in  reality  of  four  layers  or  shells,  enclosed  one  within  the 
other,  but  only  three  of  which  are  complete;  they  are:  (1)  the  yolk 
membrane  ;  (2)  the  external  layer  of  the  blastoderm  ;  (3)  the  middle 
layer  ;  (4)  the  inner  layer. 

By  ulterior  modifications,  the  layers  of  the  blastoderm  form 
the  various  organs  of  the  foetus,  and  what  have  been  termed  its 
annexes,  or  enveloping  membranes.  The  diiferent  layers  have  also 
received  other  names  than  those  mentioned,  according  to  their  functions: 
thus,  the  external  or  serous  has  been  named  the  sensitive  layer,  because 
it  originates  the  epidermis  and  the  organs  of  sense  ;  the  middle  layer 
has  been  named  the  vascular  or  germinative,  as  it  contains  the  principal 
vessels  of  the  embryo,  and  the  locomotory  organs  are  developed  in  its 
substance  ;  while  the  internal  layer  is  known  as  the  mucous  or  intestino- 
glanclular,  from  its  constituting  the  mucous  membranes,  its  principal 
portion  forming  the  intestines  and  glands.  Each  of  these  layers 
furnishes,  in  the  course  of  its  development,  the  intra-foetal  and  the 


I'EVKlJiVMEST  <>F  rilE  KM /!/:)'<>. 


73 


extra-fcEtal  parts.  We  shall  examine  the  latter  first ;  merely  noting, 
in  the  meantime,  that  the  intra-fcetal  parts  of  the  external  or  sensitive 
layer  of  the  blastoderm  form  the  epidermis  and  its  appendages — as  the 
hair,  claws  or  hoofs,  glands  of  the  skin  etc. — the  central  nervous 
system,  and  the  organs  of  sense — sucli  as  the  retina  and  tlie  labyrinth 
of  the  ear ;  while  tlie  extra-foctal  parts  it  forms  are  due  to  its  alteration 
in  shape. 

The  foetus,  as  we  have  seen,  is  a  circular  body  applied  against  a 
certain  point  of  the  blastoderm,  whose  outer  layer  is  continuous,  and 
extends  over  the  internal  face  of  the  chorion  and  the  surface  of  the 
embryo  without  any  limit.  But  the  inflection  or  bending  of  the  latter 
at  its  two  extremities  causes  the  external  layer  to  become  depressed, 
and  to  constitute  two  folds ;  one  investing  the  head,  the  other  the 
opposite  extremity  of  the  body.  The  lateral  parts  of  the  embryo  are 
also  inflected  towards  each  other  to  form  the  thoracic-abdominal  cavity. 


r^. 


tr-vj^  •. 


Fig.  43. 

OvcM  Twenty  to  Twenty  kive  Days  Old. 

1,  VUlositie.s  of  the  Vitelline  Membrane  ;  2,  External  Layer  of  the  Bla.stoilerni, 
or  .Second  Chorion,  with  its  Villosities  ;  3,  Uiiiliilical  Vesicle,  formed  by 
the  Inner  Layer  <>f  the  Blastoderm  ;  4,  Vessels  of  the  Umbilical  Vesicle  ; 
5,  Cephalic  and  Caudal  Processes  ;  6,  Embryo ;  7,  Allantoid  Vesicle. 

and  it  is  thus  enclosed  in  the  serous  layer,  whose  sides  soon  meet  above 
the  back  of  the  young  creature,  and  a  short  pedicle — the  superior 
umbilicus — joins  the  two  portions  of  the  blastoderm.  This  pedicle  soon 
disappears,  and  the  embryo  is  then  enclosed  in  an  independent  sac — the 
amnion  already  referred  to.  The  sensitive  layer  is,  tlicrcfore,  decom- 
posed into  two  sections  :  an  internal,  the  amnion  ;  and  an  external,  the 
serous  vesicle,  which  is  applied  against  the  inner  face  of  the  zona 
pellucida,  and  concurs  to  form  the  cliorion. 

The  middle  layer  will  be  noticed  hereafter,  and  we  now  go  to  the 
internal  layer.  The  intra-fcetal  parts  of  this  so-called  "  mucous  layer  " 
form  the  epithelium  of  the  intestines  and  the  glands  belonging  thereto, 
the  respiratory  apparatus,  the  kidneys,  and  the  bladder.  These  organs 
are  developed  at  the  same  time  as  the  extra-fcrtal  parts. 
♦^  In  curving  in  upon  itself,  the  embryo  encloses  a  portion  of  the  internal 
blastodermal  layer,  but  the  union  between  the  free  and  the  imprisoned 
parts  is  at  first  largely  maintained  ;  soon,  however,  it  contracts,  and  in 


74 


OBSTETRICAL  PHYSIOLOGY. 


a  brief  period  is  only  represented  by  a  somewhat  narrow  canal,  the 
inferior  umbilical  ring.  The  mucous  layer  is  therefore  divided  into  two 
distinct  portions  :  the  intestinal  furrow,  or  intra-fcetal  portion  ;  and  the 
livihilical  vesicle,  vesicula  alba,  or  extra-fcetal  portion.  These  two 
divisions  communicate  by  the  omplialo-mescnteric  or  vitelline  duct.  The 
"  umbilical  vesicle"  is  filled  with  a  granular  fluid,  which  is  conveyed  by 
the  omphalo-mesenteric  vessels  for  the  nutrition  of  the  foetus;  when  this 
alimentary  reserve  is  nearly  expended,  the  allantois  appears.  This 
begins  by  a  small  enlargement,  which  the  intestinal  furrow  pushes 
towards  the  inferior  part  of  the  abdominal  cavity ;  the  enlargement 
becomes  elongated  and  vesicular-looking,  and  gradually  increases  in 
size  by  bringing  the  umbilical  vessels  towards  its  borders.     Becoming 


Fig.  44. 

Ovum  about  a  Month  Ou>. 

1,  Vitelline  Membrane  or  Primitive  Chorion,  which  has  almost  disappeared ; 
•2,  External  Layer  of  the  Blastoderm  or  Second  Chorion  ;  3,  Allantois  pene- 
trating the  Villosities  ;  4,  Umbilical  Vesicle  ;  5,  Union  of  the  Caudal  and 
Cephalic  Processes,  and  Formation  of  the  Cavity  of  the  Amnion  ;  6,  Embryo  ; 
7,  Allantois. 


still  more  elongated,  it  passes  through  the  umbilicus  and  spreads  itself 
over  the  inner  face  of  the  chorion,  betw^een  the  latter  and  the  amnion. 
It  is  divided  into  two  sacs  by  a  constriction,  the  urachiis,  at  the 
umbilical  ring ;  the  inner  sac  is  the  smallest,  and  forms  the  bladder  ; 
while  the  external,  the  most  voluminous,  composes  the  ^jro^er 
allantois. 

We  have  now  seen  that  the  vitelline  membrane,  lined  by  the  serous 
vesicle,  forms  a  complete  shell  around  the  ovum  in  process  of  develop- 
ment ;  and  that  the  layers  of  the  blastoderm  eventually  constitute  three 
membranous  sacs,  two  of  which  envelop  the  embryo.  These  various 
membranes  constitute  the  "  envelopes ''  or  "  annexes  "  of  the  young 
creature  during  utero-gestation,  and  in  describing  them  it  is  usual  to 
include  the  "  cord"  composed  of  bloodvessels,  as  well  as  the  capillary 
ramifications  which  establish  and  maintain  such  important  relations 
between  the  mother  and  its  offspring  during  this  period. 


ArrEyn.tdKs  of  thk  iw.tus. 


SECTION  II.— APPENDAGES  OF  THE  F(ETUS. 

The  appendages  or  annexes,  then,  comprise  the  chorion,  a  membranous 
envelope  exactly  adapted  to  the  uterus  ;  the  amnion,  a  second  ovoid 
sac  included  within  the  latter,  and  containing  the  fcetus  ;  the  allantoic, 
a  n^embrane  composed  of  two  layers,  wliich  are  spread  over  the  external 
face  of  the  amnion  and  the  inner  surface  of  the  chorion,  and  thus  lines 
the  cavity  formed  by  these  two  envelopes ;  a  small  bladder  of  a  pyri- 
form  shape,  the  umbilical  vesicle  ;  the  jylaccnta,  a  collection  of  vascular 
tufts  grafting  the  fcetus  to  the  mother;  and  the  umbilical  cord,  com- 
posed  of  vessels  that  attach  the  foetus  to  the  envelopes  which  contain  it, 
and  which  ultimately  ramify  in  the  placental  tufts.  We  will  describe  each 
of  these  in  detail,  as  a  correct  knowledge  of  their  anatomy  is  essential 
to  the  comparative  obstetrist.  As  before,  we  will  take  Solipeds  as  the 
type  of  comparison. 

Chokion. 

The  cJwrion,  the  outer  envelope  proper  to  the  ovum,  is  found  covering 
it  loosely  at  the  earliest  period  of  its  existence,  and  corresponds  to  the 
membrane    lining    the  egg  in  oviparous  animals.      It  is  a  vast  mem- 


Fig.  4r.. 

Chobiox  ok  thk  Mark  .\t  Mio-tkkm  :  Inklatkd. 

A,  Posterior  portion  occupying  the  Body  of  the  Utenis  ;  V,  Left  Cornu  plicated 
and  sacculated  ;  C,  Right  Cornu,  longer  than  the  left,  and  containing  a 
portion  of  the  Fcetus. 

branous  sac,  completely  closed,  and  which,  being  moulded  upon  the 
uterine  cavity,  resembles  the  uterus  in  form,  having  a  body  and  two 
cornua;  the  latter,  however,  are  not  co-extensive  witli  those  of  the 
uterus.  When  the  chorion  is  distended,  its  cornua  show  fine  and  deep 
plica;  or  bulgings,  like  the  caecum  ;  the  cornua  are  always  unequal  in 
size,  that  in  which  the  fcetus  is  developed  being  of  course  the  largest. 
The  external  surface,  otherwise  smooth,  is  studded  witii  innumerable 
small,  red,  short  papilla?  or  "  processes,"  which  are  formed  by  the 
placental  villous  tufts.  This  papillary  face  adheres  slightly  to  the 
internal  surface  of  the  uterus,  and  between  the  two  surfaces  a  trifling 
quantity  of  brown  or  blood-coloured  fluid  is  found.     The  inner  face  is 


76 


OBSTETRICAL  PHYSIOLOGY. 


lined  by  the  external  layer  of  the  allantois,  to  which  it  is  closely 
adherent  except  at  the  insertion  of  the  vascular  cord,  where  there  exists 
a  kind  of  conical  infundibulum  occupied  by  the  umbilical  vesicle.  On 
this  surface  the  umbilical  arteries  and  veins  ramify,  their  minute 
divisions  traversing  the  membrane  to  form  the  placental  villosities.    The 


Fig.  46. 

FcETAL  Membranes  of  the  Cow  at  Mid-term. 

A,  Uterus  opened  on  its  left  side  ;  B,  B,  Cotyledons  of  the  Uterus ;  C,  C,  Placen- 
tulse ;  D,  D,  Allantois  ;  E,  Vesicle  of  the  Urachus  ;  7,  Amnion  ;  G,  Um- 
bilical Cord. 


chorion  may  be  divided  into  two  laminae,  the  outer  of  which  has  been 
called  the  cxochorion,  and  the  inner  the  endochorion.  From  the  endo- 
chorion  are  derived  the  vessels  which  pass  to  the  villi,  the  chorion  itself 
being  destitute  of  vessels  until  the  allantois  is  developed.  The  structure 
of  this  envelope  is  that  of  a  delicate  cellular  membrane,  traversed  by 
the  vascular  ramifications  of  the  placenta.     In  many  places  its  cellular 


APPENDAGES  OF  THE  FtETrs. 


77 


arranirement  closely  resembles  that  of  vegetables,  each  ceil  containing 
a  distinct  nucleus  ;  the  villi  have  the  same  texture,  but  tlieir  cells  are 
tilled  with  a  granular  matter.  Tiie  strength  of  the  membrane  is  greatest 
in  the  early  ovum  ;  it  is  formed  by  the  zona  jicllucida,  which  is  lined  by 
the  external  layer  of  the  blastoderm.  It  is  thought  that  the  primitive 
chorion  disappears  by  resorption,  and  that  this  blastodermic  layer 
becomes  the  definitive  chorion  ;  also  that  when  the  allantois  lias  spread 


Fig.  47. 

F(KTAL    MrMBRANKS    OK   THK    (Jo.AT   AT    Fri.I,   Tl.MK:    TwiNS. 

A,  Cervix  of  the  I'teruM  ;  B,  Ltft  Cornu  ;  C,  Kiirht  Cornu  ;  J),  Allantois  of 
one  of  the  K.i'tuses  ;  K,  Amni-.n  „f  ditto  ;  F,  Portion  of  the  I'terine  Wall 
left  at  the  middle  of  its  Body,  where  the  Fa-tUHes  come  in  contact  ;  G,  I'nion 
of  the  Two  Chorions  at  the  Cervix  Uteri. 

itself  between  the  amnion  and  the  external  envelope,  carrying  outward 
the  umbilical  vessels,  this  detinitive  chorion  becomes  vascular,  and 
furnished  with  its  numerous  villosities. 

Differences. 

liuminants. 
In  Ruminants,  the  chorion  corresponds  to  the  internal  face  of  the 
uterus,  whose  form  it  repeats,  and  with  whose  surface  it  is  more  or  less 


OBSTETRIC  A  L  PHYSIOL  OG  Y. 


in  contact.  The  middle  of  its  inner  surface  is  united  to  the  amnion 
and  the  allantois  by  loose  gelatinous  connective  tissue,  so  laminated 
that  it  might  be  mistaken  for  different  layers  of  membrane.  It  is  only 
covered  by  the  allantois  in  the  portions  corresponding  to  the  cornua, 
which  are  longer  than  those  of  the  uterus.  It  offers  numerous  small  red 
masses,  studded  at  variable  distances  from  each  other  on  the  surface 
next  the  uterus,  and  w^hich  effect  a  very  important  connection  between 
the  latter  and  the  chorion.  These  are  the  placentida,  to  which 
we  shall  allude  presently. 

In  the  Sheep  and  Goat,  when  there  are  two  young  creatures,  the 
cornua  of  the  chorion  are  joined,  so  as  to  look,  externally,  like  one 
sac. 


Fig.  4S. 

F(ETUS    A.ND    1\KTAL    MeMBR.\NES    OF    THE    CaT. 

a,  a,  Chorion  ;  h.  Zonular  Placenta  ;  (/,  Umbilical  Vesicle,  with  its  Expansions, 
f,  between  Amnion  and  Placenta,  and  g,  its  Pedicle  of  attachment  to  a  loop 
of  small  intestine  ;  li,  Allantois  ;  Tc,  Foetus. 

Pig. 
In  the  Pig  there  are  no  cornua,  but  the  whole  appears  as  an  elongated 
sac,  whose  two  extremities,  much  exceeding  those  of  the  embryos,  are 
i-elated  to  the  envelopes  of  the  contained  progeny.  Its  internal  face  is 
similar  to  that  of  Euminants ;  on  its  external  face  are  groups  of 
numerous  small  papillae ;  so  that  placentation  in  this  animal  is  dis- 
seminated, though  here  and  there,  between  the  innumerable  groups  of 
papilliB,  are  bare  spots  merely  covered  with  epithelium,  and  there  are 
no  papillae  at  its  extremities. 

Bitch  and  Cat. 
In  the  Bitch  and  Cat,  the  arrangement  of  the  chorion  is  similar  to 
that  of  the  Pig  ;  it  has  no  cornua,  its  extremities  are  obtuse,  and  its 


APPENDAGES  OF  THE  FCETUS. 


79 


inner  face  is  everywhere  in  contact  with  the  allantois,  though  it  does 
not  adhere  closely  to  it. 

Amnion. 

The  amnion  is  the  second  complete  sac  enveloping  the  fcutus.     It 
lloats  freely  in  the  chorial  sac,  to  which  it  is  only  attached  at  a  single 


Tig.  r.'. 

FcKTl'S    OK    MaUK    AM)    ITS    ExVKLOPES. 

A,  Chorial  Sac  ;  C,  Amnii)tic  Sac  withdrawn  from  the  Allantoid  Cavity,  and 
opened  to  expose  the  Fiutus  ;  1),  Infundilxiliun  of  the  I'rachns  ;  V>,  Allantoid 
portion  of  the  I'nibilical  Cord  :  h,  Portion  of  the  Kxtcrnal  Surface  of  the 
Chorion  destitute  of  Placental  Villosities,  and  correnponding  to  the  j)oint  of 
insertion  of  three  pediculated  llippomanes. 

point,  through  the  medium  of  the  umbilical  cord  ;  and  it  contains  the 
ftctus,  which  is  fixed  to  its  inner  face  by  the  same  means.  It  is  formed 
by  the  external  layer  of  the  blastoderm.  It  envelops  the  embryo  very 
closely  at  an  early  period,  and  is  continuous  with  the  common  integu- 
ment of  the  foetus  at  the  open  abdominal  parietes.     At  a  later  period  it 


80  OBSTETRICAL  PHYSIOLOGY. 

is  distended  with  fluid,  and  so  is  separated  from  the  foetus  ;  and  after 
being  reflected  upon  the  funis,  of  which  it  forms  the  outer  coat,  it 
terminates  at  the  umbilicus.  In  shape  it  is  at  first  spherical,  but  is 
afterwards  ovoid,  and  it  has  thin  transparent  walls.  The  external  face 
is  covered  by  the  inner  layer  of  the  allantois,  to  which  it  slightly 
adheres.  The  internal  face  is  quite  smooth,  and  applied  more  or  less 
directly  to  the  skin  of  the  foetus.  It  exhales  or  secretes  a  fluid — the 
liquor  amnii — which  bathes  the  foetus,  and  serves  an  important  purpose 
in  intra-uterine  life. 

In  the  foetus,  as  above  mentioned,  the  amnion  is  continuous  with  the 
skin  around  the  umbilicus,  and  is  constituted  by  two  superposed  layers: 
one,  a  very  fine  fibrous  membrane  that  adheres  to  the  allantois  ;  and 
another,  an  epithelial  layer,  which  lines  the  inner  face  of  the  latter. 
At  certain  points  of  its  internal  surface  in  Solipeds,  according  to  some 
authorities,  though  denied  by  others,  there  are  small  white  opaque 
masses  of  what  are  supposed  to  be  epidermic  cells  ;  hence,  this  mem- 
brane has  been  designated  a  true  epidermis  of  the  blastoderm.  Though 
thin  and  transparent,  it  is  nevertheless  of  a  firm  texture,  and  resists 
laceration  better  than  the  other  membranes.  It  does  not  exhibit  either 
vessels  or  nerves  when  in  a  healthy  condition.  When  the  amniotic  sac 
is  inflated,  there  is  observed,  at  the  portion  adjoining  the  infundibulum 
of  the  urachus,  a  kind  of  vascular  plexus,  having  the  shape  of  a  goose's 
foot,  between  the  branches  of  which  the  two  superposed  layers  are 
much  less  transparent  than  elsewhere.  At  this  part,  between  the 
amnion  and  the  allantois,  is  the  small  membranous  pouch,  quite 
empty,  in  which  the  umbilical  vesicle  terminates  ;  and  here  also  the 
amniotic  sac  forms,  opposite  the  cord,  a  little  conical  cul-de-sac. 
Towards  the  termination  of  gestation,  one  of  the  extremities  of  the  pouch, 
corresponding  to  the  posterior  limbs  of  the  foetus,  is  stretched  into  a 
very  short  wide  horn. 

LiQUOK   x\mnii. 

The  liquor  amnii  is  an  albuminous  alkaline  fluid  contained  in  the 
amniotic  sac,  in  which  the  foetus  is  suspended  as  in  a  hydrostatic 
bed.  It  is  in  greater  or  less  quantity,  according  to  the  period  of  gesta- 
tion— being  abundant  and  limpid,  or  slightly  lactescent,  at  an  early 
period  ;  and  becoming  scantier,  viscid,  and  citron  or  reddish-tinted  at 
an  advanced  stage,  when  it  is  adhesive  and  agglutinates  the  hair.  In 
a  Mare  twenty-one  weeks  pregnant,  Gurlt  found  two  pounds  twelve 
ounces  of  fluid ;  in  another  at  thirty-six  weeks,  four  pounds  five 
ounces  ;  and,  finally,  in  one  about  the  fortieth  week,  the  allantoid  and 
amniotic  fluids  weighed  collectively  nineteen  pounds  and  half  an 
ounce.  Its  colour  during  this  period  may  be  due  to  the  meconium 
thrown  out  from  the  digestive  passages  of  the  foetus  ;  and  its  composi- 
tion doubtless  varies  with  the  development  of  the  latter.  It  is  some- 
what salt  to  the  taste,  and  contains  99  per  cent,  of  water,  as  well  as 
albumin,  mucosine,  kreatin,  glycose,  and  salts,  the  chief  of  which  are 
chlorides  of  sodium  and  potassium,  and  the  sulphate  and  phosphate  of 
lime.  There  is  also  a  yellow  matter  analogous  to  bile,  as  well  as  urea. 
A  peculiar  acid,  the  amniotic,  has  also  been  found  in  it,  in  addition  to 
fragments  of  meconium  from  the  intestines  of  the  foetus,  epithelial  cells 
and  their  nuclei,  besides  portions  of  the  thick  epidermis  which  covers 
the  plantar  surface  of  the  hoof  of  Solipeds.  Towards  the  end  of  gestation 
the  albumin  diminishes.     Probably  the  formation  of  the  mucous  layer 


APFEXDAdES  OF  THE  F(ETUS.  81 

that  invests  the  young  animal  at  birth,  is  due  to  the  precipitation  on  its 
skin  of  the  mucus  and  yellow  matter  contained  in  this  lluid.  Hoppe- 
Seyler  gives  its  cliemical  composition  as  water,  holding  in  solution  a 
small  quantity  of  casein,  kreatin,  lactic  acid,  grape-sugar,  and  saline 
matter,  and  therefore  resembling  very  dilute  serum. 

The  «5t'5  of  the //(/uor  a??in»"  are  varied  and  important.  It  is  not  very 
probable  that  it  serves  as  nutriment  for  the  fa'tus  in  the  early  period  of 
intra-uterine  life  ;  though  it  has  been  found  in  the  stomach  of  those 
young  animals  which  had  been  purposely  fro/en  in  their  membranes,  and 
then  dissected  ;  portions  of  the  hoof  epithelium  have  also  been  dis- 
covered in  the  fcctal  stomach.  It  preserves  an  equable  temperature  for 
the  young  creature;  maintains  the  integrity  of  its  exterior  before  the  skin 
is  covered  by  the  peculiar  sebaceous  coating  ;  favours  its  movements  and 
its  development,  by  removing  it  from  unequal  pressure  ;  diminishes  the 
impression  from  sudden  external  movements  and  shocks,  thus  preserving 
it  from  injury  ;  and  allows  it  to  obey  the  laws  of  gravitation.  It  also  pro- 
tects the  mother  from  injury  by  the  foetus,  towards  the  termination  of 
gestation.  During  parturition,  it  protrudes  the  membranes ;  is  the  primary 
agent  in  dilating  tlae  os  uteri ;  shields  tlie  foetus  from  the  direct  action 
of  the  uterine  contractions,  whose  violence  might  compromise  its 
existence  ;  renders  the  dilatation  of  the  os  easy  and  prompt ;  and, 
finally,  by  lubricating  the  vagina,  causes  the  passage  of  the  fotus 
through  it  to  be  more  gentle  and  expeditious  than  it  would  otherwise 
be. 

Differences  in  the  Amnion  of  other  Animals. 

Biiminants. 

The  amnion  in  Ruminants  is  similar  to  that  of  the  Mare.  It  is  eauly 
separated  into  two  layers,  and  shows  on  its  inner  surface,  particularly 
near  where  it  invests  the  umbilical  cord,  a  large  number  of  whitr  or 
yellowish- white  bodies.  In  the  Cow  these  are  sometimes  elongated  in 
the  form  of  papillae;  at  other  times  they  exist  in  flattened,  slightly 
raised  patches,  about  one-fourth  of  an  inch  long.  Sometimes  they  are 
single  ;  occasionally  they  are  in  clusters.  They  consist  of  large,  flat, 
nucleated  cells,  resembling  a  squamous  epithelium  ;  it  is  concluded 
that  they  are  the  seat  of  formation  of  a  glycogenic  material.  Up  to  a 
certain  period  of  intra-uterine  life  they  increase  in  size,  and  then 
degenerate — their  organization  and  development  being  in  inverse  relation 
to  the  development  of  the  liver,  whose  function  they  assume,  with  regard 
to  glycogenation.  Externally  the  amnion  is  altogether  in  contact  with 
the  allantois  and  chorion. 

Puj. 

It  does  not  differ  in  the  Pig. 

Difch  and  Cat. 
In  the  Bitch  and  Cat  the  amnion  is  entirely  covered  by  the  amniotic 
layer  of  the  allantois,  to  which  it  adheres  in  the  same  manner  as  in  the 
^lare  ;  the  two  membranes  are  only  separated  by  the  umbilical  vesicle, 
and  there  is  no  trace  of  the  pouch  and  vascular  plexus  seen  in  that 
animal.  In  the  amniotic  liquid,  crumbs  of  meconium  are  found  towards 
the  end  of  gestation. 

Allantois. 
The  allantois  arises  on  the  front  part  of  the  posterior  extremity  of  the 
mucous  layer  which  is  closing  to  form  the  intestine,  as  a  growth  of  the 

6 


82 


OBSTETRICAL  PHYSIOLOGY. 


intestine,  which  proceeds  very  rapidly.  It  passes  out  where  the  ventral 
laminae  are  still  unclosed,  in  the  region  of  the  umbilicus,  and  reaches, 
either  mediately  or  immediately,  the  inner  surface  of  the  exochorion. 
By  the  constriction  of  the  umbilicus,  it  is  separated  into  two  portions 
which  communicate  ;  that  within  the  body  of  the  embryo  is  the  saccu- 
lated urinary  bladder,  with  the  uraclms  or  tube  of  communication.  It 
receives  its  vessels  from  the  hypogastric  artery  ;  these  are  spread  out 
as  a  vascular  layer,  especially  upon  that  portion  of  its  surface  which 
faces  the  exochorion.  The  vessels  form  a  distinct  layer — the  endo- 
cliorion.  As  a  membrane  it  lines  the  inner  face  of  the  chorion,  and  is 
reflected  around  the  point  of  insertion  of  the  umbilical  cord,  to  be 
spread  over  the  outer  face  of  the  amnion  ;  in  this  way  it  transforms  the 
chorionic  sac  into  a  kind  of  serous  cavity,  in  which  the  amniotic  sac  is 
enclosed  like  a  viscus. 

The  inner,  or  amniotic  layer,  is  so  loosely  united  to  the  amnion,  that 


Fig.  50. 

A,  Foetus ;  B,  Cavity  of  the  Amnion  ;  C,  Cavity  of  the  Allantois  ;  D,  Um- 
bilical Vesicle  :  1,  Chorion  ;  2,  Chorial  Layer  of  the  Allantois  ;  3,  Amniotic 
Layer  of  the  Allantois  ;  4,  Amnion  ;  5,  Urachus,  the  expansion  of  which 
forms  the  Allantois  ;  6,  Pedicle  of  the  Umbilical  Vesicle. 


a  slight  dissection  or  inflation  will  readily  detach  it.  When  inflation 
is  practised,  the  separated  membrane  presents  a  wavy  appearance,  from 
the  presence  of  numerous  cellular  attachments  it  has  with  the  amnion  ; 
as  the  inflation  is  forced  these  bands  tear  with  a  noise  like  the  crackling 
of  parchment,  and  with  care  the  whole  of  the  portion,  which  is  equal  in 
extent  to  the  amnion,  may  be  removed.  The  chorial  allantois  adheres 
much  more  firmly,  and  in  some  parts  it  can  scarcely  be  dissected  away. 
Inflation,  however,  demonstrates  its  existence  and  continuity  with  that 
on  the  amnion  ;  for  if,  after  opening  the  allantoid  sac  by  cutting  through 
the  chorion  and  the  layer  covering  it,  we  introduce  a  tube  between  the 
two  membranes — which  is  easily  done  near  a  large  vessel,  a  slight 
inflation  causes  the  air  to  penetrate  between  the  allantois  and  chorion, 
though  only  in  the  track  of  the  vessels  of  a  certain  size,  where  the 
adherence  is  slight ;  a  more  powerful  inflation  will  cause  the  air  to 
follow  the  smaller  vascular  ramifications,  and  render  the  membrane 
still  more  apparent,  but  not  at  the  points  vrhere  the  vessels  have  almost 


Jf'I'/-:\f>.lf,'ES  OF  THE  FCETCS.  83 

become  capillaries.  If,  instead  of  forcinfr  the  air  towards  the  ramifica- 
tions, it  is  sent  in  the  contrary  direction,  it  will  be  seen  to  pass  to  that 
])ortion  of  the  membrane  covering  the  umbilical  cord,  and  insinuate 
itself  between  the  amnion  and  the  layer  of  allantois  enveloping  it,  thus 
proving  the  continuity  of  the  membrane. 

As  has  been  stated,  the  cavity  of  this  sac  is  in  communication  with 
the  interior  of  the  bladder  by  means  of  the  nracJnis — a  narrow  canal  in 
the  amniotic  portion  of  the  umbilical  cord,  and  which  widens  at  the 
origin  of  the  allantoidean  portion,  where  its  walls  are  continuous  with 
the  amniotic  layer  of  the  membrane,  as  well  as  the  chorial  layer,  after 
being  prolonged  as  a  sheath  around  the  cord.  These  arrangements 
show  the  allantoid  cavity  to  be  a  kind  of  urinary  reservoir  or  dependency 
of  the  bladder,  the  fundus  of  which  is  prolonged  in  an  infundibular 
manner  as  far  as  the  umbilicus,  to  constitute  the  urachus,  which  follows 
the  umbilical  vessels  in  the  amniotic  portion  of  the  cord,  and  ends  by 
forming  the  allantoid  cavity. 

The  structure  of  this  membrane  is  slightly  fibrous,  with  a  layer  of 
epithelium  ;  it  is  thin  and  pellucid,  and  appears  to  be  destitute  of 
vessels  at  a  late  period  of  fcetal  life.  It  bears  on  its  surface  the  umbilical 
vessels,  from  the  umbilicus  to  the  chorion. 

The  allantois  contains  a  fluid — the  allantoic  liquid — the  quantity  of 
which,  like  that  of  the  amnion,  is  greatest  at  an  early  period.  It  is 
then  colourless  or  slightly  turbid  ;  but  with  the  growth  of  the  foetus  it 
gradually  assumes  a  yellowish  hue,  until  near  parturition,  when  it  is 
brown.  It  presents  somewhat  the  same  physical  properties  as  the 
liquor  amnii,  and  contains  albumin,  osmazone,  a  nitrogenous  mucilagi- 
nous matter  insoluble  in  alcohol,  a  particular  principle  named  allanto'inc, 
which  appears  to  be  the  urate  of  urea,  with  lactic  acid,  lactate  of  soda, 
and  phosphates  of  soda,  lime,  and  magnesia.  Allantoic  acid  is  not 
found  in  this  fluid  in  Rolipeds.  In  addition  to  the  large  percentage  of 
water,  there  is  a  notable  proportion  of  sugar  at  an  early  epoch  of  fcetal 
life  ;  this,  however,  gradually  and  linally  disappears  towards  the  ter- 
mination of  gestation. 

It  is  probable  that  before  the  fa-tal  circulation  is  fully  established,  the 
allantoid  fluid  serves  to  nourish  the  young  creature,  but  that  towards 
the  end  of  gestation  it  is  a  product  of  the  urinary  secretion  of  the  foetus. 
It  is  certain  that  as  gestation  approaches  its  termination,  the  renal 
excretion  of  the  young  animal  passes  from  the  bladder  along  the 
urachus,  and  deposits  near  the  allantoic  orifice  of  that  tube  a  thick  fluid 
of  a  reddisli  colour,  and  possessing  a  urinous  odour  ;  it  contains  uro- 
erithrin  and  hippuric  acid. 

The  fluid  contains,  besides,  whitish  filaments,  and  small  oval  or 
discoid  masses  of  a  brownish  colour  from  the  size  of  a  pea  to  that  of  a 
hen's  egg,  either  floating  about  in  the  cavity  or  attached  to  the  allantois 
by  a  narrow  pedicle.  Sometimes  they  are  very  niimerous,  and  at  other 
times  there  is  only  one.  From  the  fanciful  notions  attached  to  them  in 
ancient  times,  they  were  named  the  "  hippomancs."  Usually  they  have 
the  consistency  and  elasticity  of  gluten,  are  flattened,  and  are  thinner 
at  the  border  than  the  centre.  Those  attached  to  tBe  allantois  are 
generally  pyriform,  and  their  pedicle  is  narrower  as  they  ai-e  more 
developed  :  proving  that  the  loose  bodies  in  the  fluid  were  originally 
appendages  of  the  allantois.  It  is  not  improbable  that  they  are  inspis- 
sated parts  of  the  allantoic  fluid  which  were  originally  deposited  upon 
the  membrane.     They  contain  much  oxalate  of  lime. 


81  OBSTETRICAL  PHYSIOLOGY. 

Differences. 

BiUminants. 

In  Ruminants  the  allantois  is  different  to  that  of  the  Mare,  being  less 
complex.  It  represents  a  very  elongated  cavity,  the  middle  portion  of 
Mrhich  is  not  extensive,  and  receives  the  insertion  of  the  urachus  ;  while 
its  extremities,  which  are  unequal,  are  prolonged  into  the  cornua  of  the 
chorion,  where  they  are  attached  by  a  small  ligament.  This  sac  is  in 
reality  an  expansion  of  the  urachus  ;  it  is  always  thrown  back  on  one 
of  the  sides  of  the  amnion.  In  the  completely  developed  foetus, 
even  at  birth,  the  allantois  still  communicates  directly  with  the  bladder 
by  means  of  the  urachus.  Frequently  in  the  Sheep  this  membrane 
exceeds  the  chorion,  and  in  the  case  of  twin  embryos,  although  the  two 
chorial  sacs  unite  by  one  of  their  cornua,  there  is  only  a  simple  external 
union  between  the  two  allantoid  membranes,  the  cavities  remaining 
isolated. 

Laminated  deposits,  like  the  Jdppomanes,  are  found  in  the  allantoic 
fluid  of  Euminants,  though  not  very  frequently.  These  deposits  are  less 
dense,  smaller,  and  of  a  lighter  colour. 

Pig. 
In  the  Pig  the  allantois  does  not  offer  any  marked  difference  from  that 
of  Euminants,  except  that  it  is  less  sacculated,  and  shows  at  the  ex- 
tremity of  each  cornua  a  small  portion  projecting  beyond  the  chorion, 
which  it  seems  to  pierce,  while  it  is  strangled  by  a  kind  of  rings  formed 
by  that  envelope.  In  the  gelatinous  tissue  connecting  the  allantois  to 
the  chorion  are  numerous  small,  white,  spherical  bodies,  each  possess- 
ing a  distinct  capsule ;  they  are  composed  of  multitudes  of  circular 
cells,  the  size  of  lymph  corpuscles,  and  quantities  of  granular  particles 
— being,  in  fact,  histologically  the  same  as  the  hij^j^onianes ,  with  which 
they  are  probably  homologous. 

Bitch  and  Cat. 
In  the  Bitch  and  Cat  it  is  disposed  in  the  same  fashion  as  in  Solipeds. 
Its  external  layer  adheres  less  closely  to  the  chorion,  except  at  the  part 
corresponding  to  the  placenta,  where  it  is  more  intimately  united. 

Umbilical  Vesicle. 

The  umhilical  vesicle,  saccus  intestinalis,  or  vcsicida  alba,  is  a  small 
fusiform  or  pyriform  pouch  lodged  in  the  infundibulum  at  the  extremity 
of  the  umbilical  cord.  Its  fundus  adheres  to  the  chorion,  while  the 
opposite  end  is  prolonged  to  a  certain  length  in  the  substance  of  the 
cord,  being  even  continued,  in  the  very  young  foetus,  to  the  abdominal 
cavity  by  a  narrow  canal  that  communicates  with  the  terminal  portion 
of  the  small  intestine. 

This  pouch  has  a  red  colour,  due  to  its  great  vascularity,  its  walls 
receiving  a  special  vessel  from  the  anterior  mesenteric  artery ;  the  ter- 
minations of  this  vessel  give  rise  to  a  corresponding  vein  that  terminates 
in  the  vena  portae.  These  are  the  two  omphalo-mesenteric  vessels.  The 
umbihcal  vesicle  in  Solipeds  is  constantly  present  as  a  normal  formation 
in  the  earlier  months  of  foetal  development,  being  formed  from  the 
extra-foetal  portion  of  the  internal  layer  of  the  blastoderm.  It  is  con- 
nected with  the  intestinal  canal  of  the  foetus  ;  being  in  reality  the 
vitellus  surrounded  by  the  blastoderm  upon  which  the  embryo  is  first 
formed ;  and  it  bears  a  perfect  analogy  to  the  yolk  of  the  egg,  except 
that  it  is  not  ultimately  enclosed  within  the  foetal  abdomen.     It  is  a. 


THH  I'l.ACKXTA.  Sf) 

transitory  organ,  and  in  the  last  months  of  foetal  life,  though  in  Solipeds 
traces  of  it  continue  until  parturition,  it  is  always  more  or  less  atrophied, 
its  cavity  has  disappeared,  and  nothing  is  left  of  it  but  a  small  reddish- 
brown  cord,  adhenng  to  one  of  the  sides  of  the  infundibulum.  Its 
vessels  also  atrophy  in  the  same  manner,  the  artery  being  nearly  always 
found  reduced  to  the  dimensions  of  a  thread. 

Its  use  is  evidently  to  contain  nutriment  for  the  foetus,  before  the 
development  of  the  placenta  ;  though  it  may  also  serve  other  purposes. 
It  is  the  first  organ  which  elaborates  and  supplies  blood  to  the  fcetus. 
In  some  instances  the  chorion  has  been  found  perforated  at  its  junction 
with  the  umbilical  vesicle,  which  was  therefore  in  communication  with 
the  cavity  of  the  uterus. 

Differences. 

Ruminants  and  Pig. 
In  Ruminants  and  the  Pig,  the  umbilical  vesicle  is  longer  than  in 
Solipeds  ;  it  also  bulges  in  the  middle,  and  its  ends  terminate  in  a  canal. 
It  is  longest  about  the  twenty-fifth  day,  and  disappears  very  early  ;  no 
traces  of  it  can  be  observed  between  the  second  and  third  month, 
after  the  abdominal  parietes  have  been  formed. 

Bitch  and  Cat. 

In  the  Bitch  and  Cat  it  remains  very  developed  up  to  the  time 
of  parturition,  and  in  form  resembles  the  allantois  of  the  Pig.  It 
is  a  transversely  elongated  sac  (Fig.  48,  d),  extending  into  the  pointed 
cornua  ( ;/')  comprised  between  the  amnion,  the  inner  layer  of  the  allan- 
tois (h),  and  the  placenta  (b) ;  it  is  provided  at  its  middle  part  with  a 
narrow  pedicle  (<j),  which  is  prolonged  into  the  umbilical  cord  and  has 
very  vascular  walls. 

The  Placenta. 

The  placenta  varies  extremely  in  different  species.  In  Solipeds  it  is 
constituted  by  a  multitude  of  short  villosities  or  filiform  papilke,  which 
are  spread  in  a  uniform  manner  over  the  whole  external  surface  of  the 
chorion  {diffused  villi  or  placenta,  constituting  a  chorion  frondosum)  ; 
though  there  is  sometimes  observed  a  tendency  to  bare  patches,  one 
especially  being  noticed  opposite  the  os  uteri,  where  there  is  no  mucous 
membrane  for  the  villi  to  penetrate.  These  villi  are  received  into  cor- 
responding depressions  or  follicles  in  the  lining  membrane  of  the  uterus. 
The  villi  are  verj-  red  in  colour,  and  consist,  like  the  chorion  itself,  of 
an  epithelial  and  a  vascular  layer,  they  being,  in  fact,  the  terminal 
ramifications  of  the  vessels  of  the  umbilical  cord.  They  are  slender  and 
easily  torn  ;  and  each  is  composed  of  a  small  quantity  of  delicate 
nucleated  connective  tissue,  covered  by  a  simple  epithelial  layer,  enclos- 
ing the  capillary  vessels,  which  are  arranged  in  loops  made  uj)  of  a 
principal  arteriole  and  two  veins,  there  being  generally  only  a  single,  or  at 
most,  a  double,  capillary  loop. 

The  villosities  of  the  fietal  placenta,  penetrating  the  newly-formed 
crypts  in  the  uterine  mucous  membrane,  bring  the  capillary  systems  of 
mother  and  fcetus  into  the  closest  relationship,  only  the  very  thin  coats 
of  the  vessels  and  the  epithelium  inter\-ening  in  the  two  circulations. 
There  is  no  fusion,  vascular  continuity,  or  direct  communication 
between  the  maternal  and  foetal  systems,  as  was  at  one  time  taught ; 
all  the  important  changes  that  occur  taking  place  through  the  walls  of 
the  capillaries  by  virtue  of  osmotic  force. 

The  function  of  the  placenta,  then,  is  to  minister  to  the  nutrition 


86  OBSTETRICAL  PHYSIOLOGY. 

and  development  of  the  foetus  by  means  of  its  intimate  relations  with 
the  uterine  vascular  system,  until  the  time  has  arrived  for  the  expulsion 
of  the  young  animal.  Notwithstanding  their  close  apposition,  the 
adherence  of  this  papillary  layer  of  the  chorion  with  the  inner  surface 
of  the  uterus  is  so  slight,  that  this  organ  can  scarcely  be  opened  with- 
out more  or  less  destroying  it.  A  small  quantity  of  a  brownish  fluid  is 
found  between  the  two. 

At  an  early  stage  of  gestation  there  is  no  placenta  ;  a  temporary  mass 
of  albuminoid  substance  accumulating  around  the  ovum  in  the  uterus, 
affords  material  for  its  nourishment  until  the  vascular  intussusceptive 
relations  between  the  chorion  and  uterine  lining  are  established.  When 
gestation  is  terminated,  the  placenta  becomes  remarkably  rigid,  the 
vessels  are  obliterated  and  transformed  into  fibrous  tissue,  and  the 
external  face  of  the  chorion  is  wrinkled  and  withered-looking. 

Differences. 
Coic. 

In  Euminants,  there  is  an  important  difference  in  the  arrangement  of 
the  placenta  from  that  just  described.  In  the  Cow  the  villi  of  the 
chorion  are  developed  and  agglomerated  in  large  numbers  at  certain 
points  of  its  surface,  to  constitute  a  multiple  or  tufted  placenta,  which 
is  composed  in  this  way  of  from  sixty  to  eighty  placentidc2,  or  "  foetal 
cotyledons."  These  are  of  a  bright  red  colour,  of  various  sizes,  and 
generally  oval  in  shape ;  they  correspond  to  the  prominences  on  the 
lining  membrane  of  the  uterus  from  which  the  deciduous  maternal  parts 
of  the  placenta  grow,  and  which  have  been  already  described  as  the 
"maternal  cotyledons"  or  "placentse";  into  these  latter  the  foetal 
processes  are  received.  The  maternal  cotyledons  are  nothing  more,  as 
has  been  stated,  than  appendages  or  thickened  points  of  the  mucous 
membrane,  whose  utricular  follicles,  more  numerous  than  elsewhere, 
have  become  enormously  enlarged,  and  crypts  have  been  formed.  They 
are  permanent,  as  before  conception  they  are  certainly  present  on  the 
inner  surface  of  the  uterus,  and  traces  of  them  may  be  already  found  in 
the  foetus  of  four  or  five  months ;  observation  also  appears  to  have 
demonstrated  that  they  may  be  increased  in  number,  or  regenerated, 
when  accidental  circumstances  render  those  in  existence  insufficient. ^ 
They  have  been  discovered  in  the  foetus  in  process  of  formation,  and 
regularly  disposed,  beside  the  ordinary  cotyledons. 

Ghauveau's  experiments  have  proved,  that  after  all  these  placentulae 
have  been  extirpated  from  the  uterus  of  the  px'egnant  Cow,  sterility 
does  not  necessarily  follow ;  but  if,  on  the  contrary,  the  animal  sur- 
vives the  operation,  it  is  still  capable  of  breeding.  In  such  circum- 
stances, accessory  cotyledons  are  developed  upon  the  surface  of  the 
uterine  mucous  membrane,  where  previously  none  existed.  Chauveau 
has  also  stated  that  during  pregnancy  the  number  of  cotyledons  is 
increased  ;  and  Colin,  in  his  Plii/siologie  Comparec,  makes  a  similar 
statement.  Professor  Franck,  of  Munich,  in  his  dissections  of  the 
gravid  uterus  of  bovines,  has  found,  in  a  large  number  of  instances, 
a  more  or  less  abundant  quantity  of  accessory  caruncles  [harunkeln)  on 
the  mucous  membrane,  and  which  had  no  corresponding  relations  with 
the  chorion.     In  one  instance  the  ordinary  cotyledons  were  entirely 

'  In  the  Journal  de  Med.  Veterinaire  de  Lyon,  M.  Strebel,  of  La  Tour,  Switzerland, 
gives  an  instance  in  which  there  was  absence  of  the  uterine  cotyledons  in  a  Cow,  and  the 
placenta  was  like  that  of  the  Mare.  Conception  took  place,  gestation  went  on  favourably, 
and  parturition  was  normal. 


THK  PLACENTA. 


87 


absent  in  an  unimpregnated  cornu,  and  in  their  stead  were  thousands 
of  the  accessory  processes  grouped  together  in  small  clusters.  The 
whole  of  the  lining  membrane  of  this  cornu  had  a  peculiar  mossy  or 
velvety  appearance.  In  a  number  of  instances  Franck  has  observed,  in 
the  immediate  neighbourhood  of  the  os  uteri,  where  cotyledons  proper 
were  absent,  groups  of  the  so-called  accessory  cotyledons,  in  their  form 
representing  a  j^lacenta  i^rcevia  (Figs.  53,  54).  Certainly,  this  kind  of 
•placenta  prccvia  in  Cattle  has  not  the  disadvantages  it  offers  in  woman  ; 
for  although  a  premature  delivery  may  occur,  a  sufhciency  of  the 
placenta  always  remains  to  maintain  the  nourishment  of  the  foetus. 
Serious  hicmorrhage  is  likewise  little  to  be  apprehended  in  such  cases ; 
and  even  disconnection  between  the  placenta  foctalis  and  the  placenta 
uterina  in  the  Cow  causes  no  injury.  This  is  not  the  case  with  the 
human  female  and  the  Bitch.  Small  haemorrhage  streaks  at  the  summit 
of  the  finer  tufts,  or  on  their  upper  surface,  are  often  noticed  in  the 


Fig.  51. 

ToKTiON  OK  Chorion  with  Placentll.*:  :  Cow. 

1,  Chorion  ;  2,  Placentulae. 

uterus  of  Cows  which  have  been  slaughtered  and   bled.     Birnbaum 
attributed  these  streaks  to  a  plethora  ex  vacuo} 

The  accessory  placentuko,  are,  both  in  shape  and  situation,  as  well  as 
in  development,  different  from  the  cotyledons  proper  ;  for  while  the 
latter,  and  of  course  also  the  foetal  cotyledons,  are  arranged  in  four 
regular  rows,  in  the  gravid  uterus,  through  the  rapid  increase  of  the 
amnion  towards  the  poles  of  the  ovum,  they  lie  somewhat  closely  to- 
gether, and  the  accessory  processes  are  placed  between  these  rows  in 
an  irregular  manner.  In  their  highest  development,  the  latter  are  so 
disposed  as  to  constitute  a  variable-sized,  felt-like  patch  ;  the  largest 
and  widest  are  usually  observed  behind  the  ordinary  cotyledons,  and 
their  form  is  very  irregular,  but  normal.  As  a  rule,  the  largest  are  not 
so  big  as  a  walnut,  and  they  are  widest  at  their  base.  In  structure  they 
resemble  the  ordinary  cotyledons,  their  bloodvessels  being  arranged  in 
the  same  manner,  while  they  are  covered  externally  by  a  sheatli  of 
epithelium.  In  the  early  period  of  pregnancy — about  the  second  or 
third  month — they  are  found  in  largest  number  on  the  entire  upper 
surface  of  the  chorion,  also  on  the  parts  between  the  oi-dinary  coty- 
^   Untersuchungtn  i'lf/er  deu  Ban  dtr  EihdiUe  der  Saugthiere,  p.  90. 


OBSTETRICAL  PHYSIOLOGY. 


Fig.  52. 

Accessory  Placentul^  in  a  Cow's  Uterus. 

They  appear  like  innumerable  miniature  cauliflowers  growing  from  the  surface 
of  the  mucous  membrane. 


Fig.  53. 

Accessory    Placentul.e   on    the    Cow's    Uterus,    constituting    what    is 
KNOWN  AS  "Placenta  Previa." 

a,  Internal  Os  ;  b,  h,  Placentul^  ;  c,  c,  Eadiating  folds  of  Mucous  Membrane, 
from  which  the  newly-formed  Placentulte  have  sprung  ;  d,  d,  Two  Normal 
Placentae  Uterinre  ;  e,  e,  Uterine  Mucous  Membrane. 


I 


THE  J'L.trEyTA. 


89 


leJons  and  the  tinest  caruncles.  It  may  here  be  mentioned  that  the 
ovum  of  the  Cow  in  the  first  week  of  pregnancy  is  smooth.  Franck 
has  never  been  able  to  discover  the  vascular  semi-detached  caruncles 
which  are  afterwards  developed  through  the  prolonf:;ation  of  the  blood- 
vessels ;  though  they  are  found  in  the  Canine  species.  He  has,  how- 
■ever,  obsen'ed  definitely-formed  vascular  chorion-cotyledons  between 
the  fourth  and  sixth  weeks  of  pregnancy.  The  interposed  cotyledons 
obsen'ed  by  Franck  have  been  noticed  by  other  anatomists.  Birnbaum 
mentions  them,  but  he  is  in  error  with  regard  to  their  development, 
inasmuch  as  he  believed  that  they  arose  from  the  uterine  glands,  which 
is   certainly   not  the  case.     The   chorial   tufts  penetrate  the  uterine 


Fig.  54. 
F(KTAi.  Portion  ok  Placenta  Pu.kvia. 
n,  n,  Newly-fornifd  F<ftal    Placenti   Pripvia,   a  Plactntule  havintj  been  dcvc- 
lopt-d  on  the  Internal  ()•»;  f>,  Blood-cli)t  and  portion  of   F<i'tal  Membranes 
which  lay  in  thu  t>3  ;  r.  Chorion. 

mucosa  by  four  digitations,  fixing  themselves  in  the  so-called  simple 
follicles,  according  to  Franck.^ 

This  excellent  authority  also  points  out,  with  regard  to  this  circum- 
stance, that  in  the  vicinity  of  the  uterine  glands  there  are  found  small 
follicles  which  are  nearly  always  unobserved.  The  connection  between 
these  chorial  tufts  and  the  uterine  mucosa  is  extremely  slight. 

At  a  later  period  of  pregnancy,  there  appear  other  caruncles  in  the 
form  of  foetal  tufts  and  cotyledons,  which  the  previously  developed  and 
prominent  maternal  cotyledons  and  caruncles  lie  opposite  to  and  in 
contact  with.  The  reason  for  this  fact  is  to  be  sought  for  in  the 
circumstance,  that  the  foetal  caruncles  pass  into  the  most  developed 
'  DtiUjiche  ZeUfchriJl  j'tir  Thiennediciii. 


90  OBSTETRICAL  PHYSIOLOGY. 

uterine  cotyledons,  and  in  consequence  bring  the  larger  tufts  of  the 
allantois  into  contact  with  the  opposite  parts  of  the  chorion.  The  inter- 
mediate caruncles  become  entirely  wasted.  Nevertheless,  with  isolated 
tufts,  sometimes  in  a  great  many,  we  find  an  increased  development, 
which  gives  rise  in  the  corresponding  uterine  mucosa  to  a  similar  forma- 
tion, and  a  close  co-optation,  or  even  an  inter-penetration  of  these 
accessory  foetal  and  maternal  cotyledons. 

When    gestation    has    commenced,    the    surface   of   the    maternal 
caruncles,  previously  smooth,  becomes  convex,  and  is  covered  with 


Fig.  55. 

Maternal  and  Fcetal  CoxtLEDONS  of  the  Cow. 

A,  Pedicle  of  the  Maternal  Cotyledon  ;  B,  B,  Maternal  Cotyledon  ;  C,  Fcetal 
Cotyledon  ;  D,  "Placental  Villi  ;  E,  Chorion. 

reticulate  processes  which  border  the  crypts,  and  give  it  a  finely  cribbled 
appearance.  The  largest  are  found  in  the  body  of  the  uterus,  and  they 
become  smaller  as  they  approach  the  extremity  of  the  cornua.  They 
arise  from  the  uterine  surface  by  a  somewhat  narrow  pedicle,  through 
which  they  receive  their  bloodvessels,  and  their  colour  is  nearly  always 
dark  yellow  ;  altogether  in  shape,  hue,  and  general  appearance,  they 
are  not  unlike  a  morel  mushroom. 

The  "  foetal"  or  "  chorial  cotyledons  "  repeat  the  disposition  of  the 
maternal  cotyledons.  They  are  bright-red  concave  patches,  each 
exactly  fitting  into  the  sinuses  of  the  corresponding  uterine  processes, 
with  which  they  strikingly  contrast  in  hue  ;  on  their  surface  they  offer 
a  multitude  of  long,  conical,  ramifying,  or  branched  vilh,   measuring 


THE  PLACENTA. 


91 


from  4  to  6-lOths  of  an  inch,  \Yhich  arc  received  into  the  depressions  of 
the  maternal  cotyledons.  This  ramifying  or  racemose  disposition  of  the 
chorial  villi  is  peculiar  to  the  Bovine  and  Ovine  species.  The  chorial 
cotyledons  are  attached  to  the  chorion  by  a  very  short,  thick  and 
vascular  pedicle  ;  between  them  and  the  maternal  cotyledons  there  is 
always  to  be  found  a  small  quantity  of  thick,  white,  milky-looking  fluid 
— the  so-called  "  cotyledonous  "  or  "  uterine  milk." 

According  to  Schlossberger,  this  uterine  milk  should  be  considered  as 
a  fluid  analogous  to  milk  or  chyle.  It  contains  88  per  cent,  of  water, 
To  of  fat,  0-7  of  salts,  and  9-6  of  a  protein  substance.  In  the  cotyledonal 
fluid,  as  well  as  in  that  on  the  surface  of  the  uterine  mucous  membrane 
of  a  Mare  towards  the  end  of  pregnancy,  Ercolani  has  demonstrated 
the  presence  of  albumin  ;  in  the  same  fluid  he  has  also  proved  the  exist- 
ence of  amidon,  dextrin,  and  sodium  chloride. ^ 


COTTLKDON  OK   A   Cow's   UtERUS. 

a  a.  Surface  of  F(ftal  Chorion  ;  h  h,  lilood vessels  of  Fn^tal  Chorion  ;  r  r.  Surface 
of  I'terine  Mucous  Membrane  ;  it  d,  Bloodvessels  of  ditto  ;  /,  Secretion  from 
T'tricuKy  (Jlands— Cotyledonous  Milk— l>ftw.en  Maternal  and  Futal  Vessel.-, 
and  which  is  necessary  to  the  Mutual  Interchange  of  liases,  and  Nutrient, 
Effete,  and  other  Matters  between  Parent  and  Offspring. 

The  reticulated  surface  of  the  maternal  cotyledons  is  homologous  with 
the  decuhia  scrotina  of  other  mammals;  but  it  possesses  a  flrmer  texture, 
and  usually  remains  attached  until  the  termination  of  gestation- -allow- 
ing the  fa-tal  villi  to  be  withdrawn  from  it  at  birth  ;  it  is  afterwards 

'  We  must  not  overlook  the  fact,  that  the  txistence  of  the  "uterine  milk"  in  the 
living  pregnant  animal  has  been  denied  by  M.  Colin  (Trailv  de  Phi/Mioloi/if  Comparce 
rff.i  Aiiiniaiix,  1872,  vol.  ii.,  p  S70),  who  states  that  this  fluid  is  simplv  a  product  of 
cadaveric  decomposition,  and  is  not  found  during  life  ;  a.s  he  h.xs  a«.sure<i  himself  in  the 
most  evident  manner,  by  opening  the  uterus  of  a  pregnant  Mare  and  Cow.  It  is  not 
found  immediately  after  death,  as  he  has  demonstrated  on  many  occasions  in  Cows  an<l 
Sheep  slaughtered  in  the  abattoirs  at  all  j)eriods  of  gestation  ;  it  is  not  even  observed 
after  six,  twelve,  or  twenty-four  hours,  or  longer,  when  the  surrounding  temperature  does 
not  favour  decomposition.  It  is  only  when  the  placentie  sp<>ntaneotisly  separate,  or  are 
disunited  by  slight  traction,  at  a  greater  or  le.ss  time  after  death,  accurdini;  to  circum- 
stances, that  the  white  or  yellowisn-red  coloured  fluid  appears  between  the  chorion  and 
uterine  mucous  membrane.  In  proportiiui  as  decomposition  has  advanced,  the  fluid  is 
abundant.  Colin  therefore  concludes  that  it  is  a  product  of  softening  and  progressive 
dissolution  of  the  uterine  mucous  membrane  and  its  cotyledons,  as  well  as  the  placentse 
themselves. 


•92  OBSTETRICAL  PHYSIOLOGY. 

shed  or  disappears  in  some  obscure  manner,  and  the  caruncle  again 
assvimes  its  smooth  surface. 

As  in  SoHpeds,  there  is  no  direct  vascular  communication  between 
the  maternal  and  foetal  cotyledons,  the  villi  of  each  being  distinct, 
though  in  close  contact,  being  only  separated  at  points  by  the  lactescent 
fluid  just  alluded  to.  This  fluid,  which  is  present  in  all  the  domesti- 
cated animals,  can  be  readily  discovered  by  carefully  withdrawing  a 
■  chorionic  tuft  from  the  alveolar  cavities  of  the  uterine  cotyledon. 

Sheep  and  Goat. 
In  the  Sheep  and  Goat  the  arrangement  of  the  placenta  is  essentially 
the  same  as  in  the  Cow,  except  that  the  maternal  cotyledons  are  deeply 
concave  or  cup-shaped  in  the  middle,  and  into  this  cavity  the  fcEtal 
placentula  is  received  and  closely  retained.  This  placentula  is  not  so 
wide  as  that  of  the  Cow,  though  it  is  thicker  and  the  villi  are  more 
delicate.  The  mode  of  termination  of  the  placental  vessels  in  the 
Sheep  is  villous  ;  in  the  Goat  it  is  pilose. 

Pig. 
In  the  Pig  the  placenta  may  be  designated  as  "  diffused,"  not  "  poly- 
cotyledonary  "  as  in  Euminants ;  though  the  tufts  do  not  form  a  con- 
tinuous layer,  as  in  the  Mare,  the  papillas  being  collected  in  small  but 
closely-grouped  clusters.  When  uninjected  they  appear  as  white 
masses  or  spots  scattered  over  the  external  surface  of  the  chorion,  thus 
giving  it  a  mottled  aspect,  caused  by  the  presence  of  feebly  vascular  and 
non-vascular  areas  ;  but  when  the  allantoic  veins  are  filled,  these  are 
seen  to  form  plexuses  in  the  centre  of  each  spot.  The  uterine  veins 
have  a  cori'esponding  arrangement,  and  the  arterial  capillaries  form  a 
fine  network,  the  meshes  receiving  the  villosities  which  carry  the  fcetal 
arterial  capillaries ;  whence  it  might  seem  that  the  nutrition  of  the 
foetus  is  effected  principally  at  the  points  of  contact  of  the  foetal  with 
the  maternal  venules,  while  the  respiratory  process  took  place  at  the 
surface  of  contact  between  the  foetal  and  maternal  arterial  capillaries. 
The  chorion  is  destitute  of  these  papillae  at  its  extremities,  which  are  in 
contact  with  the  chorion  of  other  foetuses  in  the  uterus. 

Bitcli  and  Cat. 

In  the  Bitch  and  Cat  the  placenta  forms  a  thick  annular  band  or 
zone,  about  one  or  one  and  a  half  inch  wide,  passing  round  the  middle 
of  the  chorion  ;  it  is  therefore  said  to  be  "  zonular."  This  zone  is  con- 
cave within,  of  a  mixed  grey-and-red  colour  when  uninjected,  livid  or 
dark  brown  during  gestation  ;  its  foetal  surface  is  lobulated,  and  the 
zone  is  limited  at  each  side  by  a  dark  green  border,  the  colouring  matter 
of  which  can  scarcely  be  removed  by  repeated  washings. 

The  placenta  is  studded  with  ramified  villi  of  a  leaf  or  plate  shape, 
which  are  implanted  in  the  uterine  mucous  follicles.  The  mucous 
membrane  in  which  these  are  situated,  and  w^hich  corresponds  to  the 
placenta,  presents  a  kind  of  vascular  fungous  development  that  appears 
after  parturition,  but  which  at  an  early  stage  of  pregnancy  has  a 
quantity  of  fluid  along  its  margin;  the  maternal  placenta,  or  scrotina 
decidua,  is  present  during  gestation,  and  can  be  separated  as  a  distinct 
layer.  There  cannot  be  a  doubt  that  the  uterine  mucous  membrane  in 
Carnivora  secretes  a  kind  of  plastic  lymph,  which  forms  this  caducous 
lining,  or  membrana  decidua ;  but  it  is  only  present  at  a  certain  period 
■  of  fcEtal  life,  and  forms  the  base  of  the  uterine  placenta. 


THE  UMBILICAL  CORD.  9S; 

Functions. 

The  functions  of  the  placenta  are  obvious  :  it  is  the  nutrient  and 
respiratory  apparatus  durin<^  a  portion  of  intra-uterine  existence  ;  and 
for  the  acconiphshment  of  these  functions  it  must  rely  upon  its  intimate 
and  healthy  relations  with  the  uterine  surface.  The  special  and  tempo- 
rary processes  of  development  being  completed,  and  the  task  of  provid- 
ing capillary  superficies  being  terminated,  whether  on  the  part  of  the 
mother  or  foetus,  the  placenta  of  the  latter  disappears,  as  well  as  the 
decidua  ;  though  they  may  not  be  thrown  oil'  together,  and  the  maternal 
decidua  may  not  be  shed  all  at  once,  but  in  successive  portions.  The 
long  period  of  gestation  necessary  to  endue  the  young  of  defenceless- 
hoofed  animals  with  suthcient  strength  before  birth,  is  perhaps  a  reason 
for  the  firmer  texture,  better  organisation,  greater  extent,  and  more 
persistent  character  of  their  "  deciduous  "  formations. 

The  comparative  study  of  the  disposition  of  the  different  kinds  of 
placenta?,  may  furnish  valuable  indications  as  to  the  procedure  which 
ought  to  be  adopted  in  artificial  delivery — the  surgical  manipulation, 
necessarily  varying  with  the  extent  and  arrangement  of  the  points  of 
union  existing  between  the  uterus  and  the  fa^tal  envelopes. 

It  has,  therefore,  been  thought  useful  to  arrange  the  domesticated 
animals  into  two  groups — those  with  a  single  placenta,  and  others  with 
a  multiple  placenta  ;  the  first  group  being  again  subdivided  according  as- 
the  placenta  is  "  diffused  "  or  "  localised."  This  arrangement  and  sub- 
division may  be  expressed  as  follows  :  — 


Single  Placenta 


Multiple  Placenta 


Diffused 
Zonular 


Horse. 
Pig. 
Dog. 
Cat. 
j      Cow. 
Localised      •       Sheep. 


(      Goat. 


U.MIilLICAL   CouD. 

The  umbilical  cord,  funis,  or  navcl-strimj,  is  a  collection  of  vessels 
which  form  the  means  of  connnunication  between  the  mother  and  foetus 
during  the  uterine  existence  of  the  latter,  and  which  loses  its  functions 
when  birth  occurs.  It  is  visible  at  the  earliest  period  of  pregnancy, 
and  is  formed  by  the  vessels  which  convey  the  blood  between  the  fuutus 
and  its  envelopes — chiefly  the  placenta.  It  is  divided,  for  facility  of 
description,  into  two  portions  :  an  amniotic,  the  longest,  always  twisted 
on  itself  like  a  rope,  and  covered  by  the  amnion,  which  passes  along  it 
to  become  continuous  with  the  skin  at  the  umbilicus  ;  and  an  allantoic 
portion,  much  shorter,  less  twisted,  and  covered  by  the  sheath  that  con- 
tinues the  two  layers  of  the  allantois  until  it  is  inserted  into  the  upper 
wall  of  the  chorial  sac,  between  the  cornua. 

Three  vessels  enter  into  the  composition  of  the  cord  :  two  arteries  a.nd 
a  vein,  which  are  embedded  in  embryonic  connective  tissue  (  Whartonian 
gelatine),  ih^t  make  them  appear  more  voluminous  than  they  really  are. 
This  "  Gelatine  of  Wharton  "  consists  of  a  mucous  basis,  in  the  substance 
of  which  is  fibrillar  tissue.  The  umbilical  arteries  arise  from  the  in- 
ternal iliac  artery,  and  course  along  the  sides  of  the  bladder  ;  reaching 
the  umbilicus,  they  pass  through  it  and  arrive  at  the  terminal  extremity 
of  the  amniotic|)ortion  of  the  cord,  where  they  give  off  some  branches 


I 


4fe 


amumozii  i 

TTvrrtiiTfr-      i_^. 

nrrrm  ir  init 


til  r.cn  tii''  .  '>RTn;rnr  gnn?- 

SttL,  vvilitiif^  TOniiL  "Cite-  b:k 


332: 


/FrftTfT  iifiin^tv;^  imnlrr  j^sffi:  ir  _  ^^iSTfe  mic  tTT^R^  siiol  incL  uri  it vrr 

i'  --•;--    -^,-  .     — - T  Mt*tT(nni.ft,    I — ^   i__  '  ~^         "-"^^jjgfTrmrrrT<r  ffxnprryf^  tv. •±^rip> 

■i'  -    TTEKr  Tmrrn'riTTrff,    -                     .  uiT«r -chf    umhwtCELi  iTEtBH, 

ix.  .  -lit   rrrTHr-  -HLTrtmg?^  CT    11-     ;. -irirrmTTHi,"  T^aill  TvisH-  il  ZB 

X*  "  -'"-  'lEL.    mill    tJE    -Wi.iri  rrtr  -iTt^f-    Itt^T  -SHEaS  mHCI  (irwi.ri  in?) 

■XT-  ' -£!IH«.  TJHrESb.       ^  ^u'  mf  XT    "_                •7irm     n  jtKPQSEBB 

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( 

X 


it- 

i- 

1- 


TT1    Tra^    ^JTTKII- 

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-  -.^     .'  •  -   frmcbif  IE  Tie- 

lacmHiii 

.  .T      ■■• :  \'.  '■-■'  -  -^  iram  ihw 


'S^aiVu 


Ib.  :iift  ?^  "imt  aawaBsntasc  it  ititt  •saad,  is  zbt^  smaat:  jb  ji 


3r 

T"-.-"  -,i- r  'ij:    r-   ---^      ._i r* 'iiac  Tffl  'isdnKt^:     ~    -i.x- 

rBsneir  aanir.  moo.  ijireaar 

—  nunsffr 


r^V-^MEtfas  OK;  JB 


""TEUXi. 


-  31  TWO 


96  OBSTETRICAL  PHYSIOLOGY. 

not  complete,  and  hernia  of  the  intestines  exists  at  birth,  or  even  for 
some  time  after  that  event. 

With  regard  to  the  curious  torsion  of  the  cord  on  itself — as  many  as 
twelve  complete  turns  having  been  counted  in  the  cord  of  a  six-months- 
old  foetus — it  has  been  held  by  some  authorities  that  this  is  only  acci- 
dental, and  depends  on  the  movements  of  the  foetus  during  the  latter 
stages  of  gestation,  or  the  displacement  it  undergoes  on  leaving  the 
uterus  ;  consequently,  that  the  spiral  twisting  of  the  vessels  is  not 
normal.  It  is  improbable,  however,  that  the  twisting  can  be  due  to 
muscular  movements  of  the  foetus  ;  as  it  is  unlikely  these  should  be 
entirely,  or  even  mostly,  in  one  direction.  It  has  been  recently 
attributed  to  the  excessive  growth  of  the  umbilical  arteries,  whereby 
they  are  compelled  to  take  a  tortuous  course ;  and  when  a  slight 
obliquity  has  once  been  established,  every  pulsation  will  tend  to  increase 
the  spiral ;  at  the  same  time  every  movement  of  the  foetus  or  the 
mother  would  be  taken  advantage  of,  the  cord  and  foetus  revolving 
together  until,  with  the  growth  of  the  latter,  the  friction  of  the  amnion 
puts  an  end  to  the  rotation.  It  does  not  appear  that  any  advantage 
accrues  to  either  foetus  or  mother  from  the  torsion  of  the  cord ;  on  the 
contrary,  it  increases  the  resistance  to  the  flow  of  blood,  and  also 
augments  rather  than  diminishes  the  danger  of  stoppage  of  the  circula- 
tion by  accidental  pressure.  Examination  of  non-displaced  foetuses 
proves  that  it  is  far  from  being  constant. 

At  birth,  the  umbilical  cord  is  usually  torn  or  gnawed  through  at  a 
short  distance  from  the  umbilicus  of  the  foitus ;  the  remaining  portion 
dries  up,  dies,  and  falls  off  in  a  few  days. 

SECTION  III.— DEVELOPMENT  OF  THE  ECETUS. 

Having  studied  the  conception  and  partial  development  of  the  young 
creature,  and  described  the  envelopes  which  surround  it,  we  will  pro- 
ceed to  notice  the  various  changes  which  occur  in  it  until  gestation  is 
completed  and  parturition  is  about  to  take  place. 

This  division  of  our  subject  is  of  much  importance  in  several  respects, 
but  more  especially  with  regard  to  the  relation  it  bears  to  teratology — 
the  branch  of  science  which  treats  of  congenital  defects,  malformations, 
and  monstrosities. 

The  transition  from  the  condition  of  the  embryo,  when  the  young 
animal  has  scarcely  assumed  a  definite  form,  to  that  of  the  foetus,  when 
it  presents  the  lineaments  of  the  species  to  which  it  belongs,  is  very 
gradual. 

The  dorsal  cord,  as  has  been  stated,  is  a  cylindrical  body  developed 
above  the  primitive  furrow,  with  slightly  attenuated  extremities,  and  at  ' 
each  side  small  opaque  quadrangular  masses,  the  vertebral  lanmice,  which 
are  in  xQ^Miy  the  j^roto-vertebra ,  or  first  rudiments  of  thevertebrge.  Each  of 
these  masses  is  perforated  by  a  small  opening,  and  is  resolved  into  three 
portions — the  proto-vertebral  cavity,  the  muscular  lamina,  situated  above 
the  cavity,  and  the  proto-vertebra  placed  below  the  cavity.  The  muscular 
lamincB,  increasing  in  volume,  are  inflected  upwards  and  at  last  unite  on 
the  median  line  of  the  back,  chiefly  forming  the  muscles  of  the  verte- 
bral furrows  ;  they  also  send  off  prolongations  downwards,  which  concur 
in  the  development  of  the  intercostal  and  abdominal  muscles,  as  well  as 
those  of  the  limbs.  The  proto-vertebrce,  bend  upwards  and  downwards 
on  each  side,  so  as  to  enclose  the  proto-vertebral  cavity  or  spinal  canal. 


hEVELOVMKXr  OF  THE  FaUCS.  97 

and  the  dorsal  cord ;  the  upper  ring  represents  the  rudiments  of  tlie 
annular  portion  of  the  vertebrir,  while  the  lower  ring  and  the  dorsal 
cord  constitute  the  vertebral  bodies  and  the  discs  uniting  them. 

The  lateral  lamince  arise  from  the  portion  of  tlie  middle  layer  of  the 
blastoderm  placed  on  each  side  of  the  vertebral  laminte.  In  the  region 
of  the  trunk  tliese  lamiuic  are  separated  for  a  certain  time  fi-om  the 
latter;  but  in  the  cephalic  region  they  are  always  adherent  to  them, 
and  at  this  part  they  are  usually  designated  the  cephalic  lam'nue.  The 
'proper  lateral  lamime  are  divisible  into  two  layers,  external  and  internal, 
united  by  a  viiddlc  layer ;  they  comprise  between  them  a  space  which 
becomes  the  plcuro-peritoneal  cavitij,  after  the  formation  of  which  the 
lateral  are  joined  to  the  vertebral  lamina.  The  internal  or  fihro-intes- 
iinal  layer  envelops  the  deeper  portion  of  the  blastodermic  layer  or 
intestinal  furrow,  the  umbilical  vesicle,  and  the  allantois  ;  it  constitutes 
the  tibrous  and  vascular  parts  of  these  membranes,  and  carries  the  ves- 
sels to  the  inner  face  of  the  chorion.  The  external  or  cutaneous  layer 
is  developed  in  two  ways  :  above,  it  glides  between  the  muscular  laminie 
and  the  fa^tal  portion  of  the  external  layer  of  the  blastoderm  to  form 
the  cutaneous  envelope  on  the  back  ;  below,  it  separates  into  two  leaves 
which  receive  between  them  the  prolongations  of  the  muscular  lamiucC 
destined  to  constitute  the  intercostal,  abdominal,  and  other  muscles  of 
this  part  of  the  body.  Of  these  two  secondary  leaves,  the  external 
forms  the  skin  of  the  trunk,  and  the  internal  the  parietal  layer  of  the 
peritoneum.  The  cutaneous  lamin®  also  furnish  an  extra-foetal  pro- 
longation— the  fibrous  layer  of  the  amnion. 

The  middle  or  mesenteric  lamime  join  at  the  median  line,  and  in  their 
substance  are  developed  the  Wolttian  bodies,  or  antecedent  deciduous 
kidneys,  and  the  principal  vessels  of  the  trunk. 

The  cephalic  lamina:'  always  remain  adherent  to  the  vertebral  laminae, 
and  are  inflected  inwards  with  them  to  form  the  anterior  part  of  the 
cephalo-intestinal  cavity,  which  is  divided  into  two  compartments — the 
pharyngeal  and  a'sophageal  cavities.  Tlie  pharyngeal  cavity  opens 
externally  by  the  mouth,  and  is  partly  enclosed  on  the  sides  by  the 
pharyngeal  arches.  The  a-sophageal  cavity  soon  shows  a  diverticulum, 
which  is  not  long  in  communicating  with  the  pleuro-peritoneal  cavity, 
and  subsequently  contains  the  heart ;  it  is  therefore  named  the  cardiac 
cavity.  The  cephalic  lamina}  also  form  the  derm  of  the  cranium,  and 
the  fibrous  layer  in  which  are  developed  some  of  the  cranial  boues. 

The  Nervous  System. 

The  development  of  the  nervous  system  comprises  the  growth  of  the 
brain,  spinal  cord,  and  nerves.  The  initial  steps  in  the  development  of 
the  brain  and  cord  have  been  already  indicated.  At  each  extremity  of 
the  medullary  cavity,  which  is  a  modification  of  the  median  furrow,  is  a 
slight  bulging.  From  the  posterior,  or  rhomboidal  sinus,  the  sacro- 
lumbar  nerves  are  given  off,  while  the  anterior  gives  origin  to  the  brain. 
This  anterior  enlargement  appears  as  tlirce  successive  dilatations  named 
the  cerebral  vesicles  or  cells,  which  are  distinguished  as  anterior,  middle, 
and  posterior.  They  are  filled  witli  fluid,  and  the  middle  slightly  sur- 
mounts the  other  two,  which  gives  the  whole  the  figure  of  a  small 
triangular  mass.  The  vesicles  increase  irregularly  in  volume,  and  their 
walls,  in  developing,  form  the  nervous  tissue  ;  while  their  cavity  persists 
and  becomes  the  space  observed  in  each  portion  of  the  encephalon.  The 
anterior  vesicle  represents  the  cerebral  hemispheres,  the  thalami  optici 

7 


98  OBSTETRICAL  PHYSIOLOGY. 

and  the  lateral  ventricles.  The  middle  vesicle  forms  the  crura  cerebri, 
corpora  quadrigcmina,  and  the  aqueduct  of  Sylvius  or  middle  ventricle. 
The  posterior  vesicle  gives  rise  to  the  medulla  oblongata,  p>ons  varolii, 
cerebellum,  and  fourth  ventricle.  The  middle  vesicle  increases  more 
rapidly  in  volume  at  first  than  the  others,  but  it  soon  stops  and  allows 
the  anterior  cell  to  develop :  from  this  time  the  encephalon  assumes  its 
oval  shape,  with  predominance  of  the  anterior  part. 

Towards  the  end  of  their  first  third  of  intra-uterine  life,  nearly  all  the 
parts  of  the  encephalon  are  distinct  ;  the  two  hemispheres  are  separated 
by  the  development  of  the  septum  lucidem,  and  the  convolutions  are 
apparent  on  their  surface:  while  the  corpora  quad  rig  em  i  na  emd  crura 
are  well  defined.  At  a  later  period  the  cerebellum  is  seen,  as  well  as 
the  2M US  Varolii,  corpora  restiformia,  and  corpora  pjiramidalia. 

"With  regard  to  the  development  of  the  spinal  cord,  we  have  observed 
that  the  medullary  canal  is  the  first  trace  of  this  part.  It  occupies  the 
whole  length  of  the  vertebral  stalk,  and  its  cavity  communicates 
anteriorly  with  the  fourth  ventricle.  When  the  spine  is  developed  the 
cord  only  increases  longitudinally  to  a  certain  degree,  and  appears  to 
ascend  in  the  canal ;  it  stops  at  the  middle  of  the  sacrum  in  the  Equine 
foetus,  but  ascends  higher  in  the  other  species.  During  this  apparent 
ascensional  movement  is  developed  the  filum  terminals,  and  the  termi- 
nating nerves  of  the  cord  (cauda  equina).  The  parietes  of  the  medullary 
canal  are  at  first  very  thin,  but  increase  in  thickness  with  the  appear- 
ance of  the  nervous  substance  of  the  cord,  and  soon  divide  into  two 
layers :  an  internal,  the  epithelium  of  the  central  canal ;  and  an 
external,  the  grey  substance  of  the  cord.  Gradually  the  canal  contracts, 
and  the  cord  shows  longitudinal  furrows.  At  the  end  of  the  first  month 
the  inferior  roots  of  the  nerves  are  in  existence,  as  well  as  the  spinal 
ganglia,  which  are  developed  at  the  expense  of  the  proto-vertebrae  ;  the 
superior  roots  are  not  distinguishable  for  some  time  after.  The  envelopes 
of  the  nervous  centres  are  furnished  by  the  proto-vertebral  laminae,  and 
are  developed  after  the  sixth  week,  following  the  formation  of  the  parts 
they  are  destined  to  cover. 

The  nerves  are  not  so  definite  in  their  development,  and  some 
obscurity  prevails  with  regard  to  them.  It  would  appear  that  the 
motor  roots  originate  in  the  cord,  but  that  the  gangha  are  formed 
separately  in  the  proto- vertebras,  and  perhaps  become  the  point  of 
departure  of  the  sensitive  roots.  The  nerve  ramifications  grow  from 
elongated  ramified  cells,  which  are  joined  by  their  extremities.  The 
nuclei  of  the  cells,  joined  to  the  periphery,  become  the  nuclei  of  the 
sheath  of  Schwann,  and  the  nei^ve  tissue  is  afterwards  deposited 
gradually  between  the  axis-cylinder  and  the  envelope.  The  great 
sympathetic  nerve  is  perceived  at  an  early  date  as  a  nodulated  cord  ;  it 
is  probably  developed  in  the  same  manner  as  the  other  nerves. 

The  Organs  of  Sense. 

The  principal  portion  of  the  organs  of  sense  belong  to  the  nervous 
system,  and  are,  of  course,  developed  with  it ;  the  other  portions  belong^ 
to  the  external  epithelial  layer,  and  to  the  derm  or  germinative  layer. 
With  regard  to  the  organs  of  vision,  two  tubulous  prolongations  arise 
from  the  anterior  cerebral  vesicle  and,  passing  forward,  terminate  in  the 
primary  ocular  vesicles,  traces  of  the  ocular  globes  ;  the  hollow  prolong- 
ments  form  the  optic  nerves,  and  the  vesicles  furnish  the  choroid  layer 
and  retina.     The  crystalline  lens,  vitreous  body,  cornea,  and  sclerotica 


DEVELOPMENT  OF  THE  FCETUS.  99 

are  derived  from  the  external  blastodermic  layer.  The  part  of  the 
integument  not  required  to  forn:  the  lens  constitutes  the  envelope  of  the 
globe.  The  latter  forms  the  sclerotica  and  cornea  ;  while  the  epiderm 
furnishes  the  epithelium  to  the  latter,  which  becomes  distinct  from  the 
sclerotica  in  about  the  fourth  month.  A  slit  occurs  at  the  lower  part  of 
the  fibrous  envelope  of  tlie  globe  ;  this  is  related  to  the  development  of 
the  vitreous  humour,  a  prolongation  of  the  derm  passing  through  this 
slit  and  entering  between  the  lens  and  the  anterior  wall  of  the  secondary 
ocular  vesicle  which  appeared  shortly  before.  There  this  prolongation 
becomes  developed  and  transformed  into  the  vitreous  humour,  wliich  at 
cue  period  is  surrounded  by  vessels,  but  shows  none  immediately  before 
birth.  It  exhibits  in  its  centre  a  transverse  canal,  which  lodges  a 
branch  of  the  arteria  centralis  of  the  retina. 

The  optic  nerve  is  developed  in  the  pedicle  connecting  the  ocular 
vesicle  with  the  anterior  cerebral  vesicle,  and  the  rci'ina  is  formed  by  the 
inner  layer  of  the  secondary  ocular  vesicle  ;  it  extends  to  the  lens  in 
changing  its  character  in  front.  The  choroid  coat  is  constituted  by  the 
posterior  layer  of  the  ocular  vesicle  ;  it  extends  as  far  as  the  lens,  and 
is  then  inflected  in  front  of  that  body  to  form  the  iris.  The  borders  of 
the  pupil  embrace  the  vascular  envelope  of  the  lens,  and  the  anterior 
face,  as  well  as  this  pupil,  is  covered  by  a  very  vascular  membrane,  the 
viemhrana  i)upillaris  ;  behind  it  is  the  equally  vascular  covering,  the 
mcmhrana  capsulo-pupillaris,  that  passes  through  the  pupil  to  the  lens  to 
envelop  it  in  a  kind  of  sac  that  disappears  towards  the  end  of  gestation. 
Previous  to  this  time  this  aperture  is  very  wide  ;  but  as  the  iris  is 
developed  the  pupil  contracts,  and  the  vessels  of  the  vascular  or 
pupillary  membrane  diminish  in  size  and  number,  until  at  last  only  a 
few  are  seen  crossing  the  transparent  membrane. 

The  protective  and  motor  apparatus  of  the  eye  is  gradually  developed 
around  the  globe.  The  eyelids  are  small  cutaneous  folds  which  are 
formed  in  the  first  third  of  uterine  life,  and  grow  and  unite  by  their 
margins  until  a  short  time  before  or  after  birth,  according  to  the  species, 
when  they  separate.  They  are  maintained  closed  by  a  thin  membrane, 
which  disappears  in  Solipeds,  Ruminants,  and  the  Pig,  before  birth  ;  but 
in  Carnivora  it  remains  until  some  days  (eight  or  ten)  after  that  event. 
So  long  as  the  lids  are  closed,  the  conjunctiva  is  only  a  sac  comnmni- 
cating  with  the  lachrymal  canal.  The  crystalline  lens  in  the  fcetus  and 
new-born  animal  distinctly  shows  the  three  septa  peculiar  to  it  ;  three 
diverge  from  each  pole  at  angles  of  120'.  The  lachrynial  gland  is  an 
appendage  of  the  epithelial  layer  which  is  intruded  above  the  globe  ; 
at  first  compact,  it  becomes  gradually  excavated  into  cavities,  from 
which  arise  the  excretory  ducts. 

The  auditory  apparatus,  consisting  of  the  intei*nal  ear,  auditory  nerve, 
and  middle  ear,  is  developed  separately.  The  labyrinth  appears  in  the 
form  of  a  vesicle  which  is  not  in  direct  relation  with  the  posterior  cere- 
bral cell,  but  is  constituted  by  a  depression  of  the  epidermic  layer — tbe 
auditor]!  fossa — that  becomes  more  and  more  marked  until  it  is  finally 
a  closed  cavity.  At  this  time  the  wall  of  the  labyrinth  is  only  a  simple 
epithelial  membrane  ;  but  this  is  soon  increased  externally  by  a  con- 
nective membrane  which  vascularises  it,  and  then  gives  rise  to  three 
layers :  an  external,  which  adheres  to  the  epithelium  to  form  the  mem- 
brane of  the  labyrinth  ;  an  external,  that  lines  the  labyrinthic  cartilage; 
and  a  middle,  whose  soft  embryonic  connective  tissue  disappears  and  is 
replaced  by  a  fluid,  the  perilymph.      At  the  same  time  that   these 


100  OBSTETRICAL  PHYSIOLOGY. 

changes  of  structure  are  taking  place,  the  vesicular  shape  of  the  laby- 
rinth is  modified,  and  shows  the  cochlea,  semicircular  canals,  utricuhis, 
and  saccuhis.  The  middle  and  external  ear  are  formed  by  the  first 
pharyngeal  slit,  which  is  never  completely  closed,  while  the  others  dis- 
appear. At  first  there  is  a  cavity  communicating  externally  by  the 
pharynx  ;  this  cavity  contracts,  then  divides  into  two  portions  by  a 
septum  in  its  middle;  this  septum  becomes  the  ^y??z_/;a?z?r?H,  while  the 
inner  cavity  forms  the  middle  car  and  Eustachian  tube,  and  the  external 
portion  the  external  auditory  canal  or  meatus.  The  ossicula  auditus  are 
at  first  cartilaginous,  and  appear  towards  the  third  month ;  after  which 
thev  gradually  ossify,  and  have  nearly  assumed  their  definitive  shape  at 
birth. 

The  concha  is  developed  beneath  the  integument  after  the  second 
month. 

The  organs  of  smell  begin  by  two  depressions  in  the  epidermic  layer, 
analogous  to  the  crystalline  lens  and  auditory  fossettes.  These  two 
olfactory  fossa  appear  below  the  ocular  vesicles,  and,  becoming  deeper, 
their  depth  is  further  increased  by  granulations  which  spring  up  on 
their  borders.  Behind,  they  communicate  with  the  pharynx,  and  the 
formation  of  the  palate  separates  them  in  front  from  the  buccal  cavity. 
From  this  time  the  nasal  fossae  are  constituted  and  completed  by  the 
development  of  the  bones  of  the  face.  The  olfactory  lobes  and  nerves 
are  at  first  tubular,  and  are  related  to  the  anterior  cerebral  vesicle. 
In  the  young  foetus  the  nostrils  are  formed  by  a  collection  of  mucus 
and  epithelium  ;  they  open  towards  the  middle  period  of  gestation. 

T]ie  Skin  and  its  Appendages. 

The  skin  and  its  appendages,  which  might  be  designated  the  tactile 
apparatus,  are  developed  by  the  epidermic  and  middle  layer  of  the 
blastoderm.  The  cutaneous  laminae,  by  the  modification  of  their  ele- 
ments, form  the  derm,  in  which  vessels  are  readily  seen  after  three 
months.  In  the  epiderm  it  is  not  long  before  the  mucous  and  horny 
layers  can  be  distinguished  ;  in  the  first,  pigment  cells  are  observed  at 
the  commencement  of  the  fifth  month  in  the  lai'ger  quadrupeds.  The 
epiderm  is  easily  detached  from  the  derm  ;  it  forms  a  peculiar  white, 
completely-enveloping  pellicle  on  the  surface  of  the  latter,  apparently 
separated  from  it  by  the  growing  hairs.  Frequently  we  find  the  integu- 
ment covered  by  a  special  coating  that  looks  like  varnish  (the  varnix 
caseosa)  ;  this  would  appear  to  be  intended  to  protect  the  epidermic 
epithelium  from  the  destructive  solvent  action  of  the  alkaline  amniotic 
fluid.  It  is  very  abundant  on  the  human  foetus  at  all  periods,  but  is 
not  found  on  that  of  animals  so  long  as  the  skin  is  glabrous.  As  soon 
as  the  hairs  begin  to  appear,  the  epiderm  is  partially  detached  in  the 
form  of  the  thin  pellicle  just  alluded  to,  and  the  decomposition  of  which 
gives  rise  to  an  appearance  like  varnish.  It  is  best  seen  in  the  foetal 
Pig,  the  hairs  on  the  skin  appearing  all  at  once  over  the  body  ;  in  the 
other  domesticated  animals  they  are  only  developed  successively,  and 
consequently  the  shedding  of  the  epiderm  occurs  partially  and  in 
patches,  which  are  insensibly  confounded  with  the  normal  epidermic 
layers.  Microscopically,  these  flakes  offer  the  same  characters  as 
epidermis  removed  by  a  vesicant ;  the  points  where  the  hairs  have 
passed  appear  as  regular  infundibuliform  openings.  When  the  fcEtus 
increases  in  volume  the  epiderm  desquamates,  and  the  debris  floats  in 
the  amniotic  fluid. 


DEVELOI'MEXT  oh'  THE  FlETUS.  101 

In  the  third  month,  the  hairs  are  perceptible  on  the  fcetus  of  the 
Mare  and  Cow.  Hair  folhcles  have  been  observed  in  embryos  of  the 
Pig  which  did  not  measure  more  than  two  inches  in  length.  They  first 
appear  about  the  eyebrows,  lips,  and  joints  of  the  limbs,  and  the  whole 
of  the  body  is  covered  at  the  sixth  or  seventh  month  ;  they  are  usually 
observed  in  the  fa'tus  of  the  Mare  and  Cow  around  the  lips,  towards 
the  eighteenth  week  of  gestation.  The  hair  may  be  shed  and  renewed 
before  birth,  for  it  has  been  found  in  the  amniotic  fluid  and  in  the 
stomach  of  the  fcctus.  Each  hair  is  developed  in  a  prolongation  of  the 
epidermic  layer  which  is  imbedded  in  the  substance  of  the  derm ;  this 
prolongation  is  constituted  by  a  bottle-shaped  mass  of  cells.  In  the 
centre  the  cells  are  modified  and  heaped  up,  so  as  to  form  a  small  cone 
whose  base  covers  the  growing  papilla  ;  this  cone  elongates,  until  it 
touches  the  superficies  of  the  epidermis,  when  it  becomes  bent  in  the 
effort  to  push  itself  through,  but,  finally,  it  issues  beyond  the  surface, 
where  it  may  grow  freely. 

The  sebaceous  and  pcrspiraiorji  glands  are  developed  in  a  similar 
manner,  at  the  middle  period  of  uterine  life.  The  horny  productions, 
such  as  the  claws,  lioo/s,  enjots,  and  cJicsniits,  are  apparent  at  an  early 
stage.  Towards  the  end  of  the  second  month  there  can  be  perceived  in 
the  foetus  of  the  Cow,  at  the  extremity  of  each  digit,  a  small,  pale,  and 
transparent  conical  tubercle  ;  this  is  the  rudiment  of  the  claw.  The 
hoofs  of  Solipeds  appear  towards  the  twelfth  week,  and  about  the  com- 
mencement of  the  fourth  month  they  are  more  developed  ;  their  texture 
has  become  firm  and  opaque,  whereas  before  it  was  gelatinous  and 
transparent,  and  has  assumed  a  fine  yellow  tint.  They  are  always 
soft,  however,  until  birth,  in  order  to  guarantee  the  integrity  of  tlie 
fa'tal  envelopes.  At  mid-term,  brown  or  black  patches  appear,  if  the 
coronet  is  pi-ovided  with  pigmentary  stains  ;  but  it  is  not  until  about 
the  end  of  gestation  that  the  horn  begins  to  show  the  greenish  tint 
proper  to  it  when  destitute  of  pigment ;  though  the  remainder  of  this 
production,  particularly  its  lower  part,  preserves  its  yellow  colour  until 
the  young  animal  is  born.  In  Solipeds  the  chesnuts  are  seen  at  mid- 
term, in  the  form  of  thin  brownish  plates,  which  soon  become  darker. 
The  structure  of  the  hoof  is  not  tubular  until  after  birth,  when,  the 
fa^al  hoof  gradually  disappearing,  the  horn  that  replaces  it  is  fibrous 
and  tubular,  and  much  more  consistent. 

The  corneous  substance  is  developed  at  the  expense  of  the  blastema 
which  the  capillaries  of  the  modified  derm  throw  out  on  its  surface. 
In  this  material  appear  nucleated  cells  which,  pressing  against  each 
other,  become  at  first  polygonal  in  shape  and  flattened,  then  lose  their 
nucleus  and  are  confounded  with  each  other.  At  a  later  period,  cells 
of  a  new  formation  are  moulded  on  the  papilhc  of  the  coronary  cushion 
and  plantar  surface  of  the  foot  of  Solipeds  and  Ruminants,  giving  it  that 
fibrous  appearance  which  is  so  striking  during  extra-uterine  life. 

The  Loconwtorij  Apparatus. 

The  development  of  bone,  and  with  it  the  locomotory  apparatus  in 
general,  next  demands  our  attention.  Bone  is  developed  in  the  blastema 
or  primitive  basis — a  transparent  glairy  mucous  matter  containing 
numerous  minute  corpuscles.  This  progressively  acquires  increased 
firmness,  sometimes  assuming  a  membranous  or  ligamentous  condition, 
usually  of  a  gristly  consistence  before  its  conversion  into  bone.  The 
change  into  cartilage  is  denoted  by  the  appearance  of  minute  nucleated 


102  OBSTETRICAL  PHYSIOLOGY. 

cells,  which  increase  in  number  and  size,  and  are  aggregated  in  rows, 
with  intercellular  tracts  where  the  ossification  is  about  to  begin.  These 
rows,  in  the  cartilaginous  basis  of  long  bones,  are  vertical  to  its  ends  ; 
in  that  of  flat  bones  they  are  vertical  to  the  margin.  The  cells  furthest 
from  the  seat  of  ossification  are  flattened  and  in  close  contact ;  nearest 
that  seat  they  become  enlarged  and  separated.  The  first  appearance  of 
bone  is  that  of  minute  granules  in  the  intercellular  tissue.  Canals  are 
next  formed  in  the  bone,  by  absorption ;  these  ultimately  receive  blood- 
vessels, and  become  the  "  vascular  canals."  The  immediate  nutrition 
of  bone  is  provided  for  by  the  production  of  minute  "plasmatic  canals," 
"  lacunae,"  or  "  bone-cells  "  from  the  vascular  ones.  Ossification  begins 
at  the  centre  of  round  bones,  and  proceeds  towards  the  surface  ;  in  flat 
bones  it  extends  between  two  membranes,  and  from  a  central  point 
towards  the  periphery  ;  in  short  bones,  towards  the  circumference;  and 
in  long  bones,  from  a  central  point  or  diapliysis,  towards  another 
centre — the  epiphysis,  situated  at  each  end.  Particular  parts  or  pro- 
cesses are  furnished  with  a  separate  centre  of  development,  named  the 
aporihysis.  Length  occurs  at  the  extremity  of  the  diaphysis,  and  bulk 
by  deposition  on  the  surface,  the  medullary  canal  of  certain  bones  being 
due  to  internal  absorption. 

The  spina  is  the  first  portion  of  the  skeleton  observed  in  the  embryo, 
it  being  represented  by  the  chorda  dorsalis,  which  is  composed  of  a  mass 
of  cells  in  the  interior  of  a  transparent  sheath.  The  proto-vertebraB 
appear  on  each  side  of  the  cord,  and  ultimately  enclose  it  and  constitute 
the  spinal  canal ;  in  this  way  results  the  external  sheath  of  the  cord,  and 
the  superior  uniting  membrane.  The  vertebral  stalk  now  exists  as  a 
membranous  axis,  but  not  for  long,  as  it  becomes  segmented  in  order 
to  form  the  vertebras,  and  these  segments  are  gradually  converted  into 
cartilage.  Each  persistent  vertebra  does  not  correspond  to  a  proto- 
vertebra,  the  latter  dividing  into  two  portions  to  constitute  two 
vertebrae.  The  body  of  the  vertebra  is  developed  more  quickly  than 
the  spinous  portion  ;  at  the  end  of  the  second  month  all  tiie  vertebral 
bodies  are  cartilaginous,  while  the  laminae  are  yet  in  a  membranous 
condition.  In  the  third  month  ossification  commences,  and  during  this 
process  the  dorsal  cord  disappears,  except  between  the  vertebrae,  where 
it  is  developed  to  form  the  intervertebral  fibro-cartilage. 

The /ace  and  cranium  are  formed  by  a  membrane  that  envelops  the 
encephalon,  and  which  is  due  to  the  proto-vertebral  laminaB.  This 
cranial  membrane  becomes  partly  cartilaginous  and  partly  fibrous,  the 
cartilage  existing  at  the  base  of  the  cranium,  and  appearing  to  be  a 
prolongation  of  the  bodies  of  the  vertebrce  :  indeed,  there  is  a  resem- 
blance between  a  vertebra  and  the  cranium,  in  so  far  as  the  latter  can 
be  resolved  into  four  portions,  each  corresponding  to  a  vertebra.  This 
cartilage  is  slowly  transformed  into  bone ;  while  the  fibrous  part, 
answering  to  the  roof  and  sides  of  the  skull,  passes  directly  into  the 
osseous  state.  The  bones  of  the  face  are  formed  by  the  j^haryngeal, 
branchial,  or  visceral  arches — a  name  given  to  four  laminae  which, 
springing  from  the  anterior  extremity  of  the  dorsal  cord,  curve  down- 
ward to  meet  those  of  the  opposite  side  ;  the  spaces  between  them  are 
named  the  "  pharyngeal  clefts."  The  upper  jaw,  mouth,  and  nasal 
cavities — composed  by  the  nasal,  maxillary,  and  palate  bones— come 
from  the  first  pharyngeal  arch  ;  while  Meckel's  cartilage,  which  passes 
from  the  handle  of  the  malleus  towards  the  lower  jaw,  is  also  an  ap- 
pendage of  it.     This  cartilage  disappears  about  the  sixth  or  seventh 


l>KrKI.(il'.\(KXT  or  THE  FiLTl'S.  103 

month.  At  tirst  the  mouth  communicates  with  the  nasal  cavities ;  the 
palate  is  developed  in  two  portions,  which  advance  towards  eacli  other, 
but  remain  for  some  time  apart ;  so  that  during  this  time  the  young 
animal  has  a  cleft  palate.^  The  second  phai-yngeal  arch  forms  the 
stapes,  the  petrous  portion  of  the  temporal  bone,  the  styloid  arch  and 
the  hyoid  branch.  The  third  originates  the  hyoid  bone  with  its 
cornua,  while  tiie  fourth  only  constitutes  the  soft  parts  in  this  region  of 
the  throat. 

The  thorax,  consisting  of  the  ribs  and  sternum,  is  an  appendage  of 
the  proto-vertebral  lamiuio,  which  incline  towards  the  lower  face  of  the 
vertebral  spine.  The  true  ribs  are  developed  most  rapidly,  and  before 
attaining  the  middle  line  they  unite  by  their  inner  extremity  to  form  a 
moiety  of  the  sternum.  A  fissure  at  this  part  separates  the  ribs  of  one 
side  from  those  of  the  other  ;  this  gradually  closing,  ends  by  disappear- 
ing altogether,  and  then  the  sternum  is  constituted.  The  ribs  are, 
after  the  petrous  portion  of  the  temporal  bone,  the  parts  of  the  skeleton 
which  ossify  most  promptly  ;  ossification  begins  in  the  middle  bones. 
The  ribs  do  not  belong  exclusively  to  the  dorsal  vertebra},  but  have  a 
tendency  to  be  developed  along  the  length  of  the  spine  ;  it  is  not  rare 
to  see  a  small  cartilaginous  nucleus  attached  to  the  lumbar  vertebrae, 
and  which  is  soon  lost  in  the  substance  of  the  abdominal  parietes ;  in 
Birds  this  body  assumes  large  dimensions  on  the  last  cervical  vertebrue. 

The  shape  of  the  thorax  differs  with  species,  being  round  in  some 
and  oval  in  others,  but  it  is  always  less  developed  in  the  foetus  than  in 
the  young  or  adult  animal. 

The  limbs  do  not  appear  until  after  the  formation  of  the  vertebral 
spine,  the  pharyngeal  arches,  and  the  thorax.  They  show  themselves 
as  four  small  prolongations  from  the  pelvis  and  chest,  slightly  thickened 
at  their  origin  and  contracted  in  the  middle.  Their  free  extremity  is 
flat,  and  is  either  simple  or  divided,  according  to  the  foot  of  the  species. 
In  these  prolongations  the  cartilaginous  segments  are  formed,  which, 
when  ossified  at  a  later  period,  constitute  the  bones  of  the  limbs. 

The  muscles  are  divided  into  four  groups,  after  their  origin.  They 
are  the  vertebral  juusclcs,  which  arise  from  the  muscular  laminae  of 
the  proto-vertebrai ;  the  visceral  7nusclcs  for  the  thoracic  and  abdominal 
cavities,  the  neck  and  jaws,  and  having  the  same  origin  ;  the  cutancoics 
muscles,  which  originate  from  the  cutaneous  lamina;  of  the  middle  layer 
of  the  blastoderm  ;  and  the  muscles  of  the  limbs,  the  development  of 
which  is  not  fully  understood. 

It  was  believed  at  a  certain  period,  that  the  muscular  fibres  are 
formed  by  the  joining  together  at  their  ends  of  several  elongated  cells. 
It  is  now  known  that  each  fibre  is  constituted  by  a  single  cell  which 
extends  in  length,  and  whose  nuclei  are  multiplied  and  placed  at  the 
surface  ;  while  the  contents  are  transformed  into  a  substance  that  pre- 
sents all  tlie  characteristics  of  contractile  tissue.  The  sarcolemma  is 
formed  after  the  fibre,  by  a  modification  of  the  connective  tissue  sur- 
rounding it. 

The  locomotory  apparatus  of  the  majority  of  the  domesticated  species 
of  animals  is  so  developed  at  birth,  that  immediately  after  that  event 
the  young  creature  can   move  with  more  or  less  alacrity.     With  the 

'  This  cleft  condition  of  the  palate  would  sometimes  appear  to  persist  after  ffctal  life. 
In  April,  1876,  at  the  Middle  Park  Stud,  in  Kent,  I  saw  a  thoroughbred  Foal  with  a 
cleft  palate.  It  was  being  s^uckled,  and  a  portion  of  the  milk,  instead  of  passing  down 
the  cpsophagiis,  escaped  from  the  nostrils.  It  was  this  unusual  course  of  the  milk  which 
led  to  the  detection  of  the  abnormality. 


104 


OBSTETRICAL  PHYSIOLOG  Y 


larger  herbivorous  quadrupeds,  the  Hmbs  of  the  new-born  animal  are 
long  to  enable  it  to  reach  the  teat,  as  well  as  to  enable  it  to  escape  by 
flight  should  danger  be  apprehended. 

The  Circulatory  System. 
The  development  of  the  circulatory  system  is  not  apparent  until  some 
days  after  the  appearance  of  the  embryo  in  the  blastodermic  layer,  there 
being  no  trace  of  vessels  in  the  germinative  space.     It  is  not  long,  how- 


m  71 


Fig.  57. 

FcETAL  Circulation  in  a  Transition  State. 

a,  b,  c',  Circle  or  Envelope  resulting  from  the  Fusion  of  the  Vitelline  Membrane, 
External  Layer  of  the  Blastodermic  Vesicle,  and  the  Transformation  of  the 
Allantois  ;  c,  The  Diminishing  Umbilical  Vesicle  ;  d.  Cephalic  Portion  of  the 
Embryo  ;  d',  Caudal  Portion  ;  e,  Ventricle  of  the  Heart  ;  /,  Auricle  of  the 
Heart  ;  i,  Aorta,  forming  the  Aortic  Arches  ;  h,  Trunk  representing  the 
Thoracic  Aorta  ;  g,  Vessel  which  becomes  the  Anterior  Vena  Cava  ;  k,  Vena 
Azygos  ;  I,  Confluents  of  the  two  Veins  g  and  k ;  m,  Confluent  of  all  the 
Veins  at  their  Entrance  into  the  Auricle  of  the  Heart ;  n,  Vessel  resulting 
from  the  Union  of  the  Allantoid  Veins  p,  p,  and  the  Omphalo-Meseraic 
Vein  q  ;  o,  Posterior  Vena  Cava  ;  p,  p,  Allantoid  Veins  ;  q,  Omphalo-Meseraic 
or  Umbilical  Vesicle  Vein  ;  r.  Posterior  or  Abdominal  Aorta  ;  s,  s,  Allantoid 
Arteries  ;  t,  Omphalo-Meseraic  Artery. 

ever,  before  the  central  organ  of  circulation  and  some  vessels  appear  in 
the  middle  layer,  and  canals  also  spread  to  the  surface  of  the  umbilical 
vesicle.  While  the  contents  of  the  vitelline  vesicle  are  being  imbibed 
by  the  embryo,  the  heart  is  in  course  of  formation  ;  bloodvessels  are 
increasing  and  extending,  the  allantois  is  completed,  and,  finally,  the 
placental  circulation  is  established  and  continues  until  birth. 

The  pleuro-peritoneal  cavity  in  the  embryo  shows  a  diverticulum  in 


DKl'KLnI'MKXT  nF  THE  FCETUS.  10'. 


front — the  cardiac  cavity,  in  the  interior  of  wliich  the  heart  is  deve- 
loped. This  organ  is  at  first  a  small  mass  of  cells,  the  innermost  of 
which  separate  in  order  to  leave  a  little  space,  and  to  create  blood 
globules.  As  soon  as  it  appears,  the  heart  contracts  and  relaxes  alter- 
nately, the  movements  being  very  slow,  though  they  gradually  become 
accelerated.  Towards  the  twelfth  day  the  organ  has  the  shape  of  a 
cylindrical  contractile  tube.  From  its  anterior  part  arise  two  branches, 
the  aortic  arches,  which  at  first  proceed  towards  the  head  of  the  em- 
bryo, but  afterwards  are  bent  backward  and  downward.  These  arches 
join  to  form  the  simjlc  aorta,  which  in  its  turn  divides  into  two  branches 
— the  subrertebral  or  common  aortie — which  run  parallel  along  the 
lower  surface  of  the  embryo,  giving  off  four  or  live  branches,  the 
omphalo-meseraic  arteries,  which  ramify  in  the  germinative  area  and 
end  in  a  vein — the  terminal  sinus.  From  this  ramification  and  sinus 
arise  two  vessels,  the  omphalo-vicscraic  veins,  which  return  to  the 
posterior  extremity  of  the  heart.  The  circulation  in  the  umbilical 
vesicle  is  very  ephemeral  in  several  species,  while  it  is  as  persistent  in 
others  ;  varying,  of  course,  with  the  duration  of  the  vesicle  itself. 

The  heart,  from  being  merely  a  cylindi"ical  tube,  undergoes  consider- 
able modifications  before  it  arrives  at  its  complete  development,  passing 
through  all  the  different  forms  which  characterise  the  organ  in  the 
various  vertebrate  animals.  The  first  change  consists  in  an  inflexion, 
by  which  the  inferior  part  becomes  the  superior;  then  it  dilates  at  three 
distinct  points — one  anterior  and  superior,  at  the  origin  of  the  aorta, 
named  the  aortic  bulb  ;  a  middle  one,  the  ventricular  cavity ;  and  a 
posterior,  the  auricular  cavity.  The  constriction  between  the  auricle 
and  ventricle  is  named  Hallcr's  passage  {d&troit). 

These  two  cavities  are  single  only  for  a  brief  period  ;  the  ventricular 
first  divides  into  two — a  division  marked  externally  by  a  fuiTOw  which 
is  visible  on  the  surface  of  the  heart  of  a  foetal  Lamb  at  the  nineteenth 
day,  and  the  twenty-fifth  in  the  Foal.  This  furrow  corresponds  to  an 
interventricular  septum  which  arises  insensibly  at  the  bottom  of  the 
ventricles  and  reaches  the  auricles,  where  it  concurs  to  form  the 
auricula-ventricular  orifices.  The  borders  of  the  openings  are  furnished 
with  a  slightly  salient  lip,  which  at  a  later  stage  develops,  and  consti- 
tutes the  mitral  and  tricuspid  valves.  The  heart  now  contains  three 
cavities — two  ventricles  and  an  auricle,  but  it  is  soon  to  have  a  fourth  ; 
for  the  auricle  becomes  partitioned  into  two  portions,  and  externally  this 
division  is  marked  by  anotlicr  depression,  corresponding  to  the  septum 
formed  in  the  cavity.  It  is  to  be  remarked,  however,  that  the  partition 
remains  incomplete  during  the  wliole  period  of  uterine  life,  being  per- 
forated by  an  opening — the  Joranwn  ovale  or  foramen  of  Botal.  The 
aortic  bulb  now  contracts  and  forms  two  vessels — the  aorta  and  pul- 
monary artery. 

The  arteries  are  developed,  partly  at  the  expense  of  the  primary 
circulation,  and  partly  in  the  vascular  layer  of  the  embryo.  The  aortic 
arches,  situated  at  the  inner  face  of  the  first  two  pharyngeal  arches, 
form  five  new  vessels,  w-hich  are  placed  within  the  other  arches  ;  all 
these,  however,  do  not  exist  at  the  same  time,  some  becoming  atrophied 
while  the  others  are  forming.  For  instance,  the  first  two  completely 
disappear  ;  the  third  forms  the  carotids  ;  the  fourth,  the  axillary  artery 
and  the  arch  or  cross  of  the  aorta  ;  the  fifth  is  atrophied  on  the  right, 
but  on  the  left  forms  the  pulmonary  artery,  the  ductus  arteriosus,  and 
the  aorta.     The  latter  is  continued  along  the  spine  by  the  fusion  of  the 


106 


OBSTETRIC  J  L  PH 1  'SIOL  00  V, 


two  primitive  aortae,  and  shows  at  its  posterior  termination  the  small 
pelvic  vessels  and  the  large  umbilical  arteries. 

The  peripheral  vessels  originate  independently  of  the  central  vessels, 
in  the  interior  of  the  vascular  layer.  They  appear  as  solid  cellular 
branches,  which  soon  become  hollow  in  their  interior,  and  free  cells 
become  visible.  As  these  new  channels  are  developed,  the  omphalo- 
meseraic  vessels  gradually  diminish  and  disappear,  until  at  last  only  one 
or  two  pass  to  the  umbilical  vesicle. 


Fig.  58. 

FcETAL  Circulation  :  Advanced  Period. 

A,  Placentulfe  ;  B',  B',  Umbilical  Veins,  with  their  Common  Trunk,  B  ;  D,  Vena 
Portse,  and  its  Anastomosis,  C  ;  E,  Ductus  Venosus ;  F,  Posterior  Vena 
Cava  ;  G,  Right  Ventricle  of  Heart  ;  H,  Pulmonary  Artery ;  J,  J,  Aorta  ; 
I,  Ductus  Arteriosus  ;  K,  Umbilical  Arteries,  with  their  Anastomosis  at  the 
extremity  of  the  ITmbilical  Cord. 


The  umbilical  veins  are  developed  immediately  after  the  formation  of 
the  omphalo-meseraic  veins,  and  join  these  ;  as  the  ramifications  of  the 
latter  diminish  in  size  the  former  increase  rapidly,  and  when  the  liver  is 
formed  around  them  they  throw  into  it  those  branches  which  are  the 
rudiments  of  the  hepatic  plexus.  Between  the  portal  and  hepatic 
veins,  the  umbihcal  vein  communicates  with  the  vena  cava  by  the 
ductus  venos^Ls  of  Aranzi,  which  does  not  exist  in  the  foetus  of  Solipeds 
in  the  last  month  of  gestation.  The  embryonic  veins  form  four  chief 
trunks — two  anterior,  the  anterior  cardinal  veins  ;  and  two  posterior,  the 


DEVELOrMEXT  OF  THE  FCETUS.  107 

postcrior  cardinal  veins.  The  veins  on  each  side  unite  in  pairs  to  form 
the  ductus  Cuvieri,  which  opens  transversely  into  the  omplialo-meseraic 
trunk  near  the  auricular  cavity.  The  anterior  cardinal  veins  issue  from 
the  cranium,  forming  the  jugular  veins,  and  communicate  by  a  trans- 
verse anastomosis  between  the  right  and  left  veins.  Below  this  the 
left  vein  gradually  atrophies,  as  does  the  ductus  Cuvieri  of  the  same 
side  ;  while  the  right  vessel  enlarges,  and  is  ultimately  the  anterior  vena 
cava. 

The  posterior  vena  cava  appears  in  the  liver  about  the  fifth  week  ;  it 
receives  the  veins  of  the  kidneys  and  the  Woltlian  bodies,  and  behind 
it  anastomoses  with  the  cardinal  veins.  The  middle  portion  of  the 
latter  disappear  and  are  replaced  by  the  vertebral  veins,  the  right  of 
which  forms  the  vena  azygos.  There,  then,  only  remain  two  caixlinal 
veins  for  the  two  extremities — the  anterior  which  enters  the  ductus 
Cuvieri,  and  the  posterior  which  constitutes  the  hypogastric  and  crural 
veins.  It  therefore  happens  that  the  venous  system  of  the  foetus,  which 
was  at  first  symmetrical,  becomes  asymmetrical  in  the  adult  animal. 

As  a  result  of  these  successive  developments,  the  placental  circulation 
is  instituted,  and  continues  the  same  until  the  end  of  gestation,  the 
heart  being  the  organ  which  circulates  the  blood  in  the  foetus.  This 
fluid,  carried  by  the  arterial  vessels,  reaches  tlie  umbilical  arteries,  and 
from  them  is  distributed  to  the  placenta.  There  it  is  respired,  depurated, 
or  arterialised,  through  indirect  contact  with  the  blood  of  the  parent, 
and  is  returned  by  the  umbilical  veins.  In  the  texture  of  the  liver  it  is 
mixed  with  the  venous  blood  of  the  intestines  and  the  hinder  part  of 
the  body,  conveyed  by  the  ductus  vcnosus,  and  is  finally  thrown  into  tlie 
right  auricle,  then  into  the  ventricle,  whence  it  is  expelled  by  a  contrac- 
tion of  that  cavity.  Instead  of  entering  the  lungs,  which  do  not  act 
during  fcctal  life  as  respiratory  organs,  the  blood  is  forced  into  the 
ductus  arteriosus,  and  thence  into  the  aorta.  So  that  the  organs  of  the 
young  creature  are  never  supplied  with  pure  blood,  but  with  a  mixture 
of  arterialised  and  venous  blood ;  this  mingling  taking  place  through 
the  foramen  ovale,  in  the  aorta  by  the  ductus  arteriosus,  and  in  the 
liver  by  the  ductus  veiiosus.  The  head  and  neck  receive  the  purest 
blood,  a  circumstance  which  probably  explains  the  predominance  in 
size  of  the  upper  to  the  lower  parts  of  the  body  of  the  fa^tus. 

At  birth,  the  conditions  of  existence  being  suddenly  changed,  very 
marked  modifications  occur  in  the  circulation.  The  lungs  then  become 
tlie  organs  of  respiration,  and  rapidly  increase  in  capacity,  while  the 
thorax  enlarges  in  a  commensurate  degree  ;  the  pulmonary  artery  also 
dilates  to  admit  the  increased  flow  of  blood,  and  the  ductus  arteriosus 
is  obliterated  to  prevent  the  mixture  of  arterial  and  venous  blood.  The 
ductus  venosus  also  aids  in  the  isolation  of  the  two  kinds  of  blood  by 
becoming  atrophied,  as  does  also  the  occlusion  of  the  foramen  ovale. 
This  opening,  however,  not  infrequently  remains  intact  in  young 
animals  ;  though,  as  a  rule,  tliis  does  not  greatly  affect  the  circulation, 
for  when  the  heart  contracts  the  auricles  are  isolated  by  the  narrowing 
of  the  orifice  and  the  elevation  of  a  valve. 

The  Bespirator;/  Apparatus. 

There  is  an  absence  of  unanimity  as  to  the  mode  of  development  of 
the  respiratory  apparatus,  and  particularly  the  lumjs.  Some  assert  that 
the  latter  are  derived  from  two  little  distended  cellular  masses  attached 
to  the  anterior  part  of  the  intestinal  tube,  and  which  afterwards  become 


108  OBSTETRICAL  FHYSIOLOGY. 

perforated  with  numerous  ramifying  cavities,  that  communicate  with 
the  trachea  ;  while  others  describe  tliem  as  commencing  by  a  median 
enlargement,  which  is  hollow,  and  opens  into  the  oesophagus.  The 
walls  of  the  orifice  of  communication  with  the  digestive  passage  become 
considerably  lengthened,  and  afterwards  form  the  trachea  and  larynx ; 
while  the  vesicle  or  enlargement  representing  the  lungs  divides  into  two 
pyriform  sacs,  each  of  which  is  greatly  subdivided  to  constitute  the 
pulmonary  lobes,  with  their  vesicles  and  infundibula.  The  trachea  is 
completed  through  the  formation  of  the  cartilaginous  rings  in  the  tube 
that  attaches  the  lungs  to  the  oesophagus  ;  the  larynx  is  developed  in 
the  same  manner,  at  the  pharyngeal  opening  of  the  tube.  This  organ, 
however,  is  not  very  distinguishable  during  foetal  life,  and  only  assumes 
its  definite  form  and  volume  at  puberty. 

Up  to  birth  the  placenta  retains  the  function  of  the  lungs,  which, 
though  ready  to  act,  only  come  into  play  when  the  creature  is  born. 
Previous  to  this  event  they  are  of  a  dark-red  colour,  firm  and  compact, 
heavier  than  water,  and  apparently  destitute  of  alveoli ;  though  these 
latter  exist,  but  are  filled  with  embryonic  elements,  and  their  walls  are 
in  contact.  A  moderate  insuffiation  is  sufficient  to  distend  the  air- 
vesicles,  when  the  lungs  become  crepitant  and  enlarged,  have  a  rosy 
colour  and  spongy  appearance,  float  in  water,  and  the  air  cannot  be 
completely  expelled  from  them.  The  same  change  immediately  occurs 
in  these  organs  when  the  young  creature  is  born  alive ;  the  external 
atmosphere,  acting  upon  the  surface  of  its  body,  causes  it  to  inspire 
deeply,  the  chest  dilates,  the  air  rushes  into  the  lungs,  and  respiration 
commences  only  to  cease  with  life.  This  alteration  in  the  colour, 
texture,  and  specific  gravity  of  the  lungs  enables  us  to  decide,  in  certain 
cases,  whether  or  not  an  animal  has  been  born  alive. 

The  thymus  gland  first  appears  towards  the  second  month,  as  a 
growth  from  the  respiratory  mucous  membrane,  near  the  larynx  ;  it  then 
descends  gradually  along  the  trachea  until  it  reaches  the  thorax,  where 
it  is  situated  between  the  layers  of  the  anterior  mediastinum.  It 
increases  in  size  until  birth,  after  which  it  remains  stationary  for  a 
short  time ;  then  it  gradually  diminishes  and  disappears  at  a  period 
which  varies  according  to  species,  and  even  individuals.  Exceptionally 
it  has  been  found  in  Horses  three  years  of  age.  It  is  a  gland  in  struc- 
ture, though  it  has  no  excretory  canal.  Its  uses  are  unknown,  but  it 
is  surmised  that  it  plays  a  part  in  the  nutrition  and  haematosis  of  the 
foetus  and  young  animal.  It  may  be  that,  like  the  spleen,  it  assists  in 
converting  the  white  corpuscles  of  the  blood  into  red  corpuscles. 

The  Digestive  Apixiratus. 

The  development  of  the  digestive  apparatus  comprises  the  formation 
of  the  alimentary  canal  and  the  organs  attached  thereto.  The  alimen- 
tarij  canal  begins  to  appear  after  the  first  outlines  of  the  nervous  centres 
and  the  vascular  apparatus  have  been  manifested.  We  have  already 
described  the  manner  in  which  the  intestinal  cavity  was  formed  from 
the  inner  lamina  of  the  blastoderm.  This  cavity,  for  convenience  of 
description,  may  be  divided  into  three  portions  :  the  anterior  intestine, 
which  originates  the  pharynx  and  oesophagus  ;  the  middle  intestine, 
which  becomes  the  stomach  and  intestines  proper  ;  and  the  posterior 
intestine,  which  constitutes  the  rectum.  The  chief,  or  middle  intestine, 
is  at  first  a  cylindrical  uniform  tube,  the  diameter  of  which  is  after- 


I'EVKLorMEXT  cF  THE  FCETVS.  109 

wards  modilied  to  constitute  the  organs  comprised  between  the  oeso- 
phagus and  rectum. 

The  mouth  begins  by  a  depression  or  cul-dc-sac,  whicli  is  limited  by 
the  maxillary  tubercles ;  it  increases  as  it  dips  towards  the  pharynx, 
from  which  it  is  only  separated  at  last  by  a  thin  membrane  ;  this  is 
eventually  absorbed,  and  the  moutli  then  communicates  with  the  com- 
mencement of  the  digestive  canal.  Towards  the  third  montli  the  mouth 
is  confounded  with  the  nasal  fossa?,  but  after  this  the  palatine  bones 
appear,  and  finally  isolate  the  two  cavities. 

The  tniujue  is  at  first  only  a  small  protuberance  from  the  maxillary 
tubercles,  but  is  completed  by  the  addition  of  a  little  growth  from  the 
second  branchial  arch.  Its  epithelium  and  glands  are  derived  from  the 
external  layer  of  the  blastoderm  ;  they  are  apparent  at  the  third  or 
fourth  month. 

The  j)}ianjux  a.ni  cesojjluKj us  lei\<;then  and  widen  as  the  foetus  grows  ; 
the  latter  at  first  communicates  with  the  trachea,  but  it  gradually 
closes,  and  ends  by  separating  entirely  from  that  tube. 

The  stomach  is  formed  by  the  dilatation  of  the  anterior  part  of  the 
middle  intestine.  This  dilatation  is  fusiform,  its  larger  axis  being 
longitudinal ;  but  it  soon  curves  on  itself,  and  then  this  axis  becomes 
transversal. 

In  Ruminants  the  stomach  is  single  when  it  first  appears,  though  it  is 
not  long  before  furrows  are  observed  on  its  outer  surface  ;  while  inter- 
nally the  particular  septa  are  seen  as  in  adult  life.  In  the  fa'tus  the 
stomach  is  small,  but  its  volume  increases  rapidly  after  birth,  when  the 
animal  commences  to  take  solid  food.  During  the  sucking  period  in 
Ruminants,  there  is  a  predominance  of  the  fourth  over  the  other  gastric 
compartments  ;  but  as  soon  as  the  young  animal  begins  to  consume 
fibrous  aliment,  the  rumen  increases  rapidly,  until  it  is  by  far  the 
largest  cavity. 

The  intestines  are  at  first  of  uniform  calibre,  thougli  in  a  short  time 
it  is  easy  to  distinguish  the  different  sections  of  which  they  are 
ultimately  composed.  In  hoofed  animals  the  ciccum  appears  very  early  ; 
it  is  situated  near  the  omphalo-meseraic  duct,  which  is  detached  from 
the  extremity  of  an  intestinal  loop  that  is  drawn  towards  the  umbilical 
ring ;  while  the  latter  is  becoming  obliterated,  this  loop  ascends  in  the 
abdominal  cavity.  The  intestines  are  quite  smooth  on  their  inner 
surface  during  the  first  two  months,  and  towards  the  third  month  show 
the  villi  and  glands  of  Lieberkiihn ;  the  Brunnerian  glands  and  the 
follicles  are  only  seen  later. 

The  rectum  arises  from  the  posterior  intestine,  and  is  developed  like 
the  other  portions. 

With  regard  to  the  anus,  there  is  observed  towards  the  caudal 
extremity  of  the  foetus  a  depression  analogous  to  the  buccal  cul-de-sac. 
This  becomes  deeper,  and  joins  the  rectum  and  genitourinary  organs ; 
later,  it  separates  from  the  last,  and  then  belongs  exclusively  to  the 
alimentary  canal. 

The  APrEND.KGKs  OF  THE  .\LiMKNT.\uv  cAN.\L  are  the  salivary  glands, 
teeth,  liver,  pancreas,  and  spleen.  The  salivarri  i/lands  are  developed 
in  a  solid  cellular  tubercle,  which  is  connected  with  the  epithelium  at  the 
upper  part  of  the  digestive  apparatus.  With  the  growth  of  this  tubercle, 
it  is  converted  into  a  series  of  cavities  having  the  form  of  glandular  cj//s- 
de-sac.  The  submaxillary  gland  appears  first,  and  is  entire  in  a  foetus 
of  only  twelve  lines  in  length  ;  the  parotid  gland  is  the  last  formed. 


no  OBSTETlih'AL   niVSloLDdV. 

The  teeth  are  developed  in  the  interior  of  a  cavity  called  the  "  dental 
follicle  "  or  "  sac,"  by  means  of  the  elements  of  three  germs  correspond- 
ing to  the  anatomical  constituents  of  the  teeth — enamel,  ivory,  and 
cementum.  The  follicle  is  an  oval  cavity  whose  wall  comprises  two 
layers  — an  external  tibrons  sac,  and  an  internal  gelatinous  lining,  at  the 
bottom  of  which  is  the  ivory  pulp  or  ijcrni.  This  is  a  prominence 
detached  from  the  bottom  of  the  sac,  and  has  exactly  the  shape  of  the 
tooth.  It  is  composed  of  a  mass  of  delicate  cellular  tissue  provided 
with  vessels  and  nerves,  and  on  the  surface  a  layer  of  elongated  cells. 
At  the  sunnnit  of  the  follicle,  facing  this  pulp,  is  the  enamel  pulp,  which 
fits  accurately  on  the  dental  pulp  like  a  cap.  This  is  made  up  of 
a  small  quantity  of  mucoid  cellular  tissue,  covered  by  a  layer  of 
cylindrical  cells  connected  with  the  buccal  epithelium  by  the  guberna- 
cnlnin  dentis.  The  cetncnt  otyan  manifestly  exists  in  the  Foal,  being 
found  at  the  base  of  the  ivory  germ,  though  it  disappears  quickly  after 
having  performed  its  function.  It  is  unnecessary  in  this  place  to  enter 
into  a  consideration  of  the  development  of  the  teeth. 

The  lirer  connnences  to  be  formed  at  an  early  period  in  all  animals, 
appearing  at  the  surface  of  the  duodenum  in  the  shape  of  one  large 
tubercle  or  two  snuxll  ones,  according  to  the  mnnber  of  lobes  in  the 
organ  of  the  adult.  To  these  external  tubercles,  corresponding  internal 
ones  arise  from  the  intestinal  epithelium  ;  the  tirst  increase  and  enclose 
the  omphalo-meseraic  vein,  while  the  second  ramify  in  their  interior 
and  form  the  biliary  ducts. 

The  liver  grows  rapidly,  and  when  about  one- third  of  the  period  of 
gestation  has  elapsed  it  nearly  tills  the  abdominal  cavity.  At  a  later 
date  this  increase  is  less  nuirked,  although  when  gestation  is  nearly 
terminated  the  gland  is  proportionately  more  voluminous  than  in  the 
adult. 

The  pa}icrcas,  like  the  salivary  glands,  is  tirst  seen  as  a  solid  cellular 
tubercle,  which  is  subsequently  hollowed  out  by  ramescent  cavities. 

The  spleen  is  developed  about  the  second  month,  on  the  great  curva- 
ture of  the  stomach  ;  it  would  appear  to  be  formed  at  the  same  time  as 
the  pancreas,  in  a  band  extending  from  the  stomach  to  the  duodenum  ; 
but  it  is  separated  from  the  pancreas  and  becomes  attached  to  the 
stomach,  where  its  elements  assume  the  character  of  splenic  tissue. 

The  Genito-urinari/  Onjans. 

The  genito-urinary  organs  are  related  to  each  other  in  their  develop- 
ment, and  have  some  parts  in  common.  Immediately  after  the 
formation  of  the  intestines,  these  organs  are  anticipated  by  the  Woljtfion 
bodies  or  prifiiordial  kidnei/s.  These  are  glandular  masses  extending 
in  front,  or  one  on  each  side,  of  the  vertebras  from  the  heart  to  the 
pelvis.  They  are  composed  of  small  transversely  disposed  tubtili 
filled  with  a  white  Huid,  and  opening  into  a  common  duct  running 
parallel  to  the  spine,  which  again  enters,  inferiorly,  that  portion  of  the 
allantois  which  becomes  the  bladder.  The  duct  is  formed  before  the 
tubuli,  and  is  one  of  the  earliest  developed  structures  in  the  embryo. 
Placed  behind  the  peritonetnn,  the  Woltlian  bodies  are  attached  by  two 
folds  of  serous  membrane — one,  the  anterior,  named  the  diapJiraijmatic 
ligament  of  the  Wo[rfla)t  bodies;  and  the  other,  posterior,  the  lumbar 
ligayncnt  of  the  Wolffian  bodies.  These  organs  secrete  at  tirst  a  fluid 
resembling  wine,  though  their  function  is  soon  greatly  modified,  as  they 
are  not  long  in  becoming  atrophied ;    then  a  portion  serves  for  the 


DEVELOPMEST  OF  THE  EiETrs. 


Ill 


development  of  the  genital  organs,  while  another  gives  rise  to  organs 
whose  use  is  not  exactly  known — such  as  the  Rosennuiller  organ,  whicii 
is  very  developed  in  the  Equine  fcutus,  and  the  canals  of  Gaertner  visible 
in  the  Cow. 

With  regard  to  the  uhinaky  oiuiANH,  we  have  mentioned  how  the 
allantois  was  derived  from  the  terminal  portion  of  the  intestine  ;  it  only 
now  remains  to  add  that  the  uriiuin/  bladder  is  derived  from  the 
abdominal  portion  of  the  allantois,  which  is  merely  a  dilatation  of  that 
sac.  During  fcetal  life  the  bladder  is  extended,  by  the  urachus,  to  the 
umbilical  ring ;  but  after  birth  this  canal  is  obliterated,  and  the  bladder 
retires  to  the  bottom  of  the  pelvic  cavity. 

The  kidjicys  appear  a  long  time  after  the  Wolrtian  bodies.     They 


Fig.  5 


Male  F(KTIs  ok  the  Makk  at  Fivk  and  a  Hai.k  Munth.s  :  the  Ahdomen 
opened  and  te.st1cle.s  expo.skh. 

l,Thii;li8  ;  2,  I'eniH—  neither  Scrotum  nor  Prepuce  an;  y«;t  fonnwi ;  'i.  IJIa/ifler, 
with  the  two  Umbilical  ArterieH  ;  1,  Abdominal  Parietes  ;  '>,  Douglas'  Fora- 
men, with  the  two  Afferent  CanalM,  h,  //;  6,  KidneyH  ;  7,  .Supra-renal  Cap 
Hule8 ;  8,  Rectum  ;  9,  MeHorchJH  or  Spermatic  Cord  ;  a,  fTubernaculuni 
Hunterii  ;  a',  Internal  Inguinal  King  ;  b,  b,  Efferent  Ductn  ;  <:,  c,  To*ticlejj ; 
d,  d,  Pampinifurm  Plexus. 


show  themselves  in  the  form  of  two  culs-dc-sac,  constituted  by  tlie 
upper  wall  of  the  small  vesicle  of  the  allantois.  These  small  cavities 
become  ramified,  and  are  ultimately  replaced  by  solid  tubercles,  in 
whose  interior  are  developed  the  tubuli  uriniferi  and  the  Malpighian 
tufts.  According  to  some  observers,  the  kidneys  only  subsequently 
communicate  with  the  ureters,  which  are  developed  separately  in  the 
middle  lamina  of  the  blastoderm,  and  terminate  in  the  pelvic  portion 
of  the  allantois. 

The  genital  organs  of  the  male  a,nd  female  offer,  at  the  commencement 
of  their  development,  the  greatest  analogies.  For  a  certain  time  it  is 
impossible  to  distinguish  the  sexes ;  so  that  some  authorities  propose 
to  term  this  the  "  indifferent  "  state  of  the  genital  organs.     Afterwards 


112 


OBSTETRICAL  FHYHIOLOG  Y, 


the  sexes  become  defined,  and  at  this  stage  the  organs  may  be  studied 
as  internal  and  external.  The  indifferent  stage  begins  about  the  sixth 
week,  when  there  appears  on  the  lower  face,  and  near  the  inner  border 
of  the  Wolffian  body,  a  small  white  cord,  which,  in  keeping  this  position, 
increases  in  volume.  This  is  the  genital  gland,  which  is  fixed  to  the 
body  by  folds  of  the  serous  membrane,  and  is  composed  of  a  collection 
of  young  cells  enclosed  in  an  envelope.  The  development  of  this  gland 
is  coincident  with  the  formation  of  Mailer's  duct  or  the  genital  canal, 
which  lies  inside  and  in  front  of  the  Wolffian  duct.  Miiller's  duct  is  at 
first  a  solid  cellular  column,  but  is  afterwards  hollowed  out  into  a 
cavity  ;  it  terminates  in  a  cul-de-sac  at  its  upper  extremity,  and  opens 
below  into  the  bladder,  near  the  Wolffian  duct.  From  these  modifica- 
tions of  the  genital  gland  and  the  ducts  of  Miiller,  it  results  that  the 
testicle  arises  from  the  gland,  which  shortens  and  widens  a  little,  while 
its  tissue  is  transformed  into  the  tubuU  seminiferi.  The  head  or  globus 
major  of  the  epididymus,  is  formed  by  the  middle  portion  of  the  Wolffian 
body  ;  the   tail  or  globus  minor,  the  vas  deferens,  and  the  ejaculatory 


Fig.  60. 

Genito-ukinaey  Organs  of  a  Fcetal  Sheep. 

a,  a.  Rudimentary  Kidneys  ;  h,  Ureters  ;  c,  c,  Testes  ;  d,  d,  Wolttian  Bodies  ; 
e,  e.  Excretory  Ducts  of  Wolffian  Bodies  or  Sperm  Ducts  ;  g,  Oviduct  with 
its  openings  /,  /. 


canal,  are  derived  from  the  Wolffian  duct.  Lastly,  the  vesiculce  semin- 
ales  and  the  commencement  of  the  urethra  are  formed  by  the  posterior 
extremity  of  the  ducts  of  Miiller,  which  joins  the  uro-genital  sinus — the 
very  short  canal  communicating  between  the  bladder  and  cloaca.  The 
developed  testicle  remains  in  the  abdominal  cavity,  maintained  there 
by  a  peritoneal  fold,  the  /j/z'ca  gubernatrix  ;  or  descends  by  the  inguinal 
canal  into  the  scrotum.  This  descent  is  preceded  by  the  appearance  of 
a  preparatory  structure — the  gubernacidum  testis — consisting  of  a  central 
axis  of  soft  gelatinous  substance  containing  many  nucleated  cells  and 
surrounded  by  fibrous  tissue,  which  soon  exhibits  the  striped  character- 
istics of  voluntary  muscle.  Some  of  these  fibres  spring  from  the  bottom 
of  the  scrotum  and  traverse  the  abdominal  ring,  while  others  arise  from 
Poupart's  ligament — the  whole,  enclosed  by  connective  tissue  and  con- 
nected by  a  fold  of  peritoneum  to  the  psoas  muscle,  extending  to  the 
testis.  This  gubernaculum,  in  shrinking  or  contracting,  draws  the 
testis  below  the  kidney  to  the  abdominal  ring,  where  it  rests  for  a  brief 
space  ;  after  which  it  reaches  the  scrotum,  where  it  is  found  after  birth 
with  the  remains  of  the  scrotal  part  cf  the  gubernaculum.     The  iliac 


DEVELOPMEXT  OF  THE  FCETUS.  113 

and  pubic  portions  of  the  muscular  tissue  now  become  the  "  cremaster" 
muscle,  while  the  sac  of  peritoneum  carried  down  with  the  testicle 
is  converted,  by  obliteration  of  the  neck,  into  the  tunica  vaginalis 
testis. 

In  Solipeds  tlie  testicles  do  not  usually  descend  into  the  scrotum  until 
six  months  after  birth  ;  when  one  or  both  do  not  appear,  as  sometimes 
happens  in  the  male  domesticated  animals,  and  remain  in  the  abdo- 
minal cavity  during  life,  the  gubernaculum,  or  what  corresponds  to  it, 
is  reduced  to  a  small  thin  cord,  without  a  trace  of  cavity,  and  showing 
only  some  few  pale  fibres  of  the  atrophied  cremaster  muscle.  In  the 
Foal  they  are  voluminous,  and  somewhat  reddish  in  colour ;  they  are 
occasionally  found  in  the  scrotum  at  birth  ;  but  they  soon  ascend  into 
the  abdomen,  to  redescend  during  the  first  year.  With  some  animals, 
however,  as  has  been  already  mentioned — and  far  more  frequently  with 
the  Horse  and  Pig  than  any  othei's — the  testicles  remain  in  the  abdomen 
during  life,  or  only  one  descends  to  its  natural  situation.  When  they 
remain  in  the  abdominal  cavity,  the  animal  is  said  to  be  "  anorchid  "  or 
"  cryptorchid  ;"  and  it  has  been  shown  that,  although  such  animals 
have  the  sexual  propensity  well  marked,  yet  they  are  unproductive  ; 
their  semen  does  not  contain  any  spermatozoa. 

When  one  testicle  has  migrated  to  the  scrotum,  leaving  one  in  the 
abdomen,  the  Horse  is  "  monorchid,"  and  possesses  the  power  of  re- 
production unimpaired. 

In  Ruminants  the  testicles  are  small,  and  are  in  the  scrotum  at  birth, 
where  they  remain.  Sometimes  there  is  a  strange  malposition  of  the 
testicles,  and  especially  in  the  Pig,  they  having  been  found  beneath  the 
chin,  in  the  flank,  and  elsewhere. 

In  the  female,  the  ovary  is  derived  from  the  genital  gland,  whose 
anatomical  elements  are  disposed  so  as  to  form  the  stroma.  Graafian 
follicles,  and  the  ova. 

In  fcetal  Solipeds  the  ovary  is  of  an  immense  size,  especially  about 
the  middle  of  gestation,  and  its  stroma  is  red  and  extremely  soft. 
In  other  animals,  and  particularly  liuminants,  this  disproportion  is  not 
observed. 

The  Fallopian  tube  and  its  pavilion  are  formed  by  the  anterior  portion 
of  Miiller's  duct,  the  extremity  of  which  presents  a  small  linear  orifice. 
The  uterus  and  vaijina  arise  from  theposterior  part  of  these  ducts,  whicli 
approach  each  other,  and  finish  by  amalgamating  posteriorly  to  form  a 
single  canal.  This  fusion  originates  the  vagina  and  body  of  the  uterus, 
the  two  diverging  portions  of  the  ducts  comprised  between  the  point  of 
union  and  the  Fallopian  tubes  forming  the  uterine  cornua.  The  uterus 
and  vagina  are  at  first  continuous  and  without  any  sign  of  demarcation, 
but  towards  the  sixth  month  the  neck  of  the  uterus  begins  to  become 
apparent. 

The  external  organs  of  tlie  female  in  their  indifferent  state  demand 
notice.  The  intestine  terminates  in  the  cloaca,  a  cavity  into  which  not 
only  this  tube  but  also  the  bladder  enters,  through  the  uro-genital  sinus. 
This  arrangement  ceases  somewhat  suddenly,  by  the  development  of  a 
transverse  septum  that  divides  the  cavity  into  two  portions — the  anal 
opening,  and  the  uro-genital  orifice.  -Vt  the  lower  end  of  the  latter 
appears  the  genital  tubercle,  the  rudiment  of  the  penis  or  clitoris,  and 
which  is  surrounded  by  cutaneous  ridges — the  genital  folds.  This 
tubercle   increases   in   size,    and  is  traversed  by  a  groove  or  fissure 

8 


114 


OBSTETRICAL  PHYSIOLOGY. 


passing  from  behind  forward.     Up  to  this  time  the  sexes  cannot  be 
distinguished. 

The  male  sex  is  marked  by  the  rapid  development  of  the  genital 


Fig.  61. 

Female  Organs  of  a  Fcetal  Deek. 

a,  Uterus ;  h,  b,  Coinua  ;  c,  c,  Oviducts  ;  d,  d,  Ovaries  ;  e,  e,  Wolffian  Bodies. 

tubercle,  which  becomes  the  penis,  whose  extremity  is  enlarged  to  con- 
stitute the  "  glans."  The  furrow  or  groove  is  closed  behind,  and  forms 
the  urethra  ;  while  the  genital  folds,  meeting  each  other  below  the 
penis,  join  to  complete  the  scrotum.     Owing  to  these  changes,  the 


Fig.  62. 

Female  Fq^tus  of  the  Cow  (natural  size). 

1,  Heart  ;  2,  Lungs  ;  3,  Diaphragm  :  4,  Kidney  :  a,  Wolffian  Body  ;  b,  Ger- 
minal Gland  ;  c,  Wolffian  Duct ;  (/,  Miillerlan  Duct ;  d',  Uterus  and  Vagina  ; 
d",  Abdominal  Opening  of  the  Oviduct ;  f,  Clitoris ;  g,  Round  Ligament  of 
the  Uterus. 


digestive  are  separated  from  the  urino-genital  organs,  and  the  urethral 
canal  is  connected  with  the  bladder  and  the  excretory  ducts  of  the 
testicle. 


I)EF£LuJ'Mh'XT  (>F  THE  FCETl'S. 


115 


The  organs  in  the  female  also  soon  indicate  the  sex.  The  uro-genital 
sinus  forms  the  vulvar  cavity  or  vestibule  of  the  vagina,  so  marked  in 
the  lower  animals.  The  genital  tuhercle  becomes  the  clitoris — the 
homologue  of  the  penis.  The  cutaneous  folds  constitute  the  labia  of  the 
vulva  ;  while  the  genital  groove  is  closed  at  one  part  of  its  extent  to 
form  the  perinieum.  The  mavimce,  appendages  of  the  generative  organs, 
appear  in  the  early  months  of  uterine  life,  and  the  teats  are  perforated 
very  soon.  They  are  also  seen  very  distinctly  in  the  male  ftttus  in  the 
early  months. 

In  certain  malformations  of  the  generative  organs,  more  or  less  of 


Fig.  63. 

(Jksital  Obi;axs  ok  .k  HRRUAPtiiiODiTB  Goat,  tmk  Malk  Pakts  i'redomi.nati.vc. 

a,  a.  Testes ;  h,  h.  Combination  of  Epididymis  with  Abdominal  Ends  of 
Miillfrian  Duct.-*  ;  (/,'/,  Vasa  OeftTuntia  ;  e,  Body  of  I'tenis  and  A'agina  ; 
/',/,  I'terine  Cornua  ;  <j,  ij,  Fallopian  Tubes. 

their  primitive  conditions  are  retained  ;  the  most  frequent  of  these 
malformations  is  hermaphrodism.  Examples  of  this  are  by  no  means 
uncommon  among  the  lower  animals,  and  the  annexed  drawing  gives  a 
good  example  of  the  organs  of  a  hermaphrodite  goat,  with  the  male 
parts  predominating.^ 


SECTION  IV.— PERIOD.S  OF  KKVKLOPMENT. 

Thus  far  we  have  traced  the  development  of  the  young  creature  in 
the  uterus ;  but  as  our  description  may  appear  a  little  confused  from 
our  having  described  the  growth  of  individual  organs,  rather  than  the 

•  For  further  details  on  the  subject  of  embryology  of  these  creatures,  see  my  trans- 
lation of  "The  Comjiarative  Anatomy  of  the  Domesticated  Animals,"  by  A.  Cbauveau 
and  S.  Arloing,  second  edition,  London,  1691. 


116  OBSTETRICAL  PHYSIOLOGY. 

foetus  as  a  whole,  it  may  be  advisable  to  adopt  the  plan  of  dividing  this 
bodily  development  into  periods,  which  will  also  give  an  approximate 
idea  of  its  age.  From  conception  to  maturity,  utero-gestation  may 
therefore  be  divided  into  seven  periods  or  stages,  as  follows  : — 

First  Period. — Towards  the  second  week  after  conception,  the  ovum 
or  germ  has  passed  from  the  ovary  into  the  uterus ;  it  is  then  about  a 
line  in  diameter  (one-twelfth  of  an  inch). 

Second  Period. — In  the  third  and  fourth  weeks  of  gestation  in  the 
Mare,  Eurainants,  and  Pig  ;  the  third  week  in  Carnivora  ;  there  appear 
the  first  traces  of  the  embryo,  and  the  head,  body,  and  limbs  can  be 
distinguished.  Towards  the  twenty-eighth  day,  the  embryo  of  the  Mare 
measures  about  six  lines,  and  that  of  the  Cow  four  lines ;  that  of  the 
Sheep  at  twenty-five  days  is  four  and  a  half  lines ;  and  the  Bitch  at 
eighteen  days  two  lines. 

Third  Period. — This  is  from  the  fifth  to  the  eighth  week  with  the 
Mare  and  Cow ;  the  fifth  to  the  seventh  with  the  Sheep  and  Goat ;  and 
the  fourth  to  the  sixth  with  the  Pig.  The  embryo  of  the  Mare  has 
acquired  a  length  of  rather  more  than  2  inches ;  that  of  the  Cow  If 
inch ;  that  of  the  Sheep  and  Goat  1|  inch ;  that  of  the  Pig  If  inch ; 
and  that  of  the  Bitch  11  to  12  lines. 

Fourth  Period. — This  is  from  the  ninth  to  the  thirteenth  week  with 
the  Mare ;  the  ninth  to  the  twelfth  with  the  Cow ;  the  seventh  to  the 
eighth  and  ninth  with  the  Sheep  and  Goat ;  the  sixth  to  the  eighth  with 
the  Pig ;  and  the  fifth  week  with  Carnivora.  The  length  of  the  foetus 
of  the  Mare  is  6  inches ;  that  of  the  Cow  bh  inches  ;  that  of  the  small 
Euminants  3J  inches  ;  that  of  the  Pig  3  inches ;  and  that  of  the  Dog 
2|  inches. 

Fifth  Period. — This  extends  from  the  fourteenth  to  the  twenty-second 
week  in  the  Mare  ;  the  thirteenth  to  the  twentieth  in  the  Cow  ;  the 
tenth  to  the  thirteenth  in  the  Sheep  and  Goat ;  the  eighth  to  the  tentli 
in  the  Pig ;  and  the  sixth  week  in  Carnivora.  At  this  stage  the  foetus 
of  the  Mare  is  about  13  inches  long;  that  of  the  Cow  12  inches;  that 
of  the  Sheep  and  Goat  6  inches ;  that  of  the  Pig  5  inches ;  and  that  of 
the  Bitch  3i  inches. 

Sixth  Period. — From  the  twenty-third  to  the  thirty-fourth  week  in  the 
Mare  ;  the  twenty-first  to  the  thirty-second  in  the  Cow  ;  the  thirteenth 
to  the  eighteenth  in  the  Sheep  and  Goat ;  the  eleventh  to  the  fifteenth  in 
the  Pig ;  the  seventh  to  the  eighth  in  Carnivora.  The  foetus  of  the  Mare 
in  this  period  has  acquired  a  length  of  more  than  2  feet ;  that  of  the 
Cow  is  about  the  same  dimensions  ;  the  foetus  of  the  Sheep  is  more  than 
a  foot ;  that  of  the  Pig  about  7  inches  ;  and  that  of  the  Bitch  5  inches. 

Seventli  Period. — From  the  thirty-fifth  to  the  forty-eighth  week — up 
to  parturition,  in  the  Mare  ;  the  thirty-third  to  the  fortieth  in  the  Cow; 
the  nineteenth  to  the  twenty-first  in  the  Sheep  and  Goat ;  the  fifteenth 
to  the  seventeenth  in  the  Pig ;  the  ninth  in  the  Bitch  ;  and  the  eighth 
in  the  Cat. 

A  newly-born  Foal  measures  about  3i  feet  long  ;  a  Calf  2  feet ;  a 
Lamb  1^  foot ;  a  Pig  about  9  or  10  inches  ;  a  Puppy  6  to  8  inches ; 
and  a  Kitten  about  5  inches. 

In  this  study  of  the  evolution  of  the  young  animal  in  utero,  one 
cannot  fail  to  be  struck  with  the  slowness  with  which  development  pro- 
gresses for  a  certain  period,  and  its  rapidity  afterwards.  The  slowness 
in  growth  may  be  accounted  for  by  the  extreme  minuteness  of  the  ovum 


PERIODS  OF  DEFELOl'MKXT.  117 

at  the  moment  of  impregnation,  and  its  containing  within  itself  alone 
the  elements  upon  which  the  primary  steps  of  evokition  depend,  there 
being  at  tirst  no  direct  connection  between  the  embryo  and  the  uterine 
vessels.  The  parts  which  in  reality  grow  most  rapidly  in  the  early 
period  of  gestation,  are  the  enveloping  membranes  and  the  Uuids  they 
contain.  In  the  Sheep,  towards  the  end  of  the  lirst  quarter  of  gesta- 
tion, the  membranes  alone  weigh  from  live  to  nine  times  more  than  the 
foetus ;  while  the  allantoic  and  amniotic  fluids  are  from  eight  to  ten 
times  as  heavy.  These  fluids  increase  in  an  absolute  manner  from  the 
commencement,  until  within  perhaps  a  short  time  of  parturition.  Rapid 
at  first,  towards  the  middle  period  their  secretion  abates,  and  then  begins 
the  more  active  development  of  the  fcrtus,  with  a  relative  diminution  in 
the  proportion  of  the  fluids ;  until  about  the  end  of  the  fourth  month 
they  only  represent  something  like  a  third  of  its  weight.  In  the  Sheep 
a  few  days  after  the  fifth  month,  or  about  birth  time,  they  are  a  sixth 
of  the  weight  of  the  young  animal. 

The  development  of  the  foetus  is  so  tardy  at  first,  that  the  fcetal 
Lamb  at  the  fortieth  day  has  scarcely  acquired  the  300th  part  of  the 
weight  it  has  at  birth ;  at  two  mouths  it  has  only  a  60th,  but  now  it 
grows  more  rapidly ;  so  that  at  the  expiration  of  the  fourth  month  it 
has  gained  more  than  one-third  of  its  total  weight. 

The  inequality  in  the  growth  of  the  different  organs  is  also  very 
notable ;  those  whose  functions  are  most  required,  such  as  the  nervous 
centres,  liver,  etc.,  attaining  considerable  proportions  very  quickly. 
The  brain,  for  instance,  soon  acquires  a  marked  predominance  over  the 
other  organs.  In  the  fcctus  of  the  Lamb  at  the  lifty-seventh  day,  the 
proportion  of  the  entire  brain  to  that  of  the  body  in  weight  is  as  1  to 
15;  at  the  seventieth  day  it  is  as  1  to  55  ;  and  at  birth  as  1  to  65.  At 
mid-term  with  the  Calf,  its  weight  is  to  that  of  the  body  as  1  to  53,  and 
at  birth  as  1  to  120. 

The  spinal  cord  does  not  follow  the  same  progression  in  growth.  In 
the  Calf  at  mid-term  it  is  only  the  421st  part  of  the  weight  of  the  foetus, 
and  at  birth  the  -iTOth  part.  In  the  Lamb  at  birth,  it  is  equal  to  the 
3-iOth  part  of  the  body. 

The  heart,  which  appears  so  early,  is  more  voluminous  in  the  embryo 
than  towards  the  termination  of  gestation  and  after  birth.  The  heart 
of  a  Calf  at  mid-term  equals  125tii  of  the  weight  of  the  body  ;  that  of  a 
Lamb  at  birth  the  120th  ;  in  the  adult  liuU  it  is  only  the  264th  part. 

The  hnujs  have,  relative  to  the  total  bulk  of  the  fa'tus,  a  variable 
weight  according  to  age.  In  those  of  the  Lamb  at  fifty-seven  days, 
they  are  equal  to  a  20th  part  of  the  weight ;  in  a  Calf  at  mid-term,  the 
33rd;  in  another  at  eight  months,  the  34th  ;  and  at  birth,  the  35th  and 
55th  ;  in  a  Foal  a  little  more  than  eight  and  a  half  months,  they  were 
the  33rd  ;  in  Lambs  and  Goats  at  birth,  they  averaged  from  the  24th 
to  the  61st  part  of  the  whole  weight. 

The  development  of  the  thymus  gland  also  varies  considerably  accord- 
ing to  age  and  species.  In  a  Calf  at  mid-term,  its  weight  was  the  137th 
part  of  the  body;  in  another  at  seven  months,  it  was  the  197th  ;  in  a 
Foal  at  birth,  the  200th  ;  in  a  Goat  at  the  same  period,  the  130th ;  and 
in  a  Lamb  eight  days  after  birth,  the  22Sth  part.  It  is  always  propor- 
tionally more  voluminous  in  Ruminants  than  Solipeds,  and  in  them  and 
the  Pig  it  extends  in  front  nearly  to  the  larynx.  In  the  Dog  it  does 
not  get  beyond  the  anterior  mediastinum,  and  is  small,  though  more 
persistent.     It  has  in  rare  cases  been  found  in  Horses  more  than  three 


118 


OBSTETRIC  A  L  PH  YSIOL  OQ  Y 


years  old ;  but,  as  a  rule,  in  the  adult  animal  it  is  only  represented  by 
a  small  and  variable  quantity  of  adipose  tissue. 

The  liver  is  extremely  voluminous  in  the  early  period  of  embryonic 
and  fcBtal  life,  but  decreases  proportionately  as  gestation  approaches 
its  close.  In  the  foetus  of  a  Lamb  at  the  fifty-seventh  day  it  has  been 
found  equal  to  l-6th  of  the  body  in  weight ;  in  Calves  at  mid-term  and 
birth  to  l-29th ;  with  the  Foal  at  birth  l-21st,  and  l-24:th  in  Lambs  at 
the  same  period.  In  the  adult  Horse  it  has  been  fomid  to  represent 
l-75th  of  the  total  weight,  and  l-83rd  in  the  Ox. 

The  intestines,  during  foetal  life,  do  not  grow  in  length  so  as  to  attain 
the  proportionate  dimensions  they  offer  in  adult  life.  In  an  Equine 
foetus  of  eight  or  nine  months,  the  small  intestines  measured  about  15 
feet,  the  caecum  6^^  inches,  and  the  large  intestines  Sh  feet,  or  a, 
total  of  about  20  feet — about  l-5th  of  their  length  in  after-life.  Shortly 
after  birth  they  acquire  l-3rd  the  length  to  which  they  attain  when 
fully  developed.  The  Calf  at  mid-term  has  only  1-lOth  the  length  of 
the  adult  intestine — being  only  sixteen  times  the  length  of  the  body, 
instead  of  twenty  times.  The  Lamb  and  Kid  at  birth  have  l-3rd  of 
their  intestines  complete — their  length  is  seventeen  to  eighteen  times 
the  length  of  the  body,  instead  of  twenty-seven  times  in  adult  life. 

The  general  proportions  of  the  body,  and  especially  those  of  the 
skeleton,  are  not  in  foetal  life  what  they  are  after  birth.  The  bones 
are,  relatively  to  the  other  parts,  more  voluminous  as  a  whole,  and 
notably  at  their  extremities,  than  in  the  adult.  The  limbs  in  particu- 
lar, and  this  more  so  in  Solipeds  and  Euminants,  have  attained  a  length 
which  is  not  at  all  proportionate  to  that  of  these  parts  when  their 
growth  is  completed.  And  several  bones  of  the  limbs,  such  as  the 
radial,  tibial,  metacarpal,  and  metatarsal  bones,  are  almost  fully 
developed  in  their  dimensions  at  birth.  The  following  interesting  table 
exhibits  the  comparative  weight  of  the  different  bones  in  the  Foal  and 
the  adult  Horse. 

The  weight  is  given  in  grammes  (15-432  troy  grains) : 


i 

d 

"a 

\^ 

a 

<o 

•a 

a> 

>>^- 

s 

.J^          g.      'Si  o 

3 

?o 

Species. 

1 

> 

o 
Q 

s 

n 

a 

§.2 
1 

5 

CO 

3 

S 

Carpu 

Metacar 

Digital  Uc 
Anteri 

o 

a 

3 

1 

c3 

51 
1^ 

grs. 

grs. 

grs. 

grs. 

grs. 

grs. 

grs. 

grs.    grs.    grs. 

grs. 

grs. 

grs. 

grs. 

grs. 

grs. 

Foal  at  Birth - 

315  1  390 

130 

383 

195 

188 

243 

59     238    139 

227 

232 

262 

66    271 

17 

Foal  at  Birth  - 

370 

350 

135 

2-26 

190 

205 

250 

40    240    131 

245 

254 

280 

62 

275 

173 

Foal  two  days 

old    -    -    - 

— 

— 

— 

159 

170 

224 

—    218     — 

— 

223 

246 

— 

255 

— 

Adult  Horse : 

large  size  - 

— 

— 

— 

— 

370 

310 

36 

45    240   170 

1 

450 

390 

360 

70 

280 

180 

SECTION  v.— PHYSIOLOGICAL  PHENOMENA  IN  THE  FCETUS. 

With  regard  to  the  physiological  phenomena  which  occur  during 
foetal  life,  we  cannot  presume  to  speak  in  detail  in  this  place.  It  is, 
however,  interesting,  and  perhaps  necessary,  to  allude  briefly  to  several 
of  the  most  important,  in  order  to  complete  this  portion  of  our  subject. 


PHYSIOLOGICAL  rilEXtiMHXA   IX  TIfK  FCETUS.  llt> 

Nervous  Functions. 

The  developmeut  of  the  tiervous  functiojis  is  one  of  these  phenomena 
worthy  of  attention.  It  appears  certain  that  the  young  creature  is 
formed  and  developed  without  the  direct  intervention  of  the  nervous 
intiuence  of  the  parent,  as  there  is  no  coniinunication  between  the 
nerves  of  the  uterus  and  the  fcetal  envelopes ;  and  it  has  not  been 
shown  that  there  are  nerves  either  in  the  latter,  or  yet  in  the  umbilical 
cord.  The  progressive  animation  of  the  new  creature  cannot,  therefore, 
be  derived  from  immediate  nervous  propagation,  or  direct  extension  of 
the  nervous  activity  from  the  mother  to  its  offspring ;  and  we  must 
look  upon  this  animation  as  originating  in  the  embryo,  and  becoming 
developed  under  the  influence  of  inappreciable  causes.  At  the  very 
commencement  of  embryonic  life,  the  nervous  system,  which,  in  extra- 
uterine existence,  holds  under  its  control  the  organic  functions,  appears 
now  to  have  no  possible  influence  on  the  phenomena  that  gradually 
manifest  themselves.  The  primary  changes  in  the  ovum  occur  before 
the  earliest  traces  of  the  nervous  system  are  apparent ;  and  while  its 
rudiments  are  forming,  those  of  other  parts  are  also  being  developed. 
Even  when  the  nervous  system  has  attained  a  somewhat  considerable 
growth,  it  does  not  appear  to  have  assumed  those  controlling  powers 
with  which  it  is  so  largely  endowed  at  a  subsequent  period. 

In  the  homogeneous  plasma  of  the  ovum,  in  the  common  blastema, 
coincidently  or  successively,  a  multitude  of  diilerent  parts  are  being 
formed  independently  of  each  other,  as  if  each  contained  within  itself 
the  why  and  wherefore  of  its  formation  and  ulterior  perfecting.  The 
nervous  system  itself  seems  to  be  submitted  to  the  same  general  laws, 
and  it  does  not  appear  to  be  dependent  upon  any  other  part,  neither  does 
any  part  depend  upon  it ;  even  when  it  is  fully  formed,  the  phenomena 
pertaining  to  growth  are  evidently  effected  without  its  stinmlating 
intervention.  Besides,  it  is  well  known  that  the  monstrosities  which 
are  sometimes  seen  destitute  of  brain  and  spinal  cord,  may  yet  reach 
the  end  of  their  foetal  development.  True,  certain  facts  have  appeared 
to  demonstrate  that  the  formation  of  parts  is  dependent  on  nervous 
action.  In  certain  monstrosities,  organs  have  not  become  developed 
when  the  nerves  which  should  have  been  distributed  to  them  were 
absent ;  in  others,  several  organs  have  become  fused  together  when 
their  nerves  were  similarly  aggregated  ;  while  an  organ  has  been 
divided  into  fractions  corresponding  to  the  accidental  development  of 
its  nerve.  The  muscles  of  the  posterior  part  of  the  body  of  the  fa'tus  of 
the  Cow  and  Pig  have  been  obsen-ed  to  be  absent  when  the  corre- 
sponding portion  of  the  spinal  cord  was,  with  its  nerves,  very  imper- 
fectly developed.  But  these  facts  do  not  prove  that  tlie  absence  of  the 
nerves  was  the  cause  of  the  non-development  of  the  nmscles ;  for  in 
such  cases  there  is  a  correlation  between  the  non-formation  of  the 
nerve  and  the  absence  of  the  muscle;  the  same  cause  whicli  has  hindered 
the  formation  of  the  one  in  a  certain  part  of  the  body  has  also  prevented 
the  growth  of  the  other  in  that  part.  It  is  the  same,  to  a  certain  point, 
with  the  relative  development  of  vessels  and  the  increase  of  the  parts  to 
which  they  are  distributed.  In  the  original  homogeneous  plasma,  there 
were  developed  the  diverse  elements  of  an  organ  at  the  same  time  as 
its  vessels,  and  the  force  which  created  the  connective,  nervous,  and 
muscular  tissues,  created  also  the  elements  of  the  vessels — ai'teries, 
veins,  and  capillaries ;  they  are  closely  related  to  each  other,  and  their 


120  OBSTETRICAL  PHYSIOLOGY. 

growth  goes  on  concurrently.  If  the  vessels  do  not  carry  a  sufficient 
supply  of  formative  material,  the  development  of  the  part  is  tardy  or 
ceases  ;  and,  on  the  other  hand,  if  the  latter  from  some  cause  becomes 
feeble  and  cannot  assimilate  this  material,  the  vessels  gradually  cease 
to  carry  it ;  consequently,  both  become  atrophied  when  they  cease  to 
grow. 

When  the  nervous  system  has  arrived  at  a  certain  degree  of  develop- 
ment, it  begins  to  assume  its  functions  ;  though  the  first  manifestations 
of  its  activity  are  very  obscure,  and  probably  limited  to  mere  tactile 
impressions,  evinced  by  movements  more  or  less  appreciable.  It  is 
well  known  that  in  the  pregnant  Mare  and  Cow,  after  their  ingestion 
of  a  large  quantity  of  cold  water,  the  foetus,  towards  the  end  of  the 
second  third  of  gestation,  and  more  particularly  in  the  later  months, 
executes  movements  which  are  at  times  so  marked  that  they  can  be  felt 
if  the  hand  is  applied  to  the  abdominal  parietes,  or  even  seen  in  the 
region  of  the  flank.  It  is  very  probable  that  these  automatic  or  reflex 
movements  may  produce  torsion  of  the  umbilical  cord,  and  in  this  way 
become  a  predisposing  cause  of  abortion.  Colin,  having  had  occasion 
to  lay  open  the  abdomen  of  a  living  pregnant  Mare  within  two  or  three 
months  of  parturition,  saw  the  foetus,  immediately  after  the  incision  in 
the  abdominal  walls,  jumping  about  in  the  uterus  in  a  very  lively 
manner  without  any  external  stimulus  being  applied  ;  it  moved  the 
whole  of  its  body,  or  withdrew  its  legs  or  head  when  pinched  through 
the  uterus  and  the  envelopes.  In  a  quarter  of  an  hour  after  removal 
from  these  and  the  mother,  it  no  longer  moved.  The  human  foetus  at 
five  months  has  been  seen  to  flex  and  extend  its  limbs  when  removed 
from  the  uterus. 

Towards  the  termination  of  gestation,  there  can  be  no  doubt  that  the 
foetal  movements  are  somewhat  energetic,  for  at  this  period  the  foetus 
changes  its  position  preparatory  to  passing  through  the  pelvis.  Thus 
the  young  Soliped,  during  the  whole  of  its  intra-uterine  existence,  lay 
with  its  abdomen  turned  upwards  and  the  posterior  limbs  lodged  in 
the  largest  of  the  two  cornua ;  but  it  now  turns  over  on  its  belly,  with 
the  legs  downwards  and  the  umbilical  cord  passing  across  one  of  its 
sides. 

The  movements  connected  with  deglutition  also  appear  to  be  per- 
formed at  an  early  stage  of  development,  for  some  of  the  hairs  which 
are  so  often  observed  in  notable  quantity  floating  in  the  amniotic  fluid, 
have  been  discovered  in  the  foetal  stomach. 

Absorption. 

The  phenomena  of  absorption  play  a  considerable  part  in  the  develop- 
ment of  the  young  animal.  As  soon  as  the  microscopic  ovule  reaches 
the  uterus,  its  vitelline  envelope  or  pellucid  zone  becomes  studded  with 
delicate,  hair-like  prolongations — villosities  without  vessels — which, 
steeped  in  the  fluid  thrown  out  on  the  uterine  surface,  transmit  this  to 
the  lamina  of  the  blastoderm.  At  first  this  absorbent  surface  is  very 
small,  and  the  growth  of  the  embryo  is  consequently  slow ;  neverthe- 
less, this  trifling  absorption  is  sufficient  to  increase  the  ovule  to  forty 
or  fifty  times  its  original  volume  before  the  blastodermic  laminae  and  the 
germinative  space  are  completed. 

Later,  when  the  umbilical  vesicle  is  formed  at  the  expense  of  the 
vascular  and  mucous  laminee,  its  vessels  absorb  the  soluble  matters  that 
are  added  to  the  mass  of  elements  necessary  for  the  growth  of  the 


PHYSIOLOGICAL  111 ES >>. MESA  IS  THK  ElETIS.  121 

embryo.  And,  finally,  when  the  chorion  is  at  last  organised,  and 
furnished  with  its  myriads  of  vascular  papilhe  in  the  form  of  dissemi- 
nated or  a^'glomerated  placentuhv,  absorption  goes  on  with  exaggerated 
activity  over  the  whole  uterine  surface  and  texture,  in  order  to  supply 
all  the  nutrition  required  for  the  now  rapid  development  of  the  foetus. 

The  nutritive  elements  are  absorbed  by  the  vessels  of  the  placental 
villosities,  transformed  into  blood,  and  conveyed  to  the  young  creature 
by  the  umbilical  veins.  This  extra-fcetal  absorption  is  supplemented  by 
that  which  is  taking  place  in  the  fluid  of  the  envelopes,  and  also  in  the 
organs  and  tissues  of  the  fa>tus  itself.  It  is  certain,  however,  that  the 
l)lacental  absorption  is  by  far  the  most  important,  and  that  the  rapid 
development  of  the  fa^tus  is  mainly,  if  not  altogether,  due  to  the  nutri- 
tive elements  obtained  there ;  while  it  is  not  improbable  that  the 
amniotic  fluid  found  in  the  stomach  and  intestines  may  act  as  a  dilator 
of  these,  modify  the  action  of  the  bile  accumulated  in  the  latter,  and 
perhaps  yield  a  small  amount  of  nutriment  ;  though  it  must  be'remem- 
bered  that  it  does  contain  much  of  the  nutritious  elements,  and  that 
the  fa?tus  which  is  unprovided  with  a  mouth,  and  therefore  cannot 
swallow,  is  nevertheless  as  well  developed  as  one  that  does  ingest  this 
fluid. 

Nutrition. 

It  has  been  shown  that  the  foetal  vascular  system  is  quite  distinct 
from  that  of  the  mother,  the  isolation  of  the  two  systems  being  complete, 
and  only  brought  into  contact  at  the  placenta  or  placentuhc.  There  the 
maternal  blood  is  conveyed  by  certain  arteries  into  particular  sinuses 
or  receptacles  of  the  uterus  containing  the  ultimate  radicles  of  these 
vessels,  which  emerge  into  veins ;  while  the  foetal  vessels,  extremely 
attenuated,  dip  down  into  these  receptacles  and  are  batlied  in  the 
blood  of  the  parent,  as  the  "gills"  or  branchiic  of  aquatic  creatures 
are  in  the  water  in  which  they  live.  But  the  actual  blood  of  parent 
and  offspring  never  meet  :  they  are  only  brought  into  indirect  contact; 
and  between  them  are  the  thin  coats  of  vessels,  basement  membranes, 
and  cells.  This  indirect  contact  is  sufficient  to  permit  the  venous  fcctal 
blood  to  become  arterial,  by  enabling  it  to  part  with  its  carbonic  acid, 
and  also  to  get  rid  of  excrementitious  matter  derived  from  the  different 
processes  connected  with  the  growth  of  the  foetus,  and  whose  retention 
in  the  blood  of  the  young  creature  would  doubtless  be  a  source  of  injury 
to  it.  This  arrangement  of  the  two  systems  of  vessels  also,  as  has  just 
been  said,  allows  certain  nutritious  elements  of  the  maternal  blood — its 
fluid  portion  only — to  be  taken  up  into  the  system  of  the  fu-tus.  In 
this  way,  as  has  been  pointed  out,  these  vascular  rootlets  of  the  placenta 
closely  correspond  to  the  villi  of  the  mucous  membrane  of  the  intestines; 
and  the  analogy  is  rendered  more  complete  when  we  know  that  the 
nutrient  material  is  selected  and  prepb,red  by  two  sets  of  cells,  one  of 
which — the  maternal — transmits  it  to  the  other — the  fcttal — in  the 
same  manner  as  the  epithelial  cells  of  the  intestinal  villi  seem  to  take 
up  and  prepare  the  nutrient  matter  that  is  destined  to  be  again  assimi- 
lated by  the  cells  which  float  in  the  circulating  fluid.  No  other  com- 
munication between  two  vascular  systems  exists  ;  and  the  fact  that  the 
blood  corpuscles  of  each  are  different  in  size,  conclusively  demonstrates 
that  they  must  be  distinct.  Nevertheless,  the  special  function  of  the 
placenta,  and  the  intimate  relation  existing,  through  it,  between  the 
fluids  of  parent  and  ofl'spring,  renders  it  evident  that  the  maternal 


122  OBSTETRICAL  PHYSIOLOGY. 

blood  may  become  impregnated  with  substances,  or  impressed  with 
attributes,  which  will  affect  the  development  or  modify  the  constitution 
of  the  foetus  ;  w^hile  pernicious  matters  generated  in  the  latter  may  prove 
more  or  less  noxious  to  the  mother. 

Circulation. 

In  order  that  the  nutritive  matters  absorbed  by  the  placental  villi  may 
reach  the  foetus  and  be  circulated  in  its  body,  it  is  necessary  that  a 
determining  and  regulating  power  should  be  brought  into  play  at  an 
early  period  in  the  existence  of  the  foetus.  This  power  appears  with 
the  formation  of  the  contractile  organ  which  has  been  named  the  heart. 
From  the  moment  when  this  important  organ  appears  in  the  form  of  a 
cylindrical  tube  at  the  commencement  of  embryonic  life,  it  dilates  and 
contracts  alternately,  first  to  receive  the  venous  blood,  and  then  to  propel 
it  into  the  arteries. 

The  fluid  w^hich  is  at  first  received  and  propelled  by  the  heart  is 
transparent,  colourless,  and  destitute  of  morphological  elements,  and 
the  organ  itself  exists  in  its  most  primitive  form.  As  has  been  stated, 
the  situation  of  the  heart  and  the  course  of  the  principal  trunks  of  the 
vascular  area  are  early  visible,  and  are  marked  by  the  peculiar  dis- 
position of  the  aggregations  of  cells  from  which  these  organs  are  to  be 
developed.  It  was  shown  that  whilst  the  outer  portions  of  these 
aggregations  were  transformed  into  the  u-alls  of  the  respective  cavities, 
the  inner  portions  appeared  to  deliquesce,  and  partly  to  remain  as 
isolated  cells  floating  in  the  resulting  fluid.  These  isolated  cells  are 
supposed  to  be  the  first  blood  corpuscles.  They  are  large,  colourless, 
vesicular,  spherical  cells,  full  of  yellowish  particles  of  a  substance  like 
fatty  matter.  Many  of  these  particles  are  quadrangular  and  flattened, 
and  have  been  called  stearine-plates,  though  their  composition  is  not 
ascertained  ;  each  cell  has  a  central  nucleus,  which  is  not  at  first  very 
distinct,  and  the  development  of  these  embryo-cells  into  the  complete 
form  of  corpuscles  is  effected  by  the  gradual  clearing-up,  as  if  by 
division  and  liquefaction,  of  the  contained  particles,  the  acquirement  of 
blood  colour  and  of  the  elliptical  form,  the  flattening  of  the  cell,  and 
the  more  prominent  appearance  of  the  nucleus. 

In  tracing  the  development  of  the  red-corpuscles  of  the  blood,  it  is 
found  that  at  first  their  nuclei  have  no  envelope,  but  contain  nucleoli ; 
that  they  present  all  the  characters  of  pale  elementary  cells,  whilst 
they  are  so  numerous  as  to  give  the  blood  a  whitish  hue.  When  more 
fully  developed  they  acquire  a  cell  and  a  reddish  tint,  and  at  a  later 
stage  are  circular,  thick  and  disc-shaped,  full-coloured,  and  about 
l-2500th  of  an  inch  in  diameter  ;  their  nuclei  are  central,  circular,  very 
little  prominent  on  the  surface  of  the  cell,  and  apparently  slightly 
granular  or  tuberculated. 

When  the  liver  begins  to  be  formed,  the  multiplication  of  blood-cells 
in  the  entire  mass  of  the  blood  ceases,  and  in  a  short  time  all  trace  of 
the  development  of  the  red  from  the  original  colourless  formative  cells 
is  lost ;  whilst,  on  the  other  hand,  there  takes  place  in  the  vessels  of  the 
liver  a  new  production  of  colourless  nucleated  cells,  which  are  formed 
around  free  nuclei,  and  which  undergo  a  gradual  change,  by  the  pro- 
duction of  colouring  matter  in  their  interior,  into  red  nucleated  cells. 
This  new  formation  of  blood  corpuscles  in  the  liver  continues  to  take 
place  during  the  whole  period  of  foetal  life  ;  but  whether  these  nucleated 
cells  themselves  undergo  transformation  into  the  non-nucleated  discs 


rHYSloLOmCAL  I'HEXO.MKXA   IX  THE  FlETI's.  \2% 

which  constitute  a  gradually  increasing  proportion  of  the  corpuscular 
components  of  the  blood  during  the  latter  period  of  embryonic  life,  or 
whether  these  are  formed  only  by  the  metamorphosis  of  lymph-cor- 
puscles, has  not  yet  been  determined. 

From  the  manner  in  whicli  the  circulation  is  carried  on  during  firtal 
life,  and  which  has  been  adverted  to,  it  is  seen  that  the  chief  propelUng. 
power  is  centred  in  the  right  side  of  the  heart  ;  the  force  of  tlie  left 
heart  being  mainly  spent  in  elYecting  a  due  supply  of  blood  to  the  head 
and  upper  extremities.  And  the  structure  of  the  heart  proves  this  to 
be  the  case,  for  the  walls  of  the  right  ventricle  have  been  found  as 
thick  as  those  of  the  left ;  while  the  walls  of  the  right  auricle  are  even 
thicker  and  more  muscular  than  those  of  the  left  auricle — a  condition 
which  persists  for  a  short  time  after  birth. 

The  isolation  that  exists  in  the  two  circulatory  systems  might  lead 
to  the  inference  that  there  was  no  relation  between  the  contractions  of 
the  heart  in  the  foetus  and  those  of  the  maternal  organ,  and  experience 
proves  this  to  be  the  case.  Naegele  has  noted  that  there  is  no  relation 
between  the  beats  of  the  heart  of  the  human  fa^tus  and  those  of  its- 
mother's  heart.  By  auscultation  he  was  able  to  distinguish  the  two 
sounds  of  the  fcjetal  heart,  and  found  it  beat  on  an  average  135  times 
per  minute — never  more  than  180,  nor  less  than  90  ;  and  he  remarked 
that  the  beats  were  sensibly  the  same  from  four  and  a  half  months,  when 
they  are  first  perceptible,  until  birth.  And  Hollmann,  in  resorting  to 
the  same  mode  of  investigation  in  Cows,  ascertained  that,  in  one  which 
was  advanced  eight  and  a  half  months  in  pregnancy,  and  whose  pulse 
was  G4  per  minute,  the  foetal  beat  was  l^l  ;  in  another  Cow,  but  which 
was  ill,  the  pulse  was  from  70  to  112,  while  that  of  the  foetus  was  113 
to  128. 

Colin  opened  a  living  Mare  which  had  been  pregnant  for  )iine  or  ten 
months,  and  a  Cow  whose  gestation  dated  about  three  months.  When 
the  uterus  of  the  Mare  was  opened,  and  the  contained  envelopes  incised 
to  extract  the  fa3tus,  the  latter  moved  actively  and  respired  deeply, 
though  at  rare  intervals.  The  umbilical  arteries  and  vein  yielded  some 
blood,  from  the  small  punctures  made  through  their  walls  ;  the  lirst 
throbbed  with  a  certain  amount  of  force,  and  the  pulsations  were  rapid. 
When  the  cord  was  divided  and  tied,  the  foetus  appeared  to  be  dead  : 
there  were  no  more  spontaneous  movements,  and  the  respiration  had 
ceased.  The  thorax  and  the  abdomen  were  now  thrown  open,  and  it 
was  observed  that  the  heart  contracted  spontaneously  and  strongly,  and 
the  pulsations  of  the  aorta  and  umbilical  arteries  could  be  very  distinctly 
felt.  At  first  the  contractions  of  the  auricles  regularly  alternated  with 
those  of  the  ventricles,  as  in  a  normal  condition  ;  but  soon,  as  occurs  in 
expiring  animals,  the  auricles  contracted  several  times  fur  one  contrac- 
tion of  the  ventricles,  as  if  it  required  several  systoles  of  these  to  fill  the 
ventricular  cavities.  At  each  contraction  the  auricles  diminished  nmch 
in  volume,  became  nearly  empty,  and  looked  very  pale,  but  assumed 
their  reddish-violet  colour  again  during  their  diastole.  At  last  tlie 
rhythmical  movements  became  altogether  perverted  ;  the  auricles  and 
ventricles  contracted  simultaneously  and  quickly,  but  more  and  more 
feebly,  and  finally  ceased  altogether  half  an  hour  after  the  thorax  had 
been  opened.  The  Cow  in  which  the  foetal  circulation  was  studied  had 
its  flank  widely  incised,  and  one  of  the  cornua  of  the  uterus  withdrawn 
through  the  opening.  Some  of  the  placentula)  were  removed  with 
difliculty  from  their  cotyledons,  and  both  bled  a  good  deal     When  the 


124  OBSTETRICAL  PHYSIOLOGY. 

umbilical  cord  was  exposed,  the  beating  of  its  very  tense  arteries  could 
be  distinctly  felt ;  and  when  compressed,  these  enlarged  between  the 
foetus  and  the  point  where  the  pressure  was  applied.  On  removing  the 
foetus  from  the  uterus,  it  did  not  make  any  perceptible  movement,  but 
then  it  was  only  three  or  four  months  old.  The  thoi'ax  having  been 
•opened,  the  action  of  the  heart  was  observed  to  resemble  that  of  the 
•other  foetus  ;  there  were  31  pulsations  in  the  first  minute,  IS  in  the 
third,  11  in  the  fourth,  and  21  in  the  fifth.  The  beats  ceased  in  about 
twenty-five  minutes.  In  these  two  experiments,  as  well  as  in  others 
made  on  smaller  animals,  M.  Colin  found  it  impossible  to  perceive  any 
•difference  in  colour  between  the  blood  of  the  umbilical  arteries  and  that 
•of  the  veins,  both  fluids  showing  a  tint  intermediate  to  that  of  the 
•arterial  and  venous  blood  of  the  adult. 

Secretion. 

With  regard  to  secretion  in  the  foetus,  it  is  worthy  of  remark  that 
•several  glandular  structures  at  an  early  period  and  during  foetal  life  ex- 
hibit a  remarkable  degree  of  activity  ;  and  more  especially  is  this  the 
•case  with  those  of  the  stomach  and  intestines,  the  liver,  the  mucous 
membrane  of  the  air-passages,  and  the  kidneys.  The  glands  of  the 
jiiouth  and  oesophagus  only  furnish  the  mucus  that  covers  the  mem- 
brane lining  these  parts,  but  it  is  not  long  before  the  stomach  is  filled 
with  a  white  or  colourless  viscid  fluid,  in  which  is  a  large  proportion  of 
■epithelial  cells  and  nuclei.  Colin  has  found  as  much  as  229  grammes 
of  this  fluid  in  the  stomach  of  a  Foal  at  birth,  from  150  to  180  in  Lambs 
at  the  same  period,  200  to  300  in  Calves  towards  the  middle  of  gesta- 
tion, and  500  to  600  in  those  at  birth.  It  is  neutral  or  slightly  alkaline, 
and  contains,  more  especially  in  the  foetuses  of  Solipeds  and  Kumin- 
ants,  a  ver}-  large  proportion  of  sugar,  with  mucine  and  salts.  This 
fluid  can  scarcely,  however,  be  looked  upon  as  a  gastric  secretion,  but 
rather  as  a  mixture  of  this  with  the  amniotic  liquid  swallowed  by  the 
foetus  ;  and  it  appears  certain  that,  though  the  mucous  glands  are  active, 
yet  those  which  elaborate  the  pepsine  are  inactive.  The  stomach 
■of  a  foetal  Calf  twenty  weeks  old,  digested  for  eight  days  in  milk  at  a 
temperature  of  20  degrees  (Cent.),  transformed  that  fluid  into  a  gela- 
tinous mass,  but  did  not  coagulate  it. 

The  secretory  function  of  the  pancreas  is  so  obscure,  that  it  has  not 
yet  been  determined. 

The  biliary  secretion  soon  appears,  and  is  remarkably  abundant.  In 
the  foetus  of  the  Cow  at  birth,  a  small  quantity  of  clear  bile  having  a 
slight  greenish  tint  is  found  in  the  gall-bladder;  and  at  the  fourth  month 
■of  gestation,  the  large  intestines  of  this  creature  and  the  foetuses  of 
Solipeds  are  filled  with  meconium,  which  is  recognisable  through  the 
walls  of  the  tube  by  its  green  hue.  The  foetal  bile  becomes  thicker  and 
deeper-coloured  as  birth  approaches ;  it  is  insipid  and  alkaline.  M. 
Lassaigne  analysed  that  of  the  foetus  of  a  Cow  six  months  old,  and 
found  two  colouring  matters,  mucus,  the  carbonate  and  chloride  of 
sodium  and  phosphate  of  lime,  but  no  picromel. 

Mixed  with  the  fluids  thrown  out  by  the  intestines  and  the  other 
matters  entering  them,  it  forms  the  meconium,  which  is  composed, 
a,ccording  to  Simon,  of  cholesterine  16,00  ;  extractive  matter  and  biliary 
resin  10,40  ;  caseous  matter  34,00  ;  picromel  6,00 ;  green  colouring 
matter  4,00 ;  and  epithelium,  mucus,  albumin  26,00.  This  meconium 
is  scanty  in  the  first  periods  of  foetal  life,  and  has  been  found  to  be 


WEIGHT  AND  DIMENSIONS  OF  THE  FlETL'S  AT  BIRTH.  Vlb 

white  in  foetuses  destitute  of  a  liver,  as  well  as  in  others  whose  intestine 
was  obliterated  below  the  entrance  of  the  biliary  duct.  It  is  very  con- 
sistent and  plentiful  in  the  intestines  at  birth,  in  those  of  a  Foal  whoso 
stomach  contained  2i29  grannnes  weight  of  the  white  viscid  fluid  above 
mentioned,  there  were  found  216  grammes  of  greyish  meconium  in  the 
small  intestines,  and  559  of  green  in  the  large  intestines.  This  product 
is  frequently  expelled  in  certain  quantities  towai'ds  the  end  of  gestation, 
and  is  found  in  the  liquor  anmii,  winch  owes  its  yellow  colour  to  its 
presence  ;  it  is  swallowed  with  this  lluid,  and  is  then  observed  in  small 
masses  in  the  stomach. 

The  liver  appears  to  bo  engaged,  during  fu>tal  life,  in  the  depuration 
of  the  blood,  as  appears  from  this  accumulation  of  meconium,  which  is 
chietly  altered  bile ;  but  at  the  same  time,  as  has  been  stated,  it  is 
serving  as  a  blood-making  organ,  and  this  is  probably  its  principal  func- 
tion before  birth. 

The  secretion  of  urine  is  somewhat  active  during  intra-uterine  life,. 
and  appears  to  be  el^ected  by  the  Woltlian  bodies  before  the  kidneys 
begin  to  act.  It  is  not,  however,  until  the  end  of  gestation  that  a  notable 
quantity  of  urine  is  found  in  the  bladder,  and  urea  in  the  allantoic  fluid 
of  the  Cow.  It  is  certain,  however,  that  this  fluid  is  not  altogether  the 
urine  of  the  fa^tus,  as  its  proportion  is  relatively  larger  at  an  early 
epoch  of  foetal  life,  and  the  connnunication  between  the  bladder  and 
allantois  is  more  limited  towards  parturition. 

With  regard  to  the  function  of  the  thyroid  and  thymus  "glands,"  as 
they  have  been  termed,  and  the  spleen  and  suprarenal  capsules,  during 
fcetal  life,  there  is  but  little  positively  known.  It  appears,  however,  to 
be  admitted  that  the  ottice  performed  by  tliese  ductless  or  vascular 
glands,  is  to  restore  to  the  circulating  current  any  substances  which 
they  may  withdraw  from  it,  and  that  their  action  is  subsidiary  to  the 
process  of  sanguification  ;  being  exercised,  perhaps,  chiefly  upon  that 
portion  of  the  nutrient  materials  which  did  not  pass  through  the 
absorbent  system  when  first  introduced,  but  was  taken  up  directly  by 
the  bloodvessels. 

SECTION  VI.— WEIGHT  AND  DIMF.XSK  )XS  OF  THE  F(ETrS  AT  BIRTH. 

The  various  phenomena  coimected  with  development  having  been 
completed,  so  far  as  uterine  existence  is  concerned,  it  may  be  useful  to 
note  wliat  has  been  ascertained  with  regard  to  the  icciyht  and  dtJiioi- 
sious  of  the  fa>tus  at  birth  ;  the  latter  being  of  much  importance 
from  an  obstetrical  point  of  view,  though  it  is  a  subject  which  has  not 
received  all  the  attention  it  merits  from  veterinary  obstetrists. 

Weight. 

With  regard  to  weight,  we  find,  as  might  be  expected,  that  this 
varies  considerably,  according  to  the  size,  breed,  and  condition  of  the 
parents,  and  other  circumstances  which  more  or  less  influence  growth. 

For  the  Horse  species,  Boussingault  estimated  that  Foals  from  parents 
weighing  from  400  to  500  kilogrammes,  weighed  at  birth  from  50  to  51 
kilogrammes.^  Franck  estimated  that  the  Foal  weighs  00685  the 
weight  of  the  mother  before  parturition.  According  to  a  table  drawn 
up  by  Saint-Cyr,  it  appears  that  a  Foal  at  birth  may  vary  in  weight 
between  31  and  55  kilogrammes,  according  to  breed  and  individual 

'  The  kilogramme  is  equal  to  2  205  pounds  cvoirdupoii>. 


126  OBSTETEICAL  PHYSIOLOGY. 

peculiarities  ;  though  between  38  and  45  kilogrammes  may  be  accepted 
as  the  average  weight. 

With  regard  to  the  Bovine  species,  Tisserant  has  stated  that  Calves 
weigh  at  birth  from  -jV^h  to  -^^th.  of  the  weight  of  the  Cow ;  whereas 
Eiedesel  gives  it  as  yV^h.  Magne  mentions  that  Calves  vary  between 
20,  25,  45,  and  50  kilogrammes.  Saint-Cyr  alludes  to  the  observa- 
tions made  at  the  Agricultural  School  of  Saulsie,  France,  where  Cows 
■of  the  Ayrshire  breed  were  chiefly  kept.  The  animals  were  main- 
tained in  good  condition  all  the  year  round,  and  though  they  were 
only  middle-sized,  their  weight  varied  between  400  and  650  kilo- 
grammes. The  Cows  were  regularly  weighed,  as  were  the  Calves 
immediately  after  birth,  and  the  register  for  1868  gave  the  following 
results.  The  weight  varied  from  31  to  55  kilogrammes — the  average 
being  32^  kilogrammes.  The  males  were  a  little  heavier  than  the 
females.  In  twenty-eight  instances,  the  average  weight  of  the  Calf 
compared  with  that  of  the  Cow  was  as  2  to  31. 

The  average  weight  of  one  hundred  Lambs  weighed  at  the  Alfort  pens, 
is  given  by  Magne  as  about  4  kilogrammes  for  both  sexes.  The  males 
■were  heaviest. 

For  the  Goat,  Colin  gives  the  weight  of  twins  in  two  instances.  In 
the  first,  one  twin  weighed  3"530,  and  the  other  3"585  kilogrammes — 
together  7'215  kilogrammes ;  in  the  second  instance,  one  twin  weighed 
2-6830,  and  the  other  2-680  kilogrammes — the  weight  of  the  two  being 
■5-310  kilogrammes. 

Dimensions. 

With  regard  to  dimensions,  Saint-Cyr  justly  regrets  the  paucity  of 
observations  which  have  been  made  on  this  important  point.  It  is  of 
course  well  known  that,  in  a  general  way,  the  fcetus  is  larger  than  the 
pelvic  opening  through  which  it  has  to  pass  at  birth,  but  we  have  to 
ascertain  how  much  larger  it  is  than  that  canal,  and  what  is  the 
-amount  of  reduction  in  volume  to  which  it  has  to  submit  in  passing  the 
outlet  of  the  pelvis.  Eainard  merely  states  that  some  measurements 
he  had  made  gave  the  diameter  of  the  thorax  of  Calves,  from  withers 
to  sternum  (vertical)  as  from  10\  to  11  inches;  and  the  diameter  from 
side  to  side  (transversal)  as  6^  to  7  inches.  Saint-Cyr,  anxious  to 
arrive  at  some  definite  conclusion  in  the  matter,  in  order  the  better  to 
understand  the  mechanism  of  natural  parturition,  as  well  as  to  gain  a 
knowledge  of  how  to  surmount  the  difficulties  of  protracted  labour, 
undertook  some  researches  in  this  direction.  His  object  was  to  ascer- 
tain the  depth  and  width  of  the  chest,  and  width  of  croup  of  the  fcetus, 
these  being  the  dimensions  which  it  is  most  important  to  compare  with 
the  different  diameters  of  the  pelvis  of  the  mother,  so  as  to  understand 
how  the  former  may  accommodate  themselves  to  the  latter.  He  gives 
the  name  of  stcrno-dorsal  line  to  the  vertical  measurement  taken  from 
the  summit  of  the  highest  dorsal  spines  to  the  sternum,  and  hiscapulo- 
liuineral  line  to  the  distance  measured  from  one  scapulo-humeral  articu- 
lation to  the  other  ;  while  the  bicoxo-fcmoral  line  is  the  measurement 
•of  the  croup  from  one  coxo-femoral  articulation  to  the  other.  From  the 
measurements  in  the  Horse  species,  we  find  that  a  Mare  measuring  a 
trifle  over  fifteen  hands  in  height,  and  whose  pelvis  was  nearly  nine- 
teen inches  in  width,  brought  forth  a  Foal  weighing  slightly  less  than 
thirty  pounds,  and  whose  sterno-dorsal  measurement  was  nearly  twelve 
inches,  biscapulo-humeral  line  7|  inches,  and  bicoxo-femoral  line  nearly 


PREOXAXry.  127 

8  inches.  The  othei*  measurements  of  Maros  and  Foals  yielded  similar 
results,  and  give  an  idea  of  the  expulsive  ellbrts  the  uterus  must  make 
to  expel  the  fcetus.  In  the  case  tirst  cited,  it  may  be  admitted  that 
the  pelvis  of  the  Mare  had,  approximately,  the  following  dimensions  : 
inlet  of  the  pelvis — sacro-pubic  diameter,  0  inches  ;  inlet  of  the  pelvis 
— bi-iliac  diameter,  8^  inches.  In  comparing  these  dimensions  with 
those  of  the  Foal  to  which  it  gave  birth,  it  is  obvious  that  the  biscapulo- 
humeral  and  bicoxo-femoral  diameters  of  the  latter  could  be  easily 
accommodated  by  the  bi-iliac  diameter  of  the  mother,  as  they  are  less 
by  1^  and  ^  inch  ;  but  it  is  not  the  same  with  regard  to  the  sacro-pubic 
diameter,  which  is  less  by  nearly  three  inches  than  the  sterno-dorsal 
line  of  the  fcietus.  It  is  therefore  evident  that,  in  order  to  pass  through 
the  pelvis,  this  line  must  be  diminished  at  least  by  three  inches.  In 
the  second  edition  of  his  work,  he  gives  the  measurements  of  other 
parts  of  the  body  of  the  fcttus,  but  their  consideration  leads  to  com- 
plexity. In  studying  the  table  he  has  drawn  up  of  these  various 
measurements  in  the  Foal,  he  thinks  an  idea  may  be  formed  of  the  force 
of  the  uterine  contractions  necessary  to  expel  the  foetus;  and  again 
remarks  that,  even  when  the  largest  circumference  of  Foals  only  slightly 
exceeds  that  of  the  pelvic  inlet  of  the  Mare,  or  is  equal  to  it,  a  great 
amount  of  accommodation  must  nevertheless  take  place  in  the  thorax 
of  the  young  creature,  as  the  sterno  dorsal  diameter  is  greater  than  the 
sacro-pubic  diameter  of  the  mother.  When  gestation  is  prolonged  the 
fa'tus  is  still  larger,  and  the  difliculty  in  its  expulsion  is  increased. 

With  regard  to  the  Bovine  species,  nine  Cows  were  tabulated.  The 
first,  the  smallest,  was  11|  hands  high,  and  the  width  of  the  croup  18J 
inches  ;  the  weight  of  the  fcetus  was  about  sixty-two  pounds,  the 
sterno-dorsal  diameter  10.\  inches,  the  biscapulo-humeral  G,',-,  inches, 
and  the  bicoxo-femoral  7i\  inches.  Another  Cow  was  l-2\  hands  higli, 
the  width  of  croup  IS^^  inches;  the  weight  of  the  fa-tus  was  about 
seventy-three  pounds,  the  sterno-dorsal  diameter  10^  inches,  the 
biscapulo-humeral  G  inches,  and  the  bicoxo-femoral  8^'^  inches.  With 
a  Cow  12?  hands  high,  and  croup  18  inches  in  width,  which  had 
experienced  a  protracted  accouchement  in  consequence  of  the  size  of 
the  calf,  and  which  had  aborted  the  previous  year,  the  weight  of 
the  fa-tus  was  sixty-six  pounds,  the  sterno-dorsal  diameter  15  inches, 
the  biscapulo-humeral  7^  inches,  and  the  bicoxo-femoral  8^  inches. 
The  circumference  of  the  chest  of  the  Calf  being  so  much  greater  than 
the  inlet  of  the  Cow's  pelvis,  explains  why  it  is  tliat  parturition  in 
this  animal,  even  when  normal,  is  longer  than  in  the  Mare. 

With  regard  to  the  Ovine  and  Caprine  species,  the  fa-tus  is  rela- 
tively smaller  in  dimensions  than  the  Calf ;  while  in  animals  which  are 
usually  multiparous,  the  young  are  always  less  in  circumference  than 
the  pelvic  inlet,  though  when  it  happens  that  they  have  only  one  foetus 
this  is  often  so  increased  in  size  that  birth  becomes  very  protracted, 
and  may  even  be  impossible. 

CHAPTER    V. 
Pregnancy. 

Gkst.\tion,  or  i^rcgnancy,  comprises  the  period  during  which  the  female 
animal  carries  its  young  while  this  is  undergoing  development.  Its 
consideration  is  of  much  moment,  and  we  will,  with  regard  to  it,  study 


128  OBSTETRICAL  PHYSIOLOGY. 

it  in  this  chapter  from  a  normal  or  physiological  point  of  view — noticing 
the  anatomical  and  functional  alterations  attending  it,  the  mode  of 
recognising  it,  its  duration  in  various  species  of  animals,  and  the  excep- 
tional departures  from  the  usual  law  with  respect  to  the  number  of 
young  produced. 

It  has  already  been  remarked  that  soon  after  fecundation  the 
female  becomes  generally  more  tranquil,  and  indifferent  to  the  male, 
who  also  does  not  seek  her  company  so  ardently  as  before  ;  while  a  cer- 
tain amount  of  sluggishness  may  be  observed  in  her  movements.  These 
changes  in  habit  become  more  marked  as  time  advances,  and  along 
with  them  the  other  alterations  referred  to,  and  now  to  be  described. 

SECTION  I.— MODIFICATIONS  IX  THE  UTERUS  DURING  PREGNANCY. 

With  the  development  of  the  foetus,  the  uterus  undergoes  important 
anatomical  and  physiological  modifications ;  while  the  system  of  the 
mother  also,  as  stated,  participates  more  or  less  generally  in  the 
phenomena  which  mark  the  period  of  gestation.  The  modifications 
and  phenomena  are  worthy  of  attentive  notice,  not  only  from  the 
importance  they  hold  with  regard  to  the  reproduction  of  animals,  but 
also  from  the  practical  issues  involved  in  the  study. 

The  anatomical  changes  in  the  uterus  are  those  relating  to  its  volume, 
structure,  form,  situation,  and  direction. 

Voluvie. 

With  regard  to  volume,  we  have  seen  that  during  and  after  copulation 
the  uterus  is  congested,  and  that,  when  conception  has  taken  place,  the 
thin  pulpy  secretion  corresponding  to  the  decidua  of  the  human  female 
covers  its  internal  surface.  The  vessels,  distended  with  blood,  gradu-. 
ally  enlarge  to  a  great  size — from  the  smallest  to  the  largest  forming 
most  intricate  and  beautiful  plexuses  on  and  in  the  texture  of  the  organ. 
The  coats  of  the  arteries  are  thickened  to  compensate  for  their  disten- 
sion, and  the  additional  labour  they  have  to  perform  ;  while  the  veins 
are  still  more  enlarged  in  calibre.  The  lymphatics  are  likewise  aug- 
mented in  number  and  dimensions  ;  and  the  nerves,  w^hich  were  com- 
paratively small  in  the  unimpregnated  state,  enlarge  and  anastomose 
so  freely  as  to  compose  a  network  similar  to  that  of  the  vessels — the 
increase  taking  place  in  the  nerve  terminations,  not  in  the  nerve  sub- 
stance. 

In  uniparous  animals  in  which  the  foetus  is  developed  in  one  of  the 
cornua,  this  becomes  greatly  increased,  and  appears  to  be  continuous 
with  the  body  of  the  uterus,  the  other  horn  looking  like  a  mere  appen- 
dage projecting  from  its  side  ;  but  with  multiparous  females  the'cornua 
increase  nearly  alike  in  size,  owing  to  their  being  each  occupied  by  the 
foetuses  (Fig.  65). 

Structure. 

These  changes  add  to  the  thickness  and  density  of  the  uterus ;  but 
there  are  others  still  more  remarkable.  While  the  organ  is  increasing 
in  volume,  becoming  rounder,  acquiring  a  greater  capacity,  and  its 
cervix  widening,  its  proper  structure  is  exaggerated  to  an  extraordinary 
degree.  This  exaggeration,  however,  does  not  occur  equally  through- 
out ;  it  is  most  marked  in  the  cornua  of  multiparous  creatures  at  the 
points  where  the  young  are  fixed — in  Euminant  animals  at  the  situa- 
tion of  the  cotyledons,  and  in  Solipeds  at  the  part  of  the  body  of  the 


MODIFICATloXS  IX  THE  UTEJiL'S. 


129 


Uterus  coiTcsponcling  to  the  fa'tal  i>laceuta.  So  that,  at  least  in  the 
early  months  of  pregnancy,  it  is  thinnest  towards  the  cervix.  The 
increased  thickness  of  the  organ,  however,  never  equals  that  observed 
in  the  human  female,  compared  with  which  the  walls  of  the  uterus  of 
the  domesticated  animals  are  thin. 

The  firmness  or  density  of  the  organ  is  always  most  conspicuous  in 
the  cornua,  and  in  the  operation  of  "spaying,"  or  castration  of  the 
female,  this  serves  as  a  useful  guide  in  enabling  the  operator  to  distin- 
guish between  them  and  the  intestines,  which  they  so  closely  resemble 
in  appearance. 

But  during  pregnancy  this  density  seems  to  diminish  as  the  organ 


Fig.  64. 

Vertical  Section  through  a  Portion   ok  thk   Uterine  Cotylkoon  or  a 
Cow  IN  AN  Eaui.t  Stage  of  IMiegnancy. 

o,  Serous  Membrane  ;  h.  Section  of  Longitudinal  Muscular  Layer  ;  c,  External, 
and  (•',  Internal  Layers  of  the  Circular  Muscle  ;  '/,  SuWmucoxa,  with  Vessels  ; 
C,  Adenoid  Tis-un  i,f  the  Cotyledon  ;  /'  New  Tissue  of  the  Placenta  Uterina  ; 
g.  Section  of  the  Mucous  Lajer  of  the  Cntyledon,  with  the  Interspaces  into 
which  the  Fatal  Cotyledons  are  inserted  ;  //,  h,  I'tricular  tJlands  piutsing 
iinder  the  Side  of  the  Cotyledon  ;  i,  i.  Large  Cotyledonal  Vessels  ;  k,  Uterina 
Mucosa  ;  /,  /,  Epitht-lial  Layer  of  the  Cotyledon. 

becomes  more  vascular,  and  the  cervix  assumes  a  much  softer  condition 
than  usual.  For  instance,  in  the  ftetal  cornu  of  a  Cow  advanced  three 
months  in  pregnancy,  the  thickness  of  the  wall  was  only  2*0  milli- 
metres, while  in  the  other  horn  it  was  4  millimetres.  In  another 
Cow  at  five  months,  it  was  4  millimetres  in  the  foetal  horn  and  5 
millimetres  in  the  vacant  one.  The  mucosa  is  thicker,  redder,  more 
pulpy  and  vascular,  than  before  impregnation  ;  the  longitudinal  rugai  it 
then  exhibited  gradually  disappear  ;  the  epithelium  covering  it  usually 
loses  its  columnar  form  ;  the  utricular  glands  enlarge — they  are  longer 
and  their  orifices  wider,  and  their  secretion,  as  well  as  that  of  the  other 
glands,  is  increased ;  the  interglandular  tissue  is  largely  and  rapidly 
augmented  by  multiplication  of  the  ceils  of  the  surface  epithelium,  and 


130  OBSTETRICAL  PHYSIOLOGY. 

proliferation  of  the  corpuscles  of  the  sub-epithelial  connective  tissue,  so 
that  the  glands  are  more  widely  separated  ;  while  the  uterine  cotyledons 
grow  quickly,  and  there  can  be  no  doubt  that  new  ones  appear. 
Rainard  speaks  of  examining  the  uterus  of  several  calves  and  lambs, 
and  finding  only  thirty  or  forty  cotyledons ;  while  after  parturition  he 
has  counted  more  than  a  hundred ;  and  more  recent  observers  have 
testified  to  this  fact.  In  the  uterus  of  a  six  months  pregnant  Cow, 
Franck  found  that  the  hoi-n  containing  the  foetus  had  forty-seven  coty- 
ledons and  weighed  3,54  pounds  ;  while  the  other  horn  had  only  forty- 
two  placentae,  and  weighed  no  more  than  0,22  pound. 

In  addition  to  these  supplementary  appendages  of  the  mucous  mem- 
branes, a  new  glandular  apparatus,  of  which  no  trace  was  to  be  found 
previous  to  gestation,  now  makes  its  appearance  in  the  form  of  a  large 
number  of  small  openings  in  the  mucosa,  each  leading  into  a  depression 
which  was  for  a  long  time  regarded  as  the  dilated  mouth  of  the  tubular 
or  utricular  glands,  but  which  is  really  a  "  crypt  "  formed  in  the  hyper- 
trophied  tissue  of  the  uterus — a  kind  of  open  follicle  placed  in  the  inter- 
glandular  part  of  the  mucous  membrane.  These  crypts  are  new 
structures,  formed  during  pregnancy,  and  are  for  the  lodgment  of  the 
villi  that  project  from  the  chorion  of  the  foetus — being,  in  fact,  the 
maternal  cotyledons  or  maternal  portion  of  the  placenta.  They  are 
small  straight  depressions,  lying  more  or  less  closely  together  through- 
out the  whole  of  the  uterine  mucous  membrane  of  the  Mare,  their 
cavity  being  lined  by  a  layer  of  tessellated  epithelium,  and  a  very  fine 
capillary  network  surrounding  each.  In  the  Cow,  these  crypts  are 
assembled  on  the  surface  of  the  projections  designated  cotyledons,  of 
which  they  constitute  nearly  the  entire  mass  during  pregnancy.  In 
the  Bitch  they  are  only  developed  where  the  ovum  is  fixed,  forming 
then  a  glandular  layer  occupying  the  contour  of  the  uterine  cornu. 

The  utricular  glands  do  not  open  directly  into  crypts,  nor  is  their 
secretion  poured  into  them,  but  on  a  definite  surface  of  the  mucous 
membrane  between  the  crypts,  the  size  and  areas  of  which  correspond, 
of  course,  to  the  size  and  arrangement  of  the  foetal  tufts. 

Between  the  foetal  and  maternal  placentae  there  is  always  a  layer  of 
epithelial  cells  of  varying  thickness,  which  represents  the  viemhrana 
decidua  or  serotina  of  woman.  If  not  during  parturition,  at  least  after- 
wards, all  placental  mammals  are  more  or  less  "  deciduate."  With  the 
Cow  and  Sheep,  for  example,  large  quantities  of  cells,  possessing  the 
character  of  epithelial  cells  of  the  pits  and  crypts  of  the  maternal 
cotyledons,  have  been  found,  mingled  with  the  villi  of  shed  foetal  cotyle- 
dons, in  the  fluid  extruded  during  and  after  parturition — showing  that 
a  portion  of  the  maternal  structure  is  carried  away  at  this  time.  The 
crypts  possess  the  sti-uctural  characters  of  secreting  organs ;  and,  indeed, 
we  cannot  but  look  upon  the  maternal  placenta  and  the  remarkably 
modified  mucous  lining  of  the  uterus  as  a  great  secreting  apparatus. 

In  addition  to  the  mucous  membrane,  the  outer  or  serous  membrane 
is  also  hyper trophied,  the  broad  ligaments  are  increased  in  every  direc- 
tion, but  especially  in  length,  and  muscular  fibres  are  abundantly 
developed  between  their  layers,  in  order  to  give  them  sufiicient  strength 
to  sustain  the  weight  of  the  uterus.  In  the  Cow,  the  fibres  even  form 
very  distinct  intercrossing  fasciculi. 

The  greatest  increase  of  all  noted  in  the  texture  of  the  uterus,  occurs 
in  the  middle  or  muscular  tunic.  There  appears  to  be  a  vast  multipli- 
cation of  the  fusiform  nucleated  fibres  going  on  during  pregnancy,  as 


MUliIFICATKiXS  IX  THE  rTKIU'S.  l:Jl 

wt'll  as- an  immense  increase  in  the  volume  of  those  already  existing'. 
This  tunic  gi'adually  becomes  redder  as  well  as  thicker,  and  the  muscular 
fasciculi  more  distinct,  and  visibly  more  numerous  ;  its  contractile 
power  also  increases.  The  inner  layer,  composed  of  circular  fibres,  is 
most  conspicuous  in  the  cornua  of  Carnivorous  animals,  and  there  tlii'y 
contract  in  tlie  interspaces  between  the  younj^,  so  as  to  form  well- 
marked  constrictions.  The  connective  tissue  which  unites  the  muscular 
fibres  also  increases  during  pregnancy,  and  becomes  markedly  fibrous. 

Sensibility. 

With  the  increase  in  volume,  weight,  and  capacity,  the  uterus  like- 
wise acquires  a  higher  degree  of  sensibility,  doubtless  from  the  develop- 
ment of  its  nerves.  So  that  between  the  cervix,  the  body,  and  the 
cornua,  there  is  established  a  sympathetic  relation  that  is  sometimes 
not  advantageous  ;  for  irritation  of  the  cervix,  howsoever  produced, 
may  bring  on  violent  contractions  of  the  whole  organ,  and  lead  to  the 
premature  expulsion  of  the  foetus.  This  expulsion,  as  is  well  known, 
sometimes  follows  copulation  ;  though,  as  a  rule,  animals  usually  do 
not  seek  to  copulate  during  pregnancy  if  left  to  their  own  natural 
instincts.  It  may  also  be  a  consequence  of  manipulation  by  the  hand 
of  the  explorer. 

This  contractility  of  the  uterus  is  sometimes  evidenced  before  par- 
turition, when  animals  have  been  killed  and  quickly  opened.  Colin 
has  witnessed  well-marked  movements  in  the  uterus  of  a  Cat  which 
contained  five  young — three  in  one  horn  and  two  in  the  other ;  these 
contractions  were  most  energetic  at  the  constricted  spaces  between  the 
fa-tuses.  The  same  talented  veterinary  physiologist  has  seen  similar 
phenomena  in  Sheep  at  different  periods  of  gestation  ;  the  cornua  con- 
tracted and  dilated  alternately,  and  approached  or  withdrew  from  each 
other  or  the  body  of  the  uterus  ;  the  movements  persisting  sometimes 
for  forty  or  fifty  minutes  after  the  animal's  death.  In  a  pregnant  Cow 
opened  when  alive,  the  same  contractions  were  noted  ;  they  became 
more  active  and  stronger  under  the  influence  of  a  slight  irritation  ;  the 
cornua  changed  their  form  in  contracting;  they  shortened  sensibly, 
and  became  twisted  on  themselves  at  their  anterior  extremity.  In  a 
Mare  identical  contractions  were  seen. 

llaller  had  long  ago  remarked  that,  even  in  unimpregnated  animals, 
these  uterine  contractions  were  present—though  they  were  most  ener- 
getic in  the  pregnant  Bitches,  Cats,  and  Rabbits  he  opened ;  the  move- 
ment was  spontaneous  and  peristaltic,  like  that  of  the  intestines,  and 
it  continued  in  the  organ,  even  when  it  was  removed  from  the  body. 
Those  veterinarians  who  have  had  occasion  to  insert  their  hand  into  the 
uterus  of  one  of  the  larger  animals,  to  adjust  the  fcctus  or  for  any 
other  object,  must  have  been  astonished,  and  frequently  embarrassed, 
at  the  firmness  with  which  the  arm  was  grasped  at  the  cer\-ix  during 
the  expulsive  efforts  the  creature  made. 

These  uterine  contractions  are  very  powerful,  and  in  all  probability 
their  rliythm  is  analogous  to  that  of  the  intestines — extending  from  the 
extremity  of  the  cornua  towards  the  cenix  in  a  peristaltic  manner, 
particularly  in  tiiose  animals  which,  like  the  Bitch  and  Pig.  have  very 
long  cornua,  with  the  young  arranged  one  after  another  in  them. 

This  increase  in  sensibility  which  the  uterus  acquires  during  gesta- 
tion, must  be  considered  as  the  organic  cause  of  its  contractions  ;  the 
sensibility  and  contractility  gradually  diminish  after  parturition,  during 


132  OBSTETRICAL  PHYSIOLOGY. 

which  they  reach  their  apogee.  Its  contractility,  which  signifies  also 
its  retractility,  enables  it  to  contract  on  itself  after  delivery,  and  to 
nearly  obliterate  its  cavity.  This  rapid  diminution  in  the  capacity 
of  the  organ  closes  the  orifices  of  the  vessels  which  open  on  its  internal 
surface  during  the  act,  and  thus  prevents  fatal  haemorrhage. 

Its  main  function,  however,  appears  to  be  concerned  in  the  expul- 
sion of  the  foetus,  and  then,  as  at  other  times,  it  is  entirely  independent 
of  the  will.  Besides,  the  intensity  of  the  contractions  is  not  always 
related  to  the  strength  of  the  animal ;  pain  deadens  and  paralyses 
the  contractile  force,  as  is  seen  in  primiparous  creatures.  "When  the 
contractions  have  been  vigorous,  the  uterus  rapidly  diminishes ;  but  if 
they  have  been  slow  and  weak,  the  organ  slowly  contracts  on  itself. 
When  it  does  not  contract  quickly  after  delivery  it  is  said  to  be  inert, 
and  the  cause  is  to  be  found  in  the  expenditure  of  its  contractile  power, 
either  through  excessive  distension,  a  delivery  too  prompt  or  too  slow, 
or  general  weakness  of  the  maternal  system.  By  prolonged  exertion, 
like  the  voluntary  muscles,  those  of  the  uterus  become  weakened ;  so 
that  when  the  act  of  parturition  has  been  protracted,  the  contractions 
of  the  organ  become  slow  and  feeble,  or  cease  altogether.  Opiates  and 
narcotics  generally  produce  the  same  effect,  and  are  therefore  success- 
fully administered  when  the  contractions  are  too  energetic  or  painful 
during  delivery  or  before  abortion.  The  contractions  are  stimulated  by 
irritation  of  the  cervix  or  body  of  the  uterus — such  as  is  produced  by 
retention  of  the  whole  or  a  portion  of  the  placenta,  titillation  of  the 
cervix  by  the  finger,  frictions  on  the  belly,  the  application  of  cold  to 
this  part,  or  the  administration  of  ergot  of  rye. 

Form. 

The  uterus,  after  conception,  begins  to  change  in  form  as  well  as  in 
volume  and  structure  ;  this  alteration,  like  the  others,  proceeds  pari 
passu  with  the  development  of  the  fojtus.  The  body  becomes  round, 
and  in  the  Carnivora,  as  already  described,  the  cornua  elongate  and 
show  the  alternate  dilatations  and  constrictions  due  to  the  presence  of 
the  young  in  their  cavities.  In  the  Mare,  Cow,  and  Sheep,  if  there  is 
but  one  foetus,  a  single  horn  is  enlarged — usually  the  right — to  contain 
the  posterior  limbs,  while  the  other  is  relativelj"  smaller  and  contracted, 
and  looks  a  mere  appendage.  When  a  Carnivorous  animal  contains 
only  one  foetus,  it  is  developed  in  the  horn,  and  not  in  the  body  of  the 
uterus,  and  it  is  not  until  parturition  commences  that  it  descends  into 
the  latter  ;  should  the  creature  die  before  delivery,  the  offspring  will  be 
found  there.  In  this  species  each  horn  generally  contains  one  or  more 
young  ;  should  there  be  only  two,  one  occupies  each  cavity ;  but  when 
there  is  only  one  foetus,  it  is  then  in  one  of  the  cornua. 

The  changes  taking  place  in  the  cervix  of  the  uterus  during  pregnancy 
have  not  been  accurately  ascertained  in  the  domesticated  animals,  as  in 
the  smaller  species  there  is  usually  no  occasion  or  necessity  to  make  an 
examination  ;  while  in  the  larger  the  risk  of  injury  to  the  examiner,  and 
of  abortion  in  the  animal,  militates  against  such  an  investigation.  It  is 
only  known  as  a  fact,  that  it  widens  at  the  termination  of  gestation,  and 
loses  its  cervical  character,  as  well  as  its  longitudinal  mucous  folds.  It 
may  also  be  noted  that,  from  being  firm  and  dense  at  ordinary  times, 
its  texture  becomes  gradually  soft  and  elastic ;  while  it  diminishes  in 
length,  its  projection  into  the  vaginal  cavity  is  lessened,  and  indeed  at 
a  late  period  almost  effaced,  it  appearing  merely  as  a  kind  of  ring. 


MOIJIFICATIOXS  I.y  THE  UTERI'S. 


133 


separating  the  uterus  from  the  vagina,  and  which  is  sometimes  a  httle 
open.  Not  infrequently,  if  not  always,  the  cavity  of  the  cen'ix  is  lilled 
with  a  plug  of  thick,  adherent,  glutinous  matter,  sometimes  so  abundant 
that  it  also  occupies  the  vagina,  and  forms  an  unpleasant  obstacle  to 


Fig.  65. 

The  Gravid  Uterus  ok  a  Mcltiparocs  anp  Inipahous  Animal. 

A,  Multipannis  Uteni«  :  a,  n'.  Ovaries  ;  b,  //,  Fitnliriii'  <>f  Kallojiiftn  Tubes, '',  c'; 
(i,  d',  Corniift  <if  I* terns — tliat  on  the  left  contains  four  EniliryoH,  on  the  right 
two,  ono  t)f  which  is  exposed  ;  e.  Body  of  Utcnis  ;  _/",  Vagina  ;  f/,  (j,  Mesometry 
<«r  Ligament  of  Uterus.  B,  Uniparous  I'terus :  c,  r'.  Fallopian  Tubes ; 
e,  Body  of  Iterus,  coutaining  early  Uterine  Ovum  ;  /,  Vagina.  C,  Early 
Uterine  Ovum. 


exploration,  though  it  docs  not  interfere  with  parturition.  We  have 
already  alluded  to  the  sensitiveness  of  the  cervix.  The  cornua,  also,  in 
becoming  wider  lose  their  inferior  and  posterior  cur\-es. 


134  OBSTETRICAL  PHYSIOLOGY. 

Situation. 

The  uterus  cannot  change  its  form  and  volume  without  its  situation 
becoming  altered.  Before,  and  until  a  certain  time  after  conception, 
the  body  of  the  uterus  is  contained  in  the  pelvis,  but  as  it  and  the  foetus 
increase  the  position  changes,  and  this  also  causes  an  alteration  in  the 
situation  of  other  organs.  In  the  Mare  the  uterus  gradually  displaces 
the  pelvic  flexure  of  the  colon  lodged  in  that  cavity,  and  passes  forward 
below  that  viscus,  towards  and  beyond  the  umbilicus,  to  rest  on  the 
floor  of  the  abdomen,  in  proximity  to  the  diaphragm,  stomach,  and  liver, 
near  the  termination  of  pregnancy.  In  its  development  it  is  situated 
chiefly  in  the  middle  line  of  the  body,  slightly  inclining  to  the  left, 
because  of  the  large  mass  of  the  colon  occupying  the  right  flank. 

In  Euminants,  the  uterus  pushes  the  rumen  and  caecum  out  of  the 
pelvis,  presses  the  mass  of  intestines  to  one  side,  and  extends  between 
the  right  sac  of  the  rumen  and  the  abdominal  walls.  The  presence  of 
the  rumen  in  the  left  flank  causes  it  to  deviate  somewhat  to  the  right. 

In  mitltijjarous  animals,  in  which  the  young  are  placed  end  to  end  in 
the  cornua,  the  latter  rest  on  each  side  of  the  floor  of  the  abdomen  and 
curve  upwards ;  in  the  Pig  they  incline  somewhat  to  the  right  side,  though 
in  all  animals  each  cornu  lies  above  its  corresponding  mammary  line. 

While  these  changes  are  taking  place,  the  broad  or  lateral  ligaments 
are  facilitating  them  by  becoming  unfolded  and  lengthened,  and  the 
uterus  in  its  increasing  bulk  extends  backwards  as  well  as  forwards. 
The  cervix,  firm  and  resisting,  approaches  the  vulva,  and  to  such  a 
degree  sometimes  that,  in  certain  breeds  of  cattle — particularly  those 
which  have  the  pelvis  wide  and  inclined  posteriorly,  and  bear  large 
calves — the  posterior  portion  of  the  vagina  appears  between  the  labia 
of  the  vulva  a  month  or  more  before  parturition,  and  especially  w^hen 
they  lie  down. 

With  other  Cows,  however,  whose  abdomen  is  very  pendant,  the 
opposite  occurs ;  for  the  uterus,  in  passing  forwards  and  downwards, 
carries  the  anterior  portion  of  the  vagina  behind  it,  and  this  cavity 
becomes  lengthened  and  constricted  posteriorly,  while  the  cervix  is 
shortened,  and  the  vulva  appears  to  be  deeply  buried  between  the 
tuberosities  of  the  ischium. 

Directio)i. 

With  regard  to  the  direction  of  the  uterus,  it  is  to  be  noted  that  its 
horizontal  position  in  the  domesticated  animals  obviates  those  lateral 
displacements  which  are  so  frequent  in  woman — its  weight,  and  that 
of  its  contents,  maintaining  it  in  an  antero-posterior  direction,  and  in  a 
line  with  the  body  of  the  animal.  This  direction  rarely  varies  to  any 
appreciable  degree,  and  it  is  only  in  a  case  of  hernia  at  the  flank,  which 
is  very  uncommon,  that  it  inclines  to  one  side.  The  only  marked 
inclination  it  assumes  is  forward  and  downward  in  Cows,  whose 
abdomen  is  very  wide  and  pendulous.  Otherwise,  the  uterus  keeps  its 
normal  direction.  Eainard  draws  attention  to  a  form  of  abdominal 
hernia  which  gives  the  uterus  a  particular  direction  ;  it  is  that  which 
takes  place  in  the  Mare  or  Cow,  in  the  vicinity  of  the  crural  arch,  when 
the  uterus,  or  one  of  its  horns  containing  the  foetus,  descends  behind 
the  corresponding  mammary  gland,  or  into  the  subcutaneous  connective 
tissue  of  the  inguinal  region,  forming  a  large  tumour  in  which  the  limbs 
of  the  young  animal  can  be  felt. 

Another  change  in  the    direction  of   the  uterus,   which  it  is  most 


MODIFICATIONS  jy  THE  (TEUrs.  135 

important  to  consider  in  the  larger  animals,  is  the  more  or  less  com- 
plete rotation  or  twisting  on  its  axis  of  this  organ — its  upper  face 
becoming  the  lower,  or  again  becoming  superior  after  describing  an 
entire  circle  ;  for  this  torsion  occasions  serious  changes  in  the  form  of 
the  cervix  and  the  direction  of  its  cavity.  The  position  of  the  cervix  is 
the  inverse  of  that  of  the  uterus,  being  always  found  on  the 
side  opposite  to  that  of  the  new  direction  of  the  organ  itself;  it  is 
directed  upwards  if  the  uterus  is  downwards,  and  if  the  latter  twists  to 
the  right  or  left  the  cervix  goes  to  the  left  or  right.  Cases  are  men- 
tioned in  which  torsion  of  tlie  cervix  itself  has  been  found  ;  and  though 
it  has  been  argued  that  the  lateral  ligaments  would  not  permit  this 
malposition,  yet  there  can  be  no  doubt  as  to  the  fact.  Lecoq  of  Bayeux, 
cited  by  Raiuard,  found  in  a  Cow  that  had  died  through  non-delivery, 
the  upper  face  of  the  uterus  tui-ned  towards  the  floor  of  the  abdomen, 
rotation  having  taken  place  from  right  to  left ;  the  utero-vaginal 
portion  was  twisted  on  itself,  and  the  suspensory  ligaments  were 
themselves  twisted  around  this  part.  Numerous  cases  are  recorded 
which  incontestably  prove  that,  during  pregnancy,  the  uterus  performs  a 
half,  or  even  a  complete  revolution  on  itself,  producing  torsion  of  the 
cervix  and  the  posterior  part  of  the  vagina,  and  consequent  strangula- 
tion of  the  organ  near  the  neck,  by  the  suspensory  ligaments;  so  that 
spontaneous  delivery  of  the  young  animal  by  the  natural  passage  is 
impossible. 

Influence  on  ami  Alteration,  in  the  Position  of  Neiijlibourimj  Organs. 

The  alterations  occurring  in  the  uterus  necessarily  bring  about  others  in 
the  neighbouring  organs  with  which  it  lias  mechanical  relations.  The 
changed  position  of  the  organ  in  the  abdominal  cavity  has  been  alluded 
to  In  the  Mare  and  Cow  the  horn  in  which  the  limbs  of  the  fcctus  is 
lodged  becomes  extended  and  displaces  the  intestines,  pushes  the 
stomach  more  to  the  left,  rests  on  the  liver,  and  is  an  obstacle  to  the 
free  movements  of  the  diaphragm.  The  suspensory  ligaments  of  the 
uterus  retain  that  organ  and  the  cornua  in  situ  ;  but  when  they,  in 
the  early  stage  of  gestation,  begin  to  extend  forward,  the  vagina  is 
lengthened,  until  at  a  later  period,  when  the  size  of  the  ftt'tus  forces  the 
uterus  backwards  into  the  pelvic  cavity,  that  canal  is  also  pushed  back 
and  forms  a  circular  enlargement  in  the  vulva.  Its  lining  membrane, 
owing  to  the  compression  and  the  increased  circulation  of  blood  through 
it,  assumes  a  violet  or  dark-brown  tint,  and  appears  to  become  thick- 
ened, while  it  secretes  a  larger  quantity  of  viscid  mucus. 

The  pressure  the  gravid  uterus  exercises  on  the  bloodvessels  of  the 
hind  limbs  and  the  vulva  and  rectum,  retards  the  venous  and  lym- 
phatic circulation  ;  so  that  towards  the  end  of  gestation,  and  especially 
in  the  Mare,  there  is  often  considerable  adema  of  these  parts.  This 
oedema  is  all  the  more  marked,  in  the  Cow  as  well  as  in  the  Mare, 
when  the  compression  is  greatest  at  the  posterior  parts  of  the  abdomen, 
towards  the  commencement  of  the  sapliena  and  mammary  veins. 

The  anlema  is  always  greatest  in  those  cases,  somewhat  rare  it  is 
true,  in  which  there  is  a  giving-way  of  the  abdominal  parietes  near  the 
crural  arch  and  above  one  of  the  mammic,  when  the  uterus  forms  a 
hernia  beneath  the  skin  ;  then  there  is  seen  an  enormous  swelling  at  the 
upper  part  of  the  limb. 

The  udder  increases  notably  in  volume,  and  it  and  the  teats  become 
tense.     In    the  Carnivora,  the  prominences  of  the  mammaj,  especially 


136  OBSTETRICAL  I'HYHIDLOGY. 

the  ventral  ones,  are  increased  by  two  rows  of  elevations  on  each  side 
of  the  linea  alba,  which  correspond  to  the  portions  of  the  cornna  in 
which  the  young  are  being  developed,  and  where  they  form  projections 
on  the  wail  of  their  sac. 

The  increase  in  volume  and  the  various  changes  which  the  gravid 
uterus  undergoes,  bring  about  alterations  in,  and  frequently  derange- 
ment of,  certain  functions.  Fortunately,  however,  these  alterations  are 
slow  and  gradual ;  so  that  the  different  organs  concerned  generally 
adapt  themselves  to  their  changed  condition  without  much  inconveni- 
ence. The  animal  becomes  lazy  and  slower  in  movement,  and  is  more 
desirous  of  quiet  and  tranquillity  as  gestation  advances.  These  indica- 
tions are  observed  at  an  early  period.  At  the  same  time  the  abdomen 
enlarges  and  changes  its  shape  :  it  becomes  rounded,  and  projects 
below  and  on  each  side  beyond  the  crural  region,  while  the  flanks 
become  hollow,  the  croup  and  thighs  wasted-looking,  and  the  sacrum 
and  external  tuberosities  of  the  ilium  more  salient. 

In  the  domesticated  animals  there  are  rarely  observed  those  dis- 
turbances in  the  digestive  organs  so  marked  at  the  commencement  of 
pregnancy  in  woman.  On  the  contrary,  immediately  after  conception, 
possibly  because  the  oestrum  has  disappeared,  the  appetite  is  increased, 
digestion  is  usually  easier,  and  all  the  formative  phenomena  seem  to 
acquire  increased  activity ;  more  use  appears  to  be  made  of  the  food  in 
the  economy,  and  there  is  a  notable  tendency  to  fatten.  This  tendency 
has  been  taken  advantage  of  by  breeders  and  feeders  of  animals  which 
are  destined  more  for  food  than  reproduction  ;  and  those  intended  for 
slaughter  are  usually  rendered  pregnant,  and  fed  until  about  the  middle 
period  of  gestation,  when  they  have  reached  their  most  favourable 
condition — as  towards  the  last  period  this  tendency  vanishes,  and 
wasting  is  more  apparent,  due  to  the  increased  demands  of  the  foetus 
and  the  enlargement  of  the  mammary  glands. 

In  some  cases,  however,  and  particularly  with  the  Cow,  the  appetite 
becomes  somewhat  depraved,  the  animals  eating  soil,  gnawing  the 
walls  or  woodwork  of  their  stable,  drinking  foul  water,  etc.,  and  very 
exceptionally  there  may  be  vomiting. ^ 

With  the  increased  bulk  of  the  uterus,  as  has  been  observed,  the 
abdominal  and  thoracic  organs  experience  more  or  less  the  effects  of 
the  compression  it  exercises  on  them.  The  diaphragm  is  pushed 
forward,  and  diminishes  the  capacity  of  the  thorax  and  the  expansi- 
bility of  the  lungs  ;  the  ribs,  encumbered  by  the  w^eight  of  the  foetus, 
are  raised  with  difficulty  by  the  muscles  of  inspiration,  so  that  respira- 
tion is  frequent  and  shallow,  and  the  creature  is  readily  "  blown"  and 
fatigued.  Digestion  may  be  somewhat  impaired  and  retarded,  and 
slight  constipation  is  not  rare.  The  strain  induced  by  the  uterus  on 
the  vagina,  and  indirectly  on  the  neck  of  the  bladder,  causes  attempts 
at  micturition  to  be  more  frequent ;  while  the  compression  on  the 
liver,  vena  portae  and  vena  cava,  explains  the  mechanical  obstruction 
to  the  circulation  and  subsequent  cedema,  particularly  in  the  Mare. 

In  addition  to  all  this,  the  blood  is  more  or  less  modified.  Its  abso- 
lute quantity  is  certainly  not  diminished  ;  on  the  contrary,  it  may  be 
increased  to  a  certain  extent ;  but  its  corpuscles  diminish  in  number  in 
a  very  perceptible  manner,  giving  rise  to  a  hydraemia  more  allied  to 
anaemia  than  anything  else. 

1  An  instance  of  this  very  rare  accident  is  given  in  the  Etat  Sanitaire  des  Animaux 
Domestiques  de  Belgique  for  1877,  p.  65. 


POSITION  OF  Till-:  FiKTI'S  IX  THE  UTEltrs.  137 

SECTION  11.— POSITION  Ol'  THK   IdlTlS  IN    IHK  UTERUS. 

The  position  of  the  fa'tus  in  the  uterine  cavity  is  pretty  well  constant 
in  the  same  species  ;  and  this  position  it  retains  more  or  less  during 
intra-uterine  existence  and  until  parturition  occurs,  when  it  is  changed. 

Brugnone,  cited  by  Eainard  and  Saint-Cyr,  writes  :  "  If  the  uterus 
of  a  Mare  be  opened  longitudinally  at  the  ninth  or  tenth  month  of 
gestation,  we  find  the  fcetus  with  its  head  directed  backwards,  and  bent 
in  such  a  way  that  its  lower  jaw  touches  the  throat  and  its  mouth  the 
breast.  It  forms  an  arc  of  a  circle — the  neck  being  in  contact  with  the 
sacrum,  and  the  spine  being  bent  round  is  turned  towartls  the  right 
or  left  side  of  the  lower  part  of  the  abdomen.  The  limbs  are  Hexed, 
the  fore  ones  in  such  a  manner  that  the  knees  reach  the  middle  of  the 
head  and  tlie  feet  the  umbihcus  ;  while  the  hind  limbs  are  doubled 
under  the  abdomen.  The  croup  and  haunches  are  at  the  bottom  of  the 
uterus,  in  the  vicinity  of  the  stomach."  The  head  may  sometimes  be 
directed  forwards. 

Colin  states  that  towards  the  termination  of  pregnancy,  the  foetus  of 
the  Mare  lies  with  the  belly  upwards,  the  hinder  limbs  in  the  longest  of 
the  uterine  cornua,  and  the  anterior  limbs  and  head  directed  towards 
the  cervix  uteri. 

In  the  Cow,  according  to  Saint-Cyr,  the  uterus  is  curved  downwards, 
the  superior  convexity  of  the  body  being  prolonged  forward  by  the 
cornu  in  which  the  fu'tus  is  partially  developed.  When  the  uterus  is 
opened,  the  ftctus  is  discovered  with  the  head  bent  Imck,  the  body  much 
inclined  and  looking  as  if  almost  lying  on  one  side,  and  pressing  on 
the  empty  cornu,  which  is  considerably  less  developed  than  that  of 
the  opposite  side,  and  which  is  also  lower.  Otherwise,  like  the  Foal, 
the  Calf  is  curved  en  arc,  the  head  more  or  less  near  the  sternum,  and 
the  limbs  flexed  and  close  together  (Fig.  46). 

According  to  Colin,  the  belly  of  the  fa'tus  is  downwards  in  Ruminants, 
and  towards  the  concavity  of  the  cornu,  the  head  being  directed 
backwards. 

In  multiparous  animals,  the  fa'tuses  are  distributed  in  the  two  cornua, 
one  after  the  other,  the  head  being  usually  turned  toward  the  cervix 
uteri,  sometimes  to  the  opposite  side,  and  the  abdomen  lying  towards 
the  concave  portion  of  the  cornua,  wliere  the  broad  ligaments  are 
attached  and  the  vessels  enter.  In  the  Sow,  however,  it  has  been 
noted  that  the  young  lie  in  a  contrary  direction  ;  the  head,  instead  of 
being  presented  to  the  cervix  uteri,  is  turned  towards  the  ovarian  ex- 
tremity of  the  cornu,  though  the  abdomen  and  limbs  always  corre- 
spond to  the  concave  border  of  the  horns,  as  it  is  there  the  placenta  is 
situated. 

In  forty-three  Cows  and  Sheep,  Colin  found  in  twenty-five  the  foetus 
in  the  right  cornu,  and  in  the  left  cornu  in  eighteen.  At  first  sight  it 
might  be  supposed  that  the  preference  for  the  right  cornu  was  due  to 
the  impediment  offered  to  development  in  the  left  by  the  large  digestive 
organs  of  these  animals  ;  but  this  difference  cannnt  have  any  influence 
on  the  function  of  the  ovaries,  the  dehiscence  of  the  Graafian  vesicles 
in  the  right  being  apparently  more  frequent  than  in  the  left.  In  mul- 
tiparous animals,  the  foetuses  are  rarely  equal  in  number  in  both  cornua, 
though  neither  of  the  latter  has  a  constant  advantage  over  the  other  in 
this  respect. 

The  position  of  the  fcetus  towards  the  termination  of  gestation  may 


138  OBSTETIUCAL  FHYHIOLOGY. 

vary  occasionally,  and  even  frequently,  owing  to  the  active  reflex  move- 
ments which  it  performs  ;  and  to  these  energetic  movements,  it  cannot 
be  doubted,  are  due  the  difficult  presentations  which  the  fojtus  offers  so 
frequently  (at  least  in  some  species)  at  birth. 

SECTION  III.— SIGNS  OF  PREGNANCY. 

Having  traced  thus  far  the  process  of  utero-gestation,  we  have  now 
to  study  the  signs  by  which  this  process  reveals  itself.  This  study  is 
very  important,  in  several  respects,  to  the  comparative  pathologist,  or 
rather  to  the  veterinary  surgeon,  whose  science  extends  beyond  patho- 
logy, and  who  is  frequently  called  upon  to  give  an  opinion  as  to  whether 
an  animal  is  or  is  not  pregnant. 

The  signs  which  announce  pregnancy  are  numerous  and  varied,  though 
they  are  not  all  reliable,  and  several  are  very  deceptive  and  not  peculiar 
to  gestation.  Indeed,  it  has  frequently  happened  that  animals  whose 
condition  was  not  at  all  certain  have  brought  forth  young,  and  others 
have  done  the  same  without  giving  rise  to  any  suspicion  that  they  were 
pregnant ;  though  it  must  be  remembered  that  at  first  there  is  nothing 
present  to  guide  one  in  forming  an  opinion  as  to  the  animal  having 
conceived. 

Nevertheless,  in  order  that  a  correct  opinion  may  be  arrived  at,  the 
most  equivocal  signs  must  be  taken  into  consideration,  as  well  as  those 
which  are,  so  to  speak,  unequivocal — indeed,  they  ought  to  receive,  for 
this  very  reason,  more  than  ordinary  attention  ;  as  it  is  a  matter  of 
much  moment,  and  particularly  in  cases  of  jurisprudence,  that  the 
veterinarian  should  be  able  to  speak  positively  as  to  the  existence  or 
absence  of  pregnancy. 

The  diagnosis  of  pregnancy  is  not  always  easy,  and  it  is  all  the  more 
difficult  as  the  stage  is  early. 

In  order  to  study  the  signs  of  pregnancy  conveniently,  it  is  usual  to 
divide  them  into  two  categories — the  certain  and  the  prohahle  signs  ;  or 
into  three  categories  as  follows:  1.  The  rational,  physiological,  or  sub- 
jective signs ;  2.  The  material  ox  objective  signs;  3.  The  sensible  signs 
which  are  derived  from  observation  and  manipulation,  in  order  to  ascer- 
tain the  presence  of  the  foetus.  In  this  study,  of  course  the  larger 
animals  will  be  more  particularly  referred  to,  because  of  their  relatively 
higher  value  and  importance,  and  their  longer  period  of  gestation ;  and 
also  because  the  veterinary  surgeon  is  most  frequently  consulted  as  to 
their  condition. 

national  Signs. 

There  are  several  rational  signs  due  to  the  modifications  broiight  about 
in  the  economy  of  the  pregnant  animal,  and  manifested  by  alterations 
in  temperament,  character,  and  aptitudes. 

The  cessation  of  heat  or  rutting  is,  perhaps,  the  earliest  subjective, 
though  it  is  certainly  not  the  most  cei'tain,  sign  of  gestation,  and  may 
even  lead  to  mistakes.  It  is  usually  manifested  soon  after  conception 
has  taken  place  (six  or  eight  days),  by  a  decrease  in  the  venereal  excite- 
ment which  marks  the  period  of  oestrum  ;  the  animal,  as  has  been  men- 
tioned, is  comparatively  tranquil  and  does  not  exhibit  any  desire  for  the 
male,  neither  does  she  neigh,  paw,  or  show  the  usual  concomitant 
symptoms  of  "heat."  If  the  male  approaches,  the  sexual  desires  are 
not  excited,  and  in  refusing  him  the  female  may  even  resort  to  aggres- 


SI'.'XS  OF  VnEny.tXCY.  139 

sive  niovements.  So  that  it  has  usually  been  held  as  a  sign  of  concep- 
tion, if  the  female  refuses  the  male  soon  after  copulation,  and  particularly 
if  a  month  or  two  has  elapsed,  and  tiie  Mare  is  in  good  condition  and 
well  fed.  But  in  some  cases  the  symptoms  of  "  heat  "  persist  for  some 
time  after  coition,  and  the  erethism  of  the  generative  organs  is  not 
allayed,  although  in  reality  impregnation  has  taken  place ;  and  in  very 
exceptional  instances  the  "  heat"  will  return  after  having  disappeared 
for  a  certain  time.  Some  ]\Iares  which  have  been  pregnant  for  two  or 
thi'ee  months,  and  especially  those  which  have  been  put  to  the  Stallion 
early  in  the  year,  will  e.xhibit  indications  of  (i^strum  when  the  weather 
becomes  warmer  and  the  pastures  afford  more  nutriment.  When  in 
this  state  the  female  may  again  accept  the  male,  and  it  may  even 
happen  that  a  second  fecundation  takes  place  at  this  time — thus 
occasioning  those  somewhat  unusual  conceptions  which  give  rise  to 
superfa'tation  ;  though  if  pregnancy  is  somewhat  advanced  it  is  danger- 
ous, and  may  occasion  abortion.  A  story  is  told  of  a  Mare  in  the 
Saint-Leger  stud,  France,  which,  after  being  pregnant  for  some  months, 
yet  showed  symptoms  of  "  heat."  Louis  XIV.,  who  was  more  inclined 
to  favour  the  desix^es  of  the  animal  than  to  listen  to  the  opinion  of 
Garsault,  the  famous  equestrian  of  that  period,  ordered  her  to  be  put 
to  the  Stallion.  This  was  done,  copulation  took  place,  and  the  Mare 
aborted. 

Stallions  exclusively  employed  for  breeding,  frequently  refuse  to 
approach  pregnant  iMares  in  which  the  "  heat"  persists  or  reappears; 
though  this  is  not  always  the  case,  particularly  with  young  Stallions. 

In  the  Cow,  as  in  the  Mare,  oestrum  may  continue  or  reappear  after 
fecundation  ;  though  as  a  rule,  I  believe,  the  male  refuses  to  copulate 
again  when  the  female  is  in  this  condition.  "  Very  often,"  says 
Grognier,  "  the  Mare  and  Sheep,  as  well  as  the  Cow,  manifest  signs  of 
'heat' ;  but  the  Bull,  better  than  the  Stallion  or  Earn,  knows  the  in- 
dications of  gestation,  and  abstains  from  having  intercourse  with  Cows 
which  are  in  this  state."  M.  Magne  remarks  that  the  Bull  accustomed 
to  consort  with  pregnant  Cows,  smells  at  them  as  it  does  at  others  going 
with  it,  but  without  being  excited  by  their  emanations.  Exceptionally, 
however,  it  must  be  noted  that  Cows  have  been  known  to  manifest 
a-strum  regularly,  and  to  receive  the  Bull,  even  a  month  before  parturi- 
tion. But  these  instances  are  very  rare  For  cattle,  therefore,  it  is  an 
almost  certain  sign  of  pregnancy  when  the  Bull  refuses  a  Cow,  though 
the  latter  may  be  in  heat. 

With  Sheep  a'strum  may  continue  after  fecundation,  and  the  Ram 
may  copulate  with  them. 

In  general  terms,  then,  it  may  be  repeated  that  the  cessation  of 
cestrum  before  its  regular  period,  and  soon  after  copulation,  indicates 
that  conception  has  taken  place  ;  that  its  persistence  or  reappearance 
in  the  Mare  and  Sheep  some  time  after  the  first  copulation,  does  not 
absolutely  imply  that  impregnation  has  not  occurred,  even  though  the 
male  again  consorts  ;  but  if  it  frequently  appears  it  is  a  presumption 
that  the  female  is  not  only  not  pregnant,  but  that  fecundation  is  not 
readily  induced. 

It  has  been  generally  observed  that  a  change  takes  place  in  the  char- 
acter of  the  animal  which  has  conceived,  and  this  sometimes  almost 
immediately  after  conception  ;  the  change  being  something  analogous 
to  that  produced  after  castration.    Mares  which  were  previously  vicious, 


140  OBSTLTSICAL  PIirSIOLOGr. 

troublesome,  or  unsteady  when  in  "heat/'  are  nearly  always  gentle  and 
tractable  when  in  foal :  the  genital  excitement  which  caused  their 
capriciousness  or  viciousness  being  allayed,  they  are  no  longer  under  its 
induence.  This  change,  when  occurring  after  copulation,  is  a  valuable 
sign  of  successful  impregnation ;  and  though  it  may  sometimes  fail,  yet 
whtn  present  it  can  scarcely  lead  to  a  mistake.  If,  on  the  contrary, 
the  animal  has  not  been  fecundated  after  one  or  more  coverings, 
if  previously  vicious  its  vices  become  exaggerated  when  again  put  to  the 
Horse. 

In  the  Cow  a  similar  phenomenon  may  be  remarked,  though  it  is  not 
so  frequent  or  marked  as  in  the  Mare. 

The  other  animals  are  seldom  so  irritable  in  their  disposition  as  to 
lead  anyone  to  notice  a  similar  change  in  them. 

A  tendency  to  fatten  is  such  a  notorious  consequence  of  impregna- 
tion, that  with  the  Cow  and  Sheep  graziers  usually  resort  to  it  in  order 
to  get  these  animals  in  good  condition  for  market,  when  they  are  in- 
tended for  slaughter.  But  this  aptitude  is  most  marked  in  the  early 
months  of  gestation  ;  for  in  the  Cow  towards  the  last  three  months,  and 
in  the  Sheep  and  Pig  at  the  last  month,  when  the  mammte  begin  to 
enlarge,  there  is  a  tendency  to  lose  condition.  According  to  the 
butchers,  there  is  less  internal  fat,  and  the  animals  altogether  are  not 
so  heavy  as  they  appear  externally,  when  gestation  has  advanced.  It 
often  happens,  particularly  with  Cows,  that  the  appetite  is  depraved, 
the  animals  eating  earth,  drinking  filthy  water,  Ucking  walls,  and 
gnawing  innutritions  substances. 

Coincidentally  with  the  progress  of  gestation,  those  animals  employed 
in  labour  for  speed  or  draught  lose  their  vigour  somewhat,  particularly 
towards  the  end  of  pregnancy:  they  become  "soft,"  and  their  paces 
slower  and  heavier — consequently,  they  require  more  urging  to  make 
them  perform  a  certain  amount  of  work.  They,  if  Mares,  trot,  gallop, 
and  jump  with  more  fatigue,  and  yield  themselves  far  less  readily  to 
inordinate  exercise  than  before — either  because  their  temperament 
alters,  their  instinct  urges  them  to  preserve  their  progeny,  or  the  fcetus 
itself  physically  embarrasses  them  in  their  movements. 

But  this  is  not  always  a  sure  sign  :  for  sometimes,  though  rarely. 
Mares  will  perform  their  work  with  the  same  energy  and  speed  as 
before  conception,  even  up  to  a  very  brief  period  before  parturition 
commences.  Taken  with  other  signs,  nevertheless,  this  may  afford 
assistance  in  diagnosing  gestation. 

At  pasture.  Cattle  and  Sheep  are  more  tranquil,  and  rest  much;  as  do 
also  Pigs  and  Bitches  during  this  period. 

2Iatenal  Signs. 

The  material,  physical,  or  objective  signs  are  those  depending  upon 
the  change  in  volume  of  the  abdomen  and  the  mammc?,  the  appearance 
of  the  milk  in  the  latter,  alterations  in  the  composition  of  the  urine,  and 
increase  in  iceight  of  the  animal. 

The  abdomen  enlarges  in  every  direction,  and  at  the  same  time 
changes  its  shape.  It  descends  or  "  drops,"  becoming  larger  inferiorly; 
the  fianks  become  hoUow,  and  the  spine  appears  more  concave  in  the 
dorso-sacral  region  ;  while  the  lateral  portions  of  the  croup  sink  so 
much  as  to  make  the  sacrum  and  haunches  towards  the  root  of  the  tail 
look  more  salient.  These  phenomena  are  progressively  developed  as 
gestation  approaches  its  term,  when  they  are  very  evident.     In  the 


SKINS  OF  I'RKGNA NC Y.  HI 

Mare  thuy  are  irrej^ular  in  tlieir  appearance,  commencing  three  or  four 
months  after  conception,  and  do  not  possess  the  same  value  in  every 
instance  ;  for  there  are  some  animals  in  which  the  ahdomen  is  scarcely 
at  all  unusually  developed,  and  particularly  the  Mure — which  is  uni- 
parous — until  n(;ar  parturition  ;  and  others,  generally  those  at  j)asture, 
or  which  have  had  a  numher  of  fuals,  that  always  have  the  helly  coii- 
siderahly  developed  and  pendulous,  and  in  which  it  is  diflicult  to  per- 
ceive any  increase,  even  when  they  are  in  foal. 

Jk'sides,  some  diseased  conditions — as  ovarian  dropsy,  uterine  poly- 
pus, hydrometra,  ascites,  impervious  vagina,  etc. — may  give  rise  to 
amplification  of  the  abdomen  ;  and  it  must  not  be  forgotten  that  Marcs 
fed  on  poor  fibrous  forage  not  unfrequently  have  the  belly  enlarged. 
So  that  of  itself  this  is  not  at  all  a  sure  criterion  of  pregnancy. 

Taken  in  connection  with  the  other  signs,  however,  the  increase  in 
the  abdomen — most  marked  towards  its  inferior  third,  and  becoming 
evident  toward  the  fifth  or  sixth  month  of  pregnancy — has  a  certain 
value.  It  is  most  noticeable,  perhaps,  in  looking  at  the  animal  from 
behind  ;  though  repeated  examinations  at  various  intervals  may  be 
necessary  to  ensure  certainty,  and  in  important  cases  it  may  even  bo 
necessary  to  have  recourse  to  measurement  of  the  abdomen. 

The  cnlanjcvient  of  the  mainvue  is  a  sign  which  varies  considerably  in 
different  species,  according  to  the  condition  of  the  females.  In  pri- 
miparous  animals,  as  the  Mare  and  Cow,  they  begin  to  increase  soon 
after  conception— towards  the  second  or  third  month.  The  udder  is 
more  prominent  and  firm  to  the  touch,  loses  its  wrinkles,  and  the  teats 
are  more  visible.  This  appearance  is  generally  only  ephemeral  and 
partially  disappears,  to  reappear  again  more  markedly  after  some 
weeks  ;  then  to  subside  and  show  itself  several  times  during  the  period 
of  gestation. 

Besides  this  mammary  enlargement  in  the  primipara,  and  which  may 
be  accepted  as  a  certain  indication,  these  glands  furnisli,  towards  the 
last  third  of  the  period  of  gestation,  a  yellow,  viscid,  transparent  liquid 
— the  colostrum— similar  to  white  of  egg,  and  wiiicli  can  be  easily 
extracted  from  the  teats  by  milking.  In  those  which  have  never  con- 
ceived, manipulation  of  the  teat  may  furnish  a  drop  or  two  of  a  watery- 
like  fluid,  but  in  two  or  three  months  after  fecundation  it  becomes 
slightly  increased  in  quantity,  and  is  now  viscid  in  consistency.  It 
gradually  increases  in  quantity  and  quality,  and  about  the  period  men- 
tioned it  has  changed  into  colostrum.  In  the  last  weeks  of  })regnancy 
this  liquid  sometimes  Vjccome  white  and  opaque,  as  well  as  less  viscid, 
and  is  then  proper  milk.  When  the  animals  have  bred  several  times, 
the  increase  in  the  size  of  the  udder  is  only  remarked  in  the  last  days 
of  gestation.  In  milch  Cows,  and  particularly  in  those  wliich  are  not 
good  "  milkers,"  another  sign  is  to  be  found  in  the  diminution  of 
the  lacteal  secretion,  and  the  shrinking  of  the  gland  some  time  after 
conception — usually  about  the  twentieth  day. 

In  the  pregnant  Mare  which  still  has  a  Foal  running  with  her,  the 
secretion  of  milk  also  ceases  some  time  before  parturition  ;  and  the 
animal  appears  to  be  aware  of  this,  for  it  weans  the  Foal  generally 
between  the  sixth  and  eighth  month. 

In  the  smaller  animals  the  enlargement  of  the  mamma;  and  the 
appearance  of  the  milk  are  usually  remarked  earlier,  and  more  regularly, 
than  in  the  larger  creatures. 

In  animals  which   have    borne   young,    similar   changes   to    those 


142  OBSTETRICAL  PHYSIOLOGY. 

observed  in  primiparge  take  place,  but  the  mammae  may  be  later  in 
enlarging. 

Though,  in  a  natural  state,  the  mammary  glands  are  only  intended 
to  furnish  aliment  to  the  young  creature  until  it  is  sufficiently  strong 
and  active  to  find  its  own  food,  when  they  suspend  their  function  ;  yet 
domestication  has  greatly  modified  their  secretory  power  in  some 
species — as  with  the  Cow,  Goat,  and  sometimes  the  Ass  and  Sheep — 
and  the  secretion  of  milk  becomes  an  almost  permanent  function.  Not 
only  this,  but  at  times  the  secretion,  as  observed  in  the  unimpregnated 
Bitch,  is  very  anomalous  and  unnatural.  In  the  non-pregnant  female 
of  various  species — not  excepting  the  human  species — the  secretion  may 
appear  naturally,  or  be  induced  by  mulsion  or  frequently  repeated 
suction  of  the  teats,  even  in  very  young  creatures,  a  short  time  after  birth  ; 
and  what  is  more  astonishing,  male  animals  have  in  rare  instances 
assumed  a  function  which  is  always  looked  upon  as  specially  charac- 
teristic of  the  female  sex  at  the  maternal  period.  So  early  as  the  days 
of  Aristotle — who  mentions  a  he-goat  which  yielded  milk — this  strange 
phenomenon  has  been  at  times  observed ;  and  M.  Lecoq  testifies  to 
an  Ox,  in  process  of  fattening,  having  the  four  rudimentary  mammae 
increased  in  volume  and  yielding  milk  which  furnished  cream,  and 
became  casein  when  an  acid  was  added  to  it. 

Certain  alterations  in  the  composition  of  the  urine  have  been  re- 
ported by  M.  Keiner  of  Giinsback,  which,  with  other  circumstances, 
might,  if  found  to  be  trustworthy,  be  valuable  as  an  aid  in  the  diagnosis 
of  pregnancy.  He  has  discovered  that  the  salts  of  lime  in  the  urine 
diminish  in  proportion  as  the  foetus  requires  these  for  the  formation  of 
its  bones ;  and  his  discovery  has  been  tested  by  a  chemist  whose 
analysis  of  this  fluid,  obtained  from  a  pregnant  Mare,  shows  that  the 
lime  lessens  very  much  as  the  time  for  parturition  draws  nig'.i.  At  the 
fifth  or  sixth  month  it  is  diminished  55  per  cent.,  and  to  70  per  cent, 
from  the  sixth  to  the  ninth  month. 

It  has  been  proposed  to  weigh  animals  which  are  suspected  to  be 
pregnant,  at  certain  intervals ;  an  increase  in  weight  being  an  evident 
accompaniment  of  growth  in  the  foetus.  In  this  direction,  Eueff  has 
recorded  that  Mares,  towards  the  fourth  or  fifth  month  of  pregnancy, 
have  shown  an  average  increase  in  weight  of  more  than  eleven  pounds 
in  eight  days,  and  he  particularly  recommends  this  aid  to  diagnosis, 
which  appears  to  be  most  useful  at  mid-term. 

It  may  be  noted  as  an  additional  aid  in  diagnosis,  that  with  the 
progress  of  gestation  the  mucous  membrane  lining  the  vulva  and 
vagina  becomes  swollen,  and  assumes  a  red  or  bluish-i-ed  hue,  instead 
of  its  usual  pink  colour ;  and  towards  the  termination  of  pregnancy, 
the  secretion  of  vaginal  mucus,  particularly  in  the  Cow,  is  largely 
increased. 

All  these  numerous  signs  are  by  no  means  to  be  implicitly  relied  upon, 
however,  as  they  are  not  infallible  in  proving  the  existence  of  pregnancy 
in  every  case  ;  some  of  them  are  only  noticeable  at  a  late  period,  while 
others  may  be  absent.  It  is  necessary  in  taking  them  into  considera- 
tion, to  distinguish  those  animals  which  are  kept  at  pasture  and  destined 
for  breeding,  from  those  which  are  kept  in  the  stable  and  used  for 
various  purposes.  With  the  first,  the  cessation  of  oestrum  and  the 
refusal  of  the  male  are  almost  certain  indications  of  conception  ;  while, 
with  the  latter,  the  same  phenomena  may  be  the  result  of  fatigue  or 
bad  food  and  mismanagement. 


SIGXS  OF  PREGXAXCV.  U3 

With  regard  to  fattenintj,  change  of  temper,  etc.,  it  is  evident  that 
they  may  depend  upon  other  causes  than  pregnancy ;  and  obesity 
can  only  be  very  conspicuous  in  primiparous  animals,  or  those  which 
are  not  rearing  young  ;  for  Glares  or  other  creatures  put  to  the  male  a 
few  days  after  parturition,  are  not  likely  to  accumulate  fat  and  rear 
their  progeny  at  the  same  time.  When,  however,  all  the  above  signs 
are  manifest  in  an  animal,  they  establish  a  very  strong  presumption, 
though  not  an  absolute  certainty,  as  to  its  condition.  It  is  not  until  a 
later  period,  when  the  abdomen  begins  to  increase  more  rapidly  in 
volume,  the  animal  becomes  sluggish,  and  the  mammio  enlarge  and 
secrete  the  viscid  fluid  just  described,  that  the  existence  of  pregnancy 
might  safely  be  attirmed. 

The  chances  of  error  in  diagnosing  pregnancy  in  the  first  half  of  the 
period  are  numerous,  and  even  up  to  a  later  stage — until  parturition,  in 
fact — these  indicative  signs  may  be  absent.  I  know  of  an  instance  in 
which  an  unfortunate  Mare  was  ridden  to  hounds  until  the  day  before 
it  gave  birth  to  a  dead  foal,  and  perished. 

Sensible  Signs. 

Wlien  the  contractility  of  the  fa>tal  muscles  begins  to  be  developed — 
which  is  towards  the  fourth  month  in  the  larger  animals — the  young 
creature  can  move,  though  the  movements  are  too  feeble  to  be  recog- 
nisable externally  at  an  early  period ;  but  later,  towards  the  end  of 
pregnancy,  they  become  vigorous  and  unmistakable. 

To  obviate  as  much  as  possible  the  risks  of  error  in  diagnosing 
pregnancy,  various  expedients  have  been  resorted  to  in  order  to 
ascertain  with  certainty  the  presence  of  the  foetus  in  the  uterus,  by 
exciting  these  movements.  Some  of  these  are  as  barbarous  as  they  are 
stupid.  One  especially  merits  the  strongest  condemnation  ;  this  is 
pouring  water  into  the  ears  of  the  Mare  or  Cow,  under  the  supposition 
that  if  the  animal  is  not  pregnant  it  will  shake  its  whole  body  to  get 
rid  of  the  fluid,  but  if  pregnant  that  it  will  only  shake  the  head  and 
ears.  Another  cruel  and  dangerous  test  is  causing  these  animals,  but 
especially  the  Mare,  to  run  very  quickly  for  a  certain  time,  and  to  give 
them  cold  water  to  drink  or  oats  to  eat  immediately  afterwards,  in 
order  to  excite  inordinate  movements  in  the  foetus.  It  will  readily  be 
understood  that  these  and  other  vicious  practices  are  very  likely  to 
produce  abortion,  and  that  they  should  therefore  be  discountenanced 
and  discontinued.  The  only  useful  and  practicable  means  tliat  can  be 
resorted  to,  are  those  which  appeal  to  the  senses  of  touch,  sight,  and 
hearing.  But  it  must  be  remarked  that  these  have  fewer  oppi^rtunities 
for  their  exercise,  and  are  more  limited  in  their  application,  in  animals 
than  in  woman. 

Qn  feeling  or  touching,  watching  the  movements  of  the  foetus  as  they 
are  manifested  externally,  and  auscultation,  we  must  mainly  rely,  and 
these  afford,  with  the  other  signs,  the  only  conclusive  evidence  we  can 
obtain. 

The  indications  obtainable  by  manual  exploration  are  through  the 
abdominal,  rectal,  and  vaginal  touch.  The  feci  of  the  abdomen  does  not 
yield  equally  certain  results  in  all  the  domesticated  animals.  In  those 
which  are  small,  as  tlie  Bitcli  and  Cat,  a  little  careful  manipulation  will 
render  the  presence  of  the  creatures  in  utcro  very  evident  towards  the 
middle  period  of  gestation  :  but  in  the  larger  animals — the  Mare  and 
Ass  on  the  one  hand,  and  the  Cow  on  the  other — there  exist  con- 
siderable differences,  as  pointed  out  by  Trasbot. 


144  OBSTETRICAL  PHYSIOLOGY. 

In  the  Cow  after  the  fifth  or  sixth  month,  the  presence  of  the 
foetus  can  be  readily  ascertained  by  this  means;  but  in  Sohpeds  it  is 
not  until  the  seventh  or  eighth  month  that  the  same  information  can 
be  derived  ;  and,  besides,  it  is  not  always  easy  to  apply  this  mode  of 
investigation  to  these  animals,  because  of  their  fidgetiness.  It  is  better 
to  examine  the  animal  when  it  is  standing,  as  the  signs  are  not  so  per- 
ceptible when  it  is  recumbent.  The  examiner  stands  on  the  right  side 
of  the  Cow,  the  left  of  the  Mare,  with  his  back  towards  the  animal's 
head,  and  applies  the  palm  of  his  right  or  left  hand  against  the  abdomen, 
immediately  below  the  flank,  about  eight  or  ten  inches  in  front  of 
the  stifle,  and  just  above  the  udder,  pressing  moderately,  the  other 
hand  resting  on  the  back.  At  this  part  of  the  abdomen  a  hard  volu- 
minous mass  can  be  felt  in  the  uterus,  while  the  movements  of  the 
foetas  are  perceptible  as  it  stirs  at  irregular  intervals,  and  causes  the 
jerks  and  shock  of  its  displacements  to  be  communica,ted  to  the  walls 
of  the  abdomen.  These  movements  are  strongest  in  the  morning,  and 
are  more  distinct  if  the  mother  is  eating  or  drinking,  especially  if  the 
water  is  cold,  or  immediately  after  feeding.  Some  old  authorities 
recommend  that,  to  render  the  movements  of  the  foetus  more  per- 
ceptible, the  Mare  should  be  trotted,  put  in  the  stable  and  given 
some  food,  and  then,  by  placing  the  hand  on  the  before-mentioned 
region,  the  foal  will  be  felt  if  it  is  there.  The  distention  of  the  stomach 
by  food  compresses  the  other  abdominal  organs,  and  especially  the 
uterus,  and  the  inconvenient  displacement  excites  the  young  creature  to 
movement.  The  ingestion  of  fluids  does  the  same,  and  particularly  if 
they  are  cold  ;  for  then  they  powerfully  affect  the  foetus  by  the  uncom- 
fortable sensation  they  give  rise  to.  Cold  water  thrown  against  the 
belly,  or  the  application  of  the  cold  wet  hand,  will  produce  a  similar 
effect.  In  the  Cow,  smart  compression  of  the  abdomen  with  the  closed 
fist  at  the  part  just  indicated,  so  as  to  push  the  uterus  upwards  and 
allow  it  to  return  with  a  little  force,  is  also  a  good  method  of  ascertain- 
ing the  presence  of  the  foetus,  and  will  prove  successful  when  simple 
application  of  the  flat  hand  will  fail.  It  is  most  likely  to  succeed 
when  there  is  not  much  food  in  the  stomach  and  intestines,  as  the 
uterus  is  then  much  easier  displaced.  When  this  compression  has  been 
made  with  some  energy,  the  uterus  strikes  the  abdominal  wall  immedi- 
ately afterwards,  and  then  there  can  be  perceived  a  firm  voluminous 
mass  ;  this  is  the  uterus  containing  the  foetus. 

At  a  more  advanced  period,  in  the  last  two  months,  the  movements  of 
the  foetus  can  be  easily  remarked  as  it  jumps  about  briskly,  striking 
the  interior  of  the  abdomen  at  brief  intervals.  This,  and  the  other 
signs  appreciable  at  this  time,  leaves  no  doubt  as  to  the  existence  of 
pregnancy.  The  foetal  movements  are  never  more  marked  and  pre- 
cipitous than  immediately  before  abortion,  at  a  late  period  of  gestation; 
they  are  then  energetic,  and  to  all  appearance  convulsive. 

With  the  smaller  animals  the  same  methods  of  exploration  may  be 
resorted  to,  and  with  the  same,  or  even  more  marked  results.  The 
perceptible  movements  of  the  foetus  of  course  settle  the  question  as  to 
pregnancy  and  the  vitality  of  the  young  creature  ;  but  their  absence  is  not 
conclusive  as  to  the  contrary,  for  it  has  not  infrequently  happened  that 
the  foetus  remained  insensible  to  this  kind  of  excitation,  and  yet  was 
alive  at  birth.  The  tests  should  be  applied  more  than  once  in  these 
doubtful  cases. 

It  maybe  noted  that  the  "feel"  of  the  abdomen  distended  by  the 


/'A'AV/.vj.V'-)'.  145 

xiterus  is  very  ditferent  when  tlie  distention  is  caused  by  fluid,  Hatus, 
etc.  The  uterine  tumour  is  firm,  liard,  elastic,  and  defined,  preserving 
its  form  in  all  positions  of  the  body  ;  whereas  in  ascites  the  swelling 
is  not  defined,  there  is  no  repercussion  on  compression  at  the  flank 
of  the  Cow,  the  fluid  obeys  the  laws  of  gravitation,  and  the  abdomen 
has  not  the  same  firm,  elastic  feel.  Percussion  will  aid  in  distinguish- 
ing between  pregnancy  and  tympanitis.  In  certain  diseased  conditions 
of  the  uterus,  however,  a  diagnosis  is  very  difficult,  and  the  next  means 
of  exploration  will  have,  in  some  of  these  embarrassing  cases,  to  be 
adopted. 

Rectal  exploration,  as  well  as  that  by  the  vagina,  can  only  be  success- 
fully carried  out  in  the  larger  animals,  because  of  the  small  dimensions 
of  these  ))assages  in  such  creatures  as  the  Bitch  and  Cat.  The  risks 
attending  this  mode  of  examination  liave  been  at  times  much  exag- 
gerated, and  there  is  really  but  little  danger  to  the  animal  so  long  as 
reasonable  precautions  are  taken  not  to  produce  injury  ;  the  foetus  has 
even  been  pushed  gently  about  in  the  uterus  without  any  accident  to  it 
or  the  parent.  After  the  third  month  it  will  afi'ord  an  indication  of 
pregnancy. 

To  examine  an  animal  per  rectum  it  should  be  standing,  and,  if 
dangerous  or  irritable,  the  twitch  may  be  applied  to  the  nose,  or  for 
safety  to  the  operator  the  hind  limbs  must  be  secured  ;  with  the  Cow, 
the  nose  seized  by  one  hand  of  an  assistant  and  a  horn  by  his  other 
hand,  will  be  sufficient.  The  bowel  should  be  emptied  of  the  fccces  it 
may  contain,  so  as  to  allow  the  oiled  hand  and  arm  of  the  explorer  to 
be  introduced  and  freely  moved  about.  When  the  abdomen  is  large 
and  pendulous,  it  is  useful  to  place  the  animal  hi^^her  before  than  behind, 
and  to  have  the  lower  part  of  the  belly  raised  by  assistants  on  each 
side,  by  means  of  a  sheet  or  sack,  or  even  their  hands  joined  beneath, 
so  as  to  throw  the  uterus  backwards  and  upwards  ;  though  in  the 
majority  of  cases  these  measures  are  not  necessary.  The  hand  being 
passed  into  the  rectum  to  beyond  the  brim  of  the  pubis,  it  is  opened 
iind  the  palm  placed  on  the  lower  surface  of  the  intestine  and  gently 
])ressed  downward,  towards  the  floor  of  the  abdomen  ;  when  there  will 
lae  felt,  if  the  animal  is  pregnant,  a  hard  irregular  mass,  more  or  less 
voluminous  according  to  the  stage  of  gestation,  and  capable  of  being 
<]isplaced  to  a  certain  extent — even  partially  brought  into  the  pelvis,  if 
parturition  is  near.  In  this  case,  the  head  or  other  parts  of  the  foetus 
can  be  distinguished  through  its  envelopes  and  the  uterine  and  rectal 
walls.  But  if  pregnancy  is  not  so  advanced — ^say  only  at  the  sixth 
month,  the  fcetus  cannot  be  so  readily  felt,  and  it  may  happen  that  at 
this  period  it  is  situated  low  down  in  the  abdomen,  or  well  forward  in 
one  of  the  horns  of  the  uterus,  and  lying  to  one  side  of  the  mesial  line 
(nearly  always  to  the  right  in  the  Cow) ;  so  that  an  inexperienced  or 
careless  examiner  might  miss  it  altogether  at  the  first  exjiloration. 
This  error  can  be  avoided  by  carefully  moving  the  introduced  hand  to 
the  right  and  left  as  far  as  the  intestine  will  permit,  with  the  animal's 
l)ody  inclined  backwards  and  the  belly  raised  by  assistants,  as  just 
<lescribed.  The  ftt'tus  should  be  excited  to  move,  if  possible,  so  as  to 
guarantee  its  presence. 

The  difficulties  are  greater  if  it  is  desired  to  know  whether  the  fcetus 
is  alive  or  dead.  Sometimes  we  may  at  once  perceive  the  movements 
of  the  young  creature  in  the  uterus  ;  but  at  other  times  it  is  motionless, 
and  cannot  be  made  to  exert  itself  except  by  moving  and  pushing  it 

10 


IK?  (>/!sTi-rn:/(\i/.  n/ys/DLixn'. 

sovoval  times.  This,  howevov,  is  not  commeiulablo,  unless  performed 
with  the  greatest  gentleness  and  care  ;  and  if  tlune  is  nethiiig  urgent, 
it  would  be  preferable  to  nuike  an  examination  at  another  time,  rather 
than  incur  the  dangerous  results  that  might  follow  this  numipulation. 

The  prominences  of  the  fix^'tus  might  be  mistaken  for  the  hard  nuisses 
of  faeces  lodged  in  the  intestines  ;  but  a  distinction  can  generally  be 
nuide  by  the  rapidity  with  which  these  prominences  appear  and  dis- 
appear through  the  sudden  movements  of  the  young  creature,  com- 
pared witli  the  slow,  regular,  peristaltic  motion  of  the  intestine  and  its 
tivcal  contents. 

Vaijiital  cxplonxtion,  as  mentioned,  can  only  bo  practised  on  the 
larger  animals.  It  is  t\ot  attemled  witli  any  more  danger  than  the 
rectal  examination  ;  but  though  it  is  of  great  value  in  wonum,  especially 
when  ballottfiiu'iit^  is  resorted  to,  yet  it  is  not  nearly  so  useful  in 
anin^als ;  for  in  consequence  of  their  horizontal  position,  this  reper- 
cussion is  not  possible.  Neither  is  it  so  valuable  as  the  exploration 
per  rectum.  It  is  practised  with  the  animal  in  the  same  position  as  for 
the  last-named  examination,  and  the  hand,  well  lubricated  with  soft 
soap  or,  better  still,  with  olive  oil,  is  inserted  into  the  vagina  as  far  as 
the  cervix  uteri.  In  the  tirst  months  of  gestation  the  uterus  descends 
into  the  abdomen  ;  consequently,  the  vagina  is  longer  and  more 
inclined  downwards  in  front :  while  the  fcvtus  is  beyond  reach  of  the 
hand.  Towards  tlie  fifth  or  sixth  month,  the  uterus,  in  expanding  in 
every  direction,  approaches  the  vulva,  and  the  canal  of  the  vagina  being- 
shortened,  it  can  be  perceived  in  the  pelvic  cavity.  The  same  manipu- 
latory numanivres  as  were  practised  in  the  rt^ctum,  amy  be  employed 
in  the  vagina  at  this  time,  but  the  results  are  far  from  being  so  satis- 
factory ;  the  vaginal  examination  should,  therefore,  never  be  preferred 
to  that  by  the  rectum. 

Ballottenient  may  be  resorted  to  in  the  smaller  animals,  by  placing 
them  in  a  vertical  position  ;  but  the  other  signs  of  pregnancy  are  usually 
so  manifest  in  them,  that  generally  there  is  little  ditVicultyin  diagnosing 
their  condition. 

Auscultation  has  not  been  much  employed  in  the  diagnosis  of  preg- 
nancy in  the  lower  animals,  though  its  value  in  womau  is  inideuiable  ; 
as  since  its  introduction  by  M.  Mayor,  of  Cieneva,  in  1818,  its  utility 
has  been  frequently  and  successfully  put  to  the  test,  not  only  to  ascer- 
tain whether  there  was  a  fa^tus,  but  also  whether  it  was  alive.  In 
woman,  either  the  uncovered  ear  or  the  stethoscope  is  applied  to  the 
abdomen ;  the  latter  is  generally  preferred,  as  by  it  the  sound  is 
limited,  as  well  as  defined. 

The  pulsation  of  the  fa'taJ  heart,  or  double  hattement,  consists  of  a 
rapid  succession  of  short,  regular,  double  pidsations,  dilTering  from 
those  of  the  adult  heart  in  rhythm  and  frequency  ;  the  sound  being  like 
the  mutlled  ticking  of  a  watch,  or  tlie  pulsations  of  the  heart  of  a  new- 

'  The  haUoffemfiit  ov  ropereiissiini  to  asoortain  the  prosonco  of  a.  ftvtiis  in  woiuau,  is 
produced  by  the  operator  placing  his  patient  in  the  upiiglit  position,  in-  if  in  bed,  raisiing 
her  shoiiUlers.  The  forefinger  is  then  introduced  into  the  vagina  and  placed  on  tlie 
cervix  uteri,  while  the  other  hand  is  employed  to  keep  the  uterine  tumour  steady  ;  then 
suddenly  but  slightly  jerking  upwards  the  point  of  the  intrmluced  tinger,  ft  sensation  is 
experienced  of  something  having  receded  from  it,  and  whicti  he  will  percei\e  to  fall 
again  on  the  point  of  his  tinger  in  a  moment  or  two.  The  jerk  oi  the  tinger  upon  tlu- 
iiead  of  the  fa-tus  causes  it  to  float  upwards  a  little  in  the  liquor  amnii,  and  its  weight 
makes  it  descend  ag.iin.  We  have  seen  that  a  kind  of  external,  or  flank  ballotlemettt, 
can  be  practised  in  the  Cow. 


I'UEQ  NANCY.  ,^7 

born  child.     In  addition  to  the  sounds  of  tlie  footal  heart,  there  is  also 

he ';  ;^u;r:-ft"  f '""'^r'  't\^  ^^^^^^^  '^^  ^^-^^  ^^'-^^  pissin"  rough 

the  greatly  er.larged  vessels  of  the  uterus,  particularly  at  the  part  to 
which  the  placenta  is  attached  ;  it  is  an  intermittent  whirling'  sound 
eard  at  an  early  period  of  pregnancy,  and  usually  regarded  as  one  of 
Its   nost  unequivocal  signs.     There  is,  in  addition,  the  v>dli^^,a  ^ the 

Teftru  "T;'"-^"''r^"'-^'^''"r^  •"  ^^^^^'"  ^-ourai/e  ;o^;-:4  tf 

the  fa-tus     It  IS  synchronous  with  the  foetal  pulsations. 

m  the  larger  animals,  auscultation  of  tlie  abdomen  for  the  nurnose  of 
aiscovenng  the  existence  of  these  sounds  is  very  ofU-n  unSessfuf 
because  of  the  intestinal  walls,  the  rumblings  and  noises  c7  the  Tntes 
tines,  and  those  of  the  rumen  in  the  Cow,  the  large  "Entity  of  amniS 
hnd  the  position  of  the  fa.tus,  etc.,  which  entirely ^mask  the  W  f  of 
the  fo-tal  heart ;  so  that  it  is  seldom,  if  ever,  resorted  to.  Lafosse  and 
resS     7"r'  ^T  '"T'"'^^  '^  '''  ^"^^  apparently  with  saisf actor 

Dre^naL  fhn,  I  V,  /''^  distinctly  in  Cows  which  were  six  months 
rauscul'taUon^  FM?' °  '""Ti}'  '^"'  ^^^^Y <^-rnn.t  always  be  perceived 
these  fa  tir he.;.  iV  '""""  ^'.'^^^•^^^"•^^"ti^^ns  that  he  has  offen  heard 
Cow  bdn^^  "^''"'^  ^'•^^'"  ^  '^  ':'  i^^  P'^'-  ^"'""te,  those  of  the 

the  mothi^    ll  i.''";^^^^^^  byth^  «tate  of 

inc  mothei  s  health  ;  he  acknowledges  that  they  cannot  be  heard  in 

teTl^osco  rii^'tr'"-  ?r'T-'^  ^'^  ^"'^^  P^^^--«'-     ^aale,  utg  t^ 
frc      r;3l  "i  ir  '"'^'^' V^'^'.  ''^"^^"'  ^"  ^'•^"^  ^"^  ^  ^'"J«  a^>«ve  the  crural 

hS  week  mi  to  r  ""L"^''  ^u  ^f  ^'\^-^  '^"  ^^^'^^^  ''^^^^  f''^"'  ^^'^  ^wenty- 

hlth  %\eek  up  to  two  hours  before  birth  ;  though   he  was  certain    from 

heir  distinctness,  that  they  might  have  been  heard  earlier    in  nm  be 

thc^y  varied  from  12G  to  128  per  minute,  the  mother's  pulse  being  6M 

80^n1r''^an^d''7''h''  '"^  '''^''''  ^^''  "^^^  succeeded  in  detecting  these 
vr^rnlntV-il  kTk  ""  Trf^  occasions  practised  auscultation  on 
pregnant  Mares,  but  have  failed  to  distinguish  the  fa-tal  pulsations. 

shouM  nrrh/' "''  '"^f^f"  V^>'  as  suggested  by  M.  Trasbot,  the  uterus 

or  ra  he,  '.?    r  ^'''^.''^'•'  '^^^^'"'^^^  ^^y  ^  long  special  stethoscope 

-or  rathe.    '  metroscope  "-introduced   by  the  vagina,   its  wide  end 

^o^L  L  K  .  ^  surrounding  the  fa.tus  being  good  conductors  of 
sound,  the  beats  of  its  heart  should  be  distinctly  heard,  if  it  is  alive 
IZ^W  in  f^"'  -«°,- .1^20.  and  Verardini,  fn  1871  have  spoken 
spS  ^'^/r«-rai7nea^  auscultation   in    the  human 


ceived    hr^    in  th  f"   '^-'^/^r  'u'  '^^'"«  '^^  pregnancy,  it  will  be  per- 

f^an  sunoo^iHrn  V^^    ^f  "°^^   '^''  condition,  there  is  but  little  more 
henhvT.l        1  ^^,,^^''l^."«..t»'^  presun.ptions   becoming  stronger  as 
the  phjMca    and  other  indications  are  more  marked.     It  is  onlv   how- 
ever, towards  the   middle  period,  when   all   the  rational  and    ;hv8?cal 

^^1^^""''  r'  "'^"  ^'"  ^°^^'^^°"  -^  ^'-*  "^«-«  has  beenscer 
alirm  wkhr .?.  ^.^'P^T'"''^  mana,-uvre8  above  described,  that  we  can 
wLn  ;   1     w     u^""  '^^"*^^''  ""^  ^"■°"'  ^^^  existence  of  pregnancy.     And 

ha     th  .'^^^    l'>-^"'''  '°  P"""""'^  ^'  *^'«  '*'^«^'  ''  '«  ^^*»  t'^  remember 
hat    this  condition    may    exist  without  being    accompanied    by  very 
evident  signs,  and  that  a  hasty  conclusion  must  not  be  drawn      When 
for  instance,  some  rational  signs  present  give  rise  to  the  presumption 


148  OBSTETRICAL  PHYSIOLOGY. 

that  an  animal  is  pregnant,  but  no  physical  indication  reveals  this  state, 
the  examinations  must  be  repeated  before  a  final  decision  is  arrived  at. 
The  value  of  experience  and  observation,  when  added  to  theoretical 
knowledge,  is  well  displayed  in  this  branch  of  veterinary  science.  Not 
unfrequently  the  diagnosis  of  pregnancy  is  surrounded  by  great  diffi- 
culties, and  a  guarded  opinion  must  therefore  always  be  given. 

SECTION  rV'.— DURATION  OF  PREGNANX'Y. 

The  duration  of  pregtiancy  varies  considerably  in  different  species 
of  domesticated  animals  ;  and  even  in  the  same  species  there  are 
individual  variations  which,  though  not  very  great,  are  yet  important ; 
so  that  the  exact  term  cannot  be  rigorously  fixed.  From  the  doe 
Eabbit,  which  carries  its  young  only  twenty-eight  to  thirty  days,  to  the 
female  Elephant,  whose  period  of  pregnancy  is,  according  to  report, 
two  years,  there  are  a  number  of  intermediate  terms  ;  and  it  is  scarcely 
possible  to  establish  a  satisfactory  relationship  between  the  duration  of 
pregnancy  and  the  other  conditions  of  organisation — such  as  size  or 
longevity.  In  closely  allied  species,  and  which  may  couple  and  pro- 
duce hybrids — as  the  Horse  and  Ass,  Sheep  and  Goat — the  period  is 
pretty  nearly  the  same. 

With  regard  to  breeds,  Wilhelms  has  remarked  that  the  Hungarian 
Cow  averages  ten  days  more  than  the  Dutch  Cow.  With  the  male 
foetus,  the  duration  of  gestation  is  greater  than  in  the  case  of  a  female. 
It  has  even  been  remarked  that  the  male  parent  may  have  an  influence 
in  this  direction.  For  instance,  a  Mare  which  has  been  put  to  a 
thoroughbred  Horse  will  be  longer  pregnant  than  when  impregnated  by 
a  common-bred  stallion ;  and  the  Mare  which  has  been  fecundated  by 
a  stallion  Ass  goes  longer  than  when  impregnated  by  a  Horse.  The 
duration  of  pregnancy  also  depends  upon  the  age  of  the  female,  and 
her  strength  and  condition  ;  a  weakly  or  much-worn  animal  does  not 
go  so  long  as  one  which  is  strong  and  weU  fed. 

The  differences  in  indi\'iduals  of  the  same  breed  or  species  may  be 
partly  accounted  for  by  the  fact,  that  impregnation  is  possible  at  any 
time  during  oestrum — a  variable  period  ;  and  if  coitus  has  taken  place 
several  times  during  this  condition,  it  is  impossible  to  predict  when 
conception  took  place.  And  even  when  contact  has  only  occurred  once 
between  the  male  and  female,  fecundation  does  not  necessarily  coincide 
with  this  intercourse ;  as  the  ovum  may  meet  the  spermatozoa  in 
different  regions  of  the  uterine  system,  and  may  therefore  only  be  ferti- 
lised some  days  after  copulation.  The  time  required  for  the  o\'um  to 
pass  through  the  Fallopian  tube  also  varies  in  different  animals.  In 
the  Eabbit  and  Guinea-pig,  for  instance,  it  takes  three  days  ;  in  Eumi- 
nants  from  four  to  five  days,  and  in  the  Bitch  from  eight  to  ten  days. 

And,  as  has  been  remarked,  various  circumstances  may  retard  or 
accelerate  the  development  of  the  foetus ;  not  only  this,  but  with  some 
animals  it  may  apparently  remain  for  a  number  of  days  in  the  uterus 
after  it  is  ready  for  birth,  without  inconvenience  to  the  mother  or  itself, 
just  as  it  may  be  born  several  days  before  the  ordinary  period  without 
compromising  its  safety. 

For  these  reasons,  the  period  of  pregnancy  can  only  be  approximately 
fixed,  though  there  are  of  course  limits  beyond  which  Nature,  ever 
provident  and  watchful  for  the  preservation  of  species,  cannot  go  without 
ceasing  to  be  natural. 


oriLirmx  of  rnEnNANcv.  149 

Mare. 

The  usual  period  of  gestation  with  the  Mare  is  eleven  inonths,  though 
it  may  vary  between  ten  and  twelve. 

From  the  observations  of  Winter,  Brugnone,  Tessier,  and  Grille,  made 
on  2S4  Mares,  it  results  that  the  shortest  period  of  gestation  was  307 
days,  and  the  longest  394  days — or  a  mean  duration  of  34()  days. 

(iayot,  in  25  instances  noted  at  the  Haras  of  Pin,  France,  found  the 
average  to  be  343i  days ;  the  shortest  being  324  days,  and  the  longest 
3G7  days. 

A  writer  in  the  Journal  d'Econoutie  riiralc  hclge  for  1829.  cited  by 
Rainard,  gives  as  the  minimum  322  days,  maximum  41!)  days,  the 
average  being  347  days. 

Colin  gives  the  average  as  345  days,  though  birth  may  occur  at 
330th  to  365th,  and  sometimes  to  the  380th  day. 

Dieterichs  gives  the  shortest  period  as  307  to  317  days,  and  the 
longest  as  409  to  419  days— the  average  being  330  to  342  days.  Bau- 
meister  and  Rueff  give  a  minimum  of  330  days,  or  eleven  months,  the 
maximum  as  420  days,  or  fourteen  months' — the  average  as  340  days,  or 
\\\  months. 

A  correspondent  of  the  Field  (May  2(jth,  1894)  alludes  to  a  Mare 
which  foaled  twelve  months  and  tvveuty-tive  days  after  the  last 
senice. 

With  regard  to  the  influence  of  breed  on  tlie  duration  of  pregnancy, 
we  have  the  researches  of  Baumeister  and  Rueff ;  from  these  it  appears 
that,  witli  pure-bred  Persian  mares,  the  gestation  period  was  341  days — 
343  for  male  foals,  and  338  for  females  ;  in  thoroughbred  Arab  Mares,  the 
average  was  338  days — 339  for  males  and  337  for  females ;  in  high- 
bred Russian  Mares,  some  of  which  belonged  to  the  Orloff  race,  the 
average  duration  was  341i  days — 341  for  males  and  342  for  females. 
With  Hnglish  Mares,  the'y  found  that  in  half-breds  the  average  was 
339^  days — 340  for  males,  and  339  for  females. 

Saint-Cyr,  referring  more  particularly  to  Gayot's  observations,  ax-rives 
at  the  following  conclusions  : 

1.  In  the  Mare,  the  normal  duration  of  pregnancy  may  be  fixed 
between  340  to  350  days— this  being  tlie  interval  in  wliich  the  majority 
of  Foals  are  born. 

2.  Some  Foals  may  be  born  alive  from  the  300th  to  tlie  310th  day, 
but  this  is  rare. 

'  Hanion  [H^cueil  <I>  Mt<l.  VeUrinaln,  lSt57)  iilludes  to  thf  ca«e  of  a  Mare  seven 
yeara  old,  which  went  beyond  her  ordinary  jwriod  of  pre^jnancy,  only  nianifeHtini;  at  the 
usual  time  the  customary  signs  of  foalinij;  though  the.ie  noon  ctBHed,  but  recurred  ajjain 
in  fifteen  days,  only  to  disappear  in  a  short  time.  .\ft«?r  this  interval  tlie  animal 
appeared  t<i  l»e  quite  well,  feeding  and  working  as  Ixfore.  At  the  sevcntt i-nth  month 
of  pregnancy  she  was  in  the  same  condition  :  but  on  the  fifteenth  day  of  the  eighteenth 
month,  she  was  sei/.ed  with  serious  .■•ymptonis  which  continued  during  four  days,  when 
death  ensued.  Hamon  txaniined  the  body  in  th<-  presence  of  many  {)eople,  who  were 
much  interested  in  the  case-,  and  discovered  a  Foal  which  weighed  seventyhve  kilogrammes, 
and  was  as  fat  and  fresh-looking  as  if  it  had  been  extracted  at  the  normal  jK-riod.  The 
tongue  protruded  from  the  mouth,  the  eyes  were  almost  gone,  the  mu?<cles  were  well 
developed  but  somewhat  blo<xlle»s,  and  the  position  of  the  fnt\is  was  natural.  The 
lunbilical  cord  had  the  same  asjn-ct  as  in  ordinary  ca-ses,  but  there  was  no  bl<K>d  in  its 
vt-isels,  and  it  waa  ruptured  at  five  or  six  centimetres  from  the  alxlominal  walls.  The 
futal  envelopes  were  hyi>ertr<>phied.  their  tot.il  thickness  being  four  to  fiv.-  centimetres  ; 
otherwise  they  were  healthy.  The  rerrix  uteri  was  of  a  great  thickness  and  very  rigid  ; 
when  dilated  it  would  only  allow  the  passage  of  the  fist.  The  litpior  amnii  wa«  reddish 
coloured. 


150  OBSTETRICAL  FHYsRiLOGV. 

3.  Births  are  frequent  between  325  and  340  days, 

4.  They  are  not  rare  from  350  to  365  days,  but  they  are  indeed  so 
after  the  latter  period. 

5.  We  may  consider  300  to  400  days  as  the  extreme  limits  within 
which  normal  gestation  occurs  in  the  Mare  ;  below  or  beyond  these  it 
ceases  to  be  natural  and  really  physiological. 

6.  According  to  the  researches  of  M.  Gayot,  pregnancy  is  often  a  little 
longer  for  a  Colt  than  a  Filly ;  and  though  this  conclusion  is  certainly 
not  founded  on  a  sufficiently  large  number  of  observations,  it  neverthe- 
less acquires  a  certain  degree  of  probability  from  being  in  conformity 
with  what  is  observed  in  the  Bovine  species. 

The  average  duration  of  pregnancy  with  thirty-three  thoroughbred 
Mares  which  foaled  at  the  celebrated  Middle  Park  Stud,  Eltham,  in 
1876,  T  find  on  examination  to  be  335i  days — the  shortest  periods  being 
316  days  (one  instance),  and  318  days'  (one  instance) ;  and  the  longest 
354  days  (one  instance),  and  348  days  (one  instance).  Between  the 
320th  and  330th  days,  there  were  only  5  instances  ;  between  the  330th 
and  340th  days,  there  were  11  instances ;  and  between  the  340th  and 
348th  days  there  were  15  instances.  Owing  to  some  of  the  Mares 
having  been  put  to  the  Horse  more  than  once,  and  in  some  cases  at 
intervals  of  several  days,  the  averages  may  not  be  absolutely  correct,  as 
the  last  coitus  has  been  the  one  which  is  reckoned  from!^  But  with 
one  Mare  (Entremet)  put  only  once  to  the  Stallion  (Rosicrucian),  the 
period  was  324  days ;  with  another  (Hilda)  put  to  the  same  Stallion,  the 
period  was  332  days ;  and  with  another  (Imogene)  and  this  StalHon,  it 
was  342  days. 

With  regard  to  sex,  there  were  sixteen  Colts  and  seventeen  Fillies:  the 
average  gestation  period  of  the  former  was  336^  days,  and  the  latter 
334  days.  The  shortest  periods  (316  and  318  days")  were  with  Fillies,  and 
the  longest  periods  were  also  with  Fillies  (354  and  348  days).  The  ages  of 
the  Mares  ranged  from  five  to  nineteen  years  ;  there  being  three  at  five, 
two  at  six,  three  at  seven,  two  at  nine,  two  at  ten,  six  at  twelve,  four  at 
fourteen,  four  at  fifteen,  two  at  sixteen,  one  at  seventeen,  one  at 
eighteen,  and  three  at  nineteen.  In  the  first  group,  pregnancy  averaged 
340  days ;  in  the  second  3501  days ;  in  the  third  3281^'  days  ;  in  the 
fourth  340i  days  ;  in  the  fifth  336  days  ;  in  the  sixth  337V.r  davs  ;  in  the 
seventh  336.i  days  ;  in  the  eighth  333  days  ;  in  the  ninth  3401  days  ;  in 
the  tenth  324  days ;  in  the  eleventh  330  ;  in  the  twelfth  325.  These 
figures  would  go  to  prove  that  the  period  of  gestation  decreases  with  age  ; 
and  indeed  we  find  that  the  shortest  pregnancies  occurred  in  Mares 
nineteen  years  old  (316  and  318  days),  and  the  longest  in  six  and  nine 
years  old  Mares  (354  and  348  days). 

The  animals  were  of  course  kept  in  the  most  favourable  conditions 
for  breeding;  and  this,  with  their  splendid  qualities  and  precocity, 
doubtless  shortened  the  period  of  gestation,  which  is  below  the  ordinary 
average.  1 

An  extensive  horse-breeder  in  Oregon,  U.S.A.,  has  been  making  some  interesting 
observations  on  the  duration  of  pregnancy  in  jMares,  as  influenced  by  the  season.  He 
writes  :  "  On  the  20th  of  .Tuly,  1879,  I  bred  a  Mare,  and  bhe  foaled  on  the  30th  of  the 
following  May.  The  next  spring  I  bred  my  Mares  early,  and  they  carried  their  Foals 
about  eleven  and  a  half  months.  "The  thought  occurred  to  me  then  that  Mares  bred  early 
in  spring  carried  their  Foals  longer  than  those  bred  later.  For  the  next  two  seasons  I 
took  charge  of  a  band  of  Mares,  and  found  that  those  bred  in  April  carried  their  Foals 
longer  than  those  bred  in  Maj-,  and  that  those  bred  in  May  went  longer  than  those  bred 
in  June  and  .Tuly.     Since  then  I  have  had  considerable  bad  luck  with  ujy  Mares  getting 


UriiATlUX  OF  riiKGXAXCy.  IM 

It  is  also  generally  admitted  that  pieginincy  is  of  longer  duration  in 
the  Ass  than  the  Ivjuine  species — from  358  to  385  days. 

In  a  stud-book  kept  in  tliis  country,  a  record  is  given  of  observations, 
from  which  it  appears  that  the  shortest  period  of  gestation  in  the  Ass 
in  eight  carefully-recorded  entries  was  3G5  days,  and  the  longest  385 
days,  of  which  there  were  two  cases.  The  mean  period  was  374  days. 
The  males  and  females  were  foreign.  When  the  female  Ass  has  been 
covered  by  the  horse  Stallion,  the  period  of  gestation  is  not  so  long. 

Coir. 

It  is  commonly  believed  that  the  Cow  is  pregnant  for  the  same  length 
of  time  as  woman,  and  this  is  to  a  certain  extent  correct,  so  far  as  the 
average  period  is  concerned  ;  but  there  are  variations  which  must  be 
taken  into  account,  and  which  will  be  apparent  if  we  look  at  the  pub- 
lished results  of  various  observers.  Of  1,062  observations  made  at  the 
.\gricultural  School  of  Saulsaie,  and  by  Blaine,  Tessier,  Grille,  and 
Fiirstenberg,  we  find  that  15  were  pregnant  for  less  than  241  days,  52 
from  241  to  270  days.  119  from  271  to  280  days,  544  from  271  to  300 
days,  230  from  281  to  2'JO  days,  70  from  290  to  300  days,  and  32  beyond 
301  days.  So  that  it  would  appear  that,  with  the  Cow,  parturition  is 
very  rare  before  the  241st  day  ;  not  so  rare  after  the  300th  day  ;  some- 
what common  from  the  240th  to  the  270th  day  ;  and  quite  common 
between  the  280th  and  the  290th  day ;  the  average  duration  of  preg- 
nancy being  about  283  days.  Colin  gives  an  average  of  from  280  to 
285  days,  though  birth  may  occur  at  the  250th  to  the  300th  day,  and 
tven  later. 

Dieterichs  gives  the  shortest  period  as  from  210  to  226  days  ;  tlie 
longest  between  326  and  353  days — average,  286  days ;  while  Bau- 
meister  and  MneW  give  the  shortest  they  observed  as  240  days,  and  the 
longest  330  days — average,  285  days.  The  average  of  the  Bernese 
Simmenthaler  breed  at  Hohenheim  was  280^  days  :  male  Calves  283 
days,  and  cow  Calves  278  days. 

Earl  Spencer  has  furnished  notes  of  764  observations,  which  would 
go  to  prove  that  no  Calf  can  be  born  alive  before  the  220th,  nor  after 
the  313th  day,  and  that  it  is  impossible  to  rear  those  born  before  the 
242nd  day.  Those  births  which  occurred  before  the  260th  day  he  con- 
sidered as  decidedly  premature,  while  those  which  took  place  after  300 
days  were  classed  as  irregular.  In  314  instances,  310  calved  after  the 
285th  day,  three  went  on  to  the  306tli  day,  and  one  to  the  .'^13th.  The 
average  given  is  284  to  285  days.  Among  the  Calves  born  between  the 
290th  and  300th  day,  there  was  a  decided  preponderance  of  males  ;  all 
those  produced  after  the  300th  day  were  females. 

with  foal  on  the  Range  by  scnih  Horse-s,  and  have  only  kept  the  time  of  those  that  I 
was  certain  of  as  to  time  of  lireeding.  The  average  number  of  dayii  of  ffestation  for 
nineteen  Mare.s  l)red  in  April  is  ;i4.S  daya  ;  average  for  twenty-three  MareH  bred  in  May 
is  34.'>  days  ;  average  for  thirteen  Marcs  bred  in  June  and  July  is  '138  days  ;  longest  time 
of  any  Mare  bred  in  April  is  .360  dayn,  shortest  time  of  any  Mare  bred  in  April  in 
332  days  ;  longest  time  of  any  Mare  bred  in  May  is  :]60  Hays,  shortest  time  of  any  Mare 
bred  in  May  is  323  days  ;  lonjjest  time  of  any  >Iare  bred  in  .Tune  and  .Inly  is  3.14  days, 
shortest  time  of  any  ^Iare  bred  in  June  and  July  is  314  days.  The  la»t  Mare  referred  to 
was  a  virgin  Mare,  and  very  fat  at  the  time  of  breeding,  and  continued  so  up  to  the  time 
of  foaling.  Mares  here  in  Oregon  usually  get  very  poor  during  the  winter  months,  but 
have  an  abundance  of  n\itritious  grass  to  run  on  during  the  spring  and  summer  months. 
It  is  my  opinion  that  Mares  which  have  an  abundance  of  nutritious  food  for  a  time  previous 
to  foaling,  bring  the  futus  to  maturity  sooner  than  they  would  were  they  kept  on  a  small 
amount  of  vers-  innutritioua  food." 


152 


OBSTETRICAL  PHYSIOLOa Y 


In  the  American  Journal  of  the  Medical  Sciences  for  1845,  the  result  of 
observations  on  62  Cows  gives  the  longest  period  as  336  days,  and  the 
shortest  as  213  days  :  the  average  for  the  male  Calves  being  288  days, 
and  females  282  days. 

An  American  breeder,  in  the  Ne%c  Live  Stock  Journal  for  July,  1882, 
gives  the  following  observations.  Only  Cows  were  noted  which  had  a 
single  service,  the  Bull  being  kept  isolated  and  no  other  Bulls  accessible. 
With  an  equal  number  of  male  and  female  Calves,  the  average  with  the 
males  was  one  day  longer. 


Cows. 

x-«  «f  ^,  X.O                      Shortest 
>o.  of  days.                 Xo.  of  days. 

Longest 
No.  of  days. 

15  in  1877  averaged 

14  in  1878         „         

17  in  1879         „         

15  in  1880         „         

9  in  1881         „         

287 
286 
285 
286 
286 

282 

279 

276  (twins) 

280 

282 

296 
292 
295 
291 
292 

Cattle-breeders,  we  believe,  generally  entertain  the  notion,  notwith- 
standing Earl  Spencer's  observations,  that  gestation  is  longer  for  a  male 
than  a  female  Calf. 

It  would  appear  that  precocity  has  a  notable  influence  on  the  dura- 
tion of  pregnancy  in  the  Cow,  in  the  more  improved  breeds  the  period 
being  shortened  ;  though  the  Calves  at  birth  are  not  so  well  developed 
as  those  of  the  common  breeds. 

Sheep  and  Goat. 
The  Sheep  and  Goat  go  with  young  about  five  months.     M.  Magne 
carefully  noted  the  pregnancy  of  429  Sheep  at  the  Alfort  Veterinary 
School  during  a  period  of  eight  years,  with  the  following  result : 


2  instances  of  143  days 


57  instances  of  150  days 


15 

144     „ 

49 

151     „ 

22 

145     „ 

23 

152     „ 

30 

146     „ 

1        13 

153     „ 

55 

147     „ 

1          7 

154     „ 

68 

148     „ 

7 

155     „ 

80 

149     ., 

3 

156     „ 

From  this  list  we  observe  that  the  difference  between  the  longest 
and  shortest  period  was  only  thirteen  days,  by  far  the  largest  number 
of  births  occurring  between  the  147th  and  151st  days  ;  the  shortest  was 
143  days  and  the  longest  156  days.  The  average  duration  of  pregnancy 
was  about  149  days.  Gestation  was  longer  with  the  female  than  the 
male  Lambs,  and  this  Magne  attempts  to  explain  by  the  greater  develop- 
ment and  weight  of  the  former,  which  rendered  parturition  more  diffi- 
cult and  slow. 

Colin  says  the  average  period  in  the  Sheep  is  151  to  152  days,  though 
parturition  may  take  place  from  the  145th  to  the  160th  day. 

Dieterichs  gives  the  shortest  period  as  146  days,  the  longest  157 — 
average  151  days  ;  and  Baumeister  and  Eueff  state  the  shortest  period 
in  the  Sheep  and  Goat  as  135  days,  the  longest  160 — average,  144  days ; 
the  male  Lambs  requiring,  as  usual,  the  longest  period.    With  regard  to 


DURA  Tl< >X  <> F  /'HKfLWA NOV.  1  f.-'i 

breed,  these  authorities  fouiul  that  the  period  of  gestation  in  Merinos 
averaged  150-3  days;  while  with  Southdowns  it  was  only  WA-l  days, 
or  six  days  loss. 

In  the  Merinos,  for  the  male  Lamb  the  average  period  was  \')\\ 
days,  female  Lamb  loO-li  days,  and  twins  149-9  days  ;  and  in  the  South- 
downs,  for  the  male  Lamb  14-4 -7  days,  female  Lamb  144- 1,  and  twins 
144  days. 

Mayne  asserts  that  the  Goat  goes  a  little  longer  than  the  Sheep — tlie 
average  being  live  months  and  some  days ;  another  authority  gives  it 
as  148  days. 

Pig. 

The  Pig  is  usually  pregnant  four  months,  or  according  to  some  au- 
thorities three  months,  three  weeks,  and  three  days.  Baumeister  and  Kuetf 
give  the  longest  period  as  130  days,  the  shortest  110 — average,  120  ; 
while  Dieterichs  gives  109  days  as  the  shortest  and  133  as  the  longest 
— average,  115  to  IK)  days  ;  and  Magne  says  that  it  is  rarely  less  than 
109  or  more  than  120  days.  Rainard  noted  the  period  of  gestation  in 
6o  Pigs,  and  reports  it  to  be  as  follows  : 

2  instances  104  days. 


10 

110  to  115  days. 

23 

IKi  to  120  days. 

27 

121  to  125  days. 

o 

i2G  days. 

1 

127  days. 

The  average  was,  therefore,  119  days,  the  interval  between  the  longest 
and  shortest  periods  being  23  days. 

Bitch, 

The  Bitch  goes  with  young  about  two  months,  or  from  5H  to  05  days  ; 
the  average  being  63  days  or  nine  weeks.  Baumeister  and  Rucff  state 
the  shortest  period  to  be  55  days,  and  the  longest  70 — the  average  being 
60  days. 

Cat. 

The  Cat  is  pregnant  from  50  to  (JO,  62,  or  even  04  days,  the  average 
being  55  days  or  eight  weeks. 

SECTION  v.— GEMKLLI PAROUS  AND  MI'LTIPAROUS  PREGNANCY. 

Among  the  domestic  animals  there  are  species  wliich  are  naturally 
uniparous — produce  only  one  at  a  birth  ;  and  others  which,  in  a  normal 
or  physiological  manner,  bring  forth  two,  three,  or  more  at  a  time,  and 
are  therefore  designated  (jemelli pi  irons  or  mnltiparous,  gestation  being 
known  as  double,  triple,  quadruple,  etc.  As  examples  of  uniparous 
animals,  we  may  give  the  Mare,  Ass,  ('ow,  Sheep  and  Goat ;  while  we 
may  cite  the  Pig,  Bitch,  and  Cat  as  mnltiparous  creatures.  As  multi- 
parity  is  normal  with  the  latter,  we  shall  not  specially  refer  to  them, 
but  will  allude  to  those  creatures  which,  naturally  uniparous,  sometimes 
bring  forth  more  than  one  progeny  at  a  time. 

It  is  seldom  that  twins  or  triplets  are  produced  by  the  larger 
domesticated  animals,  and  particularly  by  the  Mare  and  Ass,  though 
instances  are  recorded  of  these  ;  while  in  the  Cow,  Sheep,  and  Goat 


154  OBSTETRICAL  PHYSIOLOdY. 

the  occurrence  of  twins,  triplets,  or  even  more  young  creatures  at  a 
birth,  is  not  so  rare. 

The  causes  of  muUiparity  are  not  well  ascertained.  It  may  be  due 
to  simultaneous  ripening  of  two  or  more  Graafian  vesicles,  which, 
rupturing  at  the  same  time,  allow  the  escape  of  the  ova  they  contain, 
and  which  may  become  impregnated  at  a  single  coitus.  Or  a  Graafian 
vesicle  may  contain  two  or  more  ova,  as  Bischoff  has  witnessed  in 
w^oman  ;  and  these  arriving  together  in  the  uterus,  may  be  fecundated 
at  one  time.  Or  it  may  even  happen  that  the  vitelline  membrane  con- 
tains two  yolks,  as  sometimes  occurs  in  the  fowl's  egg  ;  and  as  the 
vitelline  mass  is  the  essential  part  of  the  egg,  it  is  evident  that  when 
this  contains  two  of  these  masses,  they  ought,  if  fecundated,  to  produce 
two  embryos. 

In  the  first  case,  each  foetus  has  ordinarily  all  its  appendages  dis- 
tinct and  completely  independent ;  or  it  may  be  that  the  two  chorions 
are  fused  together,  in  which  circumstance  the  two  foetuses  will  then 
have  a  common  envelope.  In  the  second  hypothesis,  this  fusion  of 
the  chorions  appears  to  be  the  rule,  although  the  envelopes  may  also 
be  independent ;  and  in  the  third  case — that  of  the  two  vitelluses 
contained  in  the  same  vitelline  membrane — not  only  the  envelopes,  but 
also  the  foetuses  may  become  united  more  or  less  closely,  and  thus  give 
rise  to  double  monsters. 

Finally,  it  is  also  possible  that  two  ova  may  become^ detached  from  the 
ovarian  cluster,  though  not  simultaneously,  but  successively ;  and  be 
fecundated,  one  after  another,  at  two  consecutive  copulations  within  a 
brief  period.  Occurrences  of  this  kind,  by  no  means  rare,  have  been 
wrongly  adduced  as  instances  of  superfoetation. 

Mare. 

Of  all  the  domestic  animals,  the  Mare  is  the  one  which  least  frequently 
brings  forth  more  than  a  single  creature  at  a  birth  ;  and  Saint-Cyr  has 
only  been  able  to  collect  fourteen  instances,  though  we  have  been  more 
fortunate.  Eueff  admits  that  one  case  of  gemellar  gestation  may  occur 
in  this  animal  in  every  250  normal  cases,  but  that  the  young  are  nearly 
always  born  dead  or  die  soon  after  birth.  In  the  register  of  a  stud,  only 
one  instance  of  twins  was  found  in  every  236f  births. 

Demoussy,  cited  by  Saint-Cyr,  observed  an  example  of  double  gestation  ;  but  the 
Foals,  though  alive  when  born,  perished  soon  after.  Lemaltre  gives  a  similar  instance  ; 
only  that  one  of  the  fcEtuses  was  expelled  at  four  months,  while  the  other  was  retained, 
was  foaled  alive  at  the  usual  time,  and  survived.  Trelut  has  seen  a  Mare  which,  at  the 
tenth  month  of  pregnancy,  cast  two  well-formed  Foals.  She  had  been  put  to  the  stallion 
five  times— on  April  23,  May  4,  16,  and  25,  and  June  5  ;  she  aborted  on  March  15.  Her 
abdomen  was  enormously  large,  and  some  time  before  abortion  she  had  received  a  kick  in 
the  flank. 

A  fourth  example  of  double  gestation  is  related  by  Goux.  The  two  Foals— a  Colt  and 
a  Filly — were  alive  when  born,  and  continued  to  thrive.  Saint-Cyr's  father,  an  agricul- 
turist, witnessed  an  analogous  occurrence,  the  progeny  also  surviving  ;  and  Saint-Cyr 
himself  saw  a  twin  birth  in  a  Mare,  one  of  the  Foals,  which  was  born  dead,  weighing 
25  kilogrammes  ;  the  other,  which  lived,  weighing  nearly  2G  kilogrammes. 

In  the  Veterinarian  are  found  a  number  of  instances  of  twin  Foals  in  this  country. 
Mr.  Milliufjton  (vol.  iv.,  p.  424)  gives  three  cases  of  this  kind,  the  Foals  being  born  alive. 
In  vol.  ix.  (p.  450)  an  account  is  given  of  a  Mare  which  died  of  hydrops  uteri,  in  which 
were  twin  Foals  ;  in  vol.  xii.  (p.  288)  is  another  account  of  two  born  dead,  and  in  vol.  xvii. 
(p.  177)  a  similar  instance. 

A  most  unusual  case  of  twin-birth  is  related  in  the  North  British  Afjricultiirist  for 
May  17,  1876  :— A  Mare,  the  property  of  Mr.  Chapman,  farmer,  Halnaby,  gave  birth  to 


i}EMKi.i.ir.uiors  .i.\/>  MrLT/r.mors  I'h'K'.-x.txcv.  io5 

a  Colt  and  Filly  foal  on  the  2n.l  March,  Isrf'.  l><«tli  livini,'.  On  tht-  Itith  March.  IS/C,  she- 
brought  forth  two  tilly  Koals,  thus  giving  birth  to  four  Foals — one  Colt  and  three  Filliefi 
— in  less  than  thirteen  months. 

The  /^V/(/  (May  10,  Is?'?)  reports  a  Mare  in  Devonshire,  which  produced  twin  Foals 
three  times  within  three  years.  The  Mare  went  full  tinii;  in  each  instance,  but  only  one 
Foal  (they  were  all  Colts)  lived  for  any  length  of  time.  According  to  the  Liitrpool 
Merrni-y  (July  23,  18-1."))  a  Mare  at  Abringhall,  tifteen  years  old,  brought  forth /o«r  Colts 
in  the  space  of  fifteen  months  1 

Raabe,  in  1S.')2,  witnessed  a  triple  birth  in  a  five  year-old  ^[are  ;  the  three  Foals  were 
born  alive,  and  were  completely  developed,  but  they  soon  died. 

Two  instiinces  of  triple  birth  are  given  by  SaintCyr,  the  most  rem.arkable  being  that 
recorded  by  Paugoui'-.  This  occurred  with  a  Mare  which,  put  to  the  Horse  only  once,  on 
February  17,  IS  13,  aborted  during  the  night  of  September  '27-28,  two  Foals  being  found  in 
one  chorion  ;  on  the  2.'ith  of  the  following  February,  it  j>rodiiced  a  third  Foal  perfectly 
formed,  and  which  lived.  In  the  second  case,  related  by  Devilliers,  the  Mare  had  been 
put  to  the  Stiillion  several  times  in  May,  June,  and  July.  On  March  10  it  produced 
three  properly-formed  but  dead  Foals,  one  having  ai)parently  ceased  to  live  some  days 
before. 

In  the  Vffrn'nnrian  for  1875  (p.  334)  allusion  is  m.ade  to  an  agricultural  Mare  in 
Norfolk,  eight  years  old,  and  not  known  to  have  been  previously  bred  from,  producing 
three  Foals  at  a  birth.  The  first  was  dead,  and  appeared  to  have  been  so  for  several  days. 
The  second  was  born  alive  immediately  after  the  birth  of  the  first,  but  only  lived  about 
half  an  hour.  The  third  was  born  dead  seven  hours  after  the  second,  but  its  condition 
showed  that  at  the  time  parturition  commenced  it  was  alive.  The  Foals  were  all  of  the 
same  colour — bay — and  were  perfectly  formed.  The  Mare  made  a  gootl  recovery.  In  the 
same  journal  for  1867  (p.  .">95),  Mr.  Newman,  of  Ilavant,  reports  the  birth  of  three  fine, 
well-develoj>ed  Foals,  two  of  which  were  born  alive  and  lived.  The  Mare,  of  the  cart- 
breed,  had  gone  the  full  i)eriod  of  pregnancy. 

In  tile  Vtteriuary  Journal  for  >Iarch,  1882,  Mac^illivray  reports  the  case  of  a  Mare 
twenty-one  years  old,  which  produced  three  Foals  at  a  birth,  one  of  which  was  dead.  Two 
years  previously  she  had  twin  Foals. 

The  most  numerous  instances  of  twin  or  triple  j^cstation  in  the  >rarc 
are,  however,  to  he  attrihuted  to  two  successive  fecundations,  of  which 
Saint-Cyr  has  collected  eight  examples.  In  all  of  these,  strange  to  say, 
the  Mares  had  been  put  to  a  Stallion  of  the  Equine  and  Asinine  species 
in  succession,  and  brought  forth  each  a  Foal  and  a  Mule.  In  the  majority 
of  these  instances,  the  two  fecundations  were  within  a  brief  period — 
the  one  succeeding  the  other  immediately,  or,  at  any  rate,  within  the 
same  day;  though  in  one  instance  there  was  an  interval  of  fifteen  days. 
Which  was  the  elder  of  the  two  Foals  in  tliese  births — the  one  first  born 
or  the  one  first  conceived  ?  Though  in  the  imman  species  such  a  ques- 
tion might  have  some  importance,  with  animals  it  has  only  a  physio- 
logical interest  ;  but  the  order  in  which  they  were  born  would,  never- 
theless, be  the  only  rational  assignment. 

The  female  Ass  more  frequently  brings  forth  twins  than  the  Mare ; 
but  even  in  this  animal  such  an  occurrence  is  rare.  In  an  average  of 
thirty  she- Asses,  kept  for  the  production  of  milk  by  a  man  at  Fa 
Chapelle  Saint-Denis,  only  four  liad  twins  in  a  period  of  seventeen 
years. 

Cow. 

Double  and  triple  births  are  not  so  unusual  in  the  Cow,  the  former 
being  far  from  uncommon.  Indeed,  it  is  so  frequent  in  some  breeds, 
and  with  individuals,  that  it  has  been  suggested  to  produce  by  selection 
a  breed  of  Cows  which  would  habitually  have  twins ;  while  even  quad- 
ruple, quintuple,  and  more  births  have  been  recorded. 

Mr.  J.  Macgillivray,  of  BanfiF,  in  an  excellent  little  "Manual  of  Veterinary  Science 
and  Practice,"  pxiblished  in  1857,  writes  : — "A  neighbour  of  mine,  Mr.  Peter  Low,  had 


156  OBSTETRICAL  PHYSIOLOGY. 

a  Cow,  a  splendid  animal,  of  the  cross  breed,  which  had  twin  Calves  yearly  for  six  suc- 
cessive years.  Two  of  her  female  progeny  have  had  twin  Calves  repeatedly.  Mr.  Low 
kept  one  of  her  male  twins,  a  Bull  ;  to  him  two  Cows  have  had  tvdn  calves,  and  there 
are  a  number  of  Cows  in  calf  to  him  just  now.  From  this  and  other  similar  cases,  I  think 
there  is  no  doubt  but,  by  proper  selection  and  management,  a  race  of  twin-bearing  cattle 
might  be  established."  And  again  he  says  : — "  From  a  paper  now  lying  before  me.  I  shall 
record  what  I  believe  to  be  a  unique  cae  of  a  calf-producing  Cow.  I  am  indebted  for 
the  particulars  to  Mr.  James  Stephen,  Balfluig  Cottage,  Alford.  '  Memorandum  regai-d- 
ing  a  small  Cow  of  the  black  Polled  breed,  which  belonged  to  the  late  Mr.  Alexander 
Stephen,  Farmton,  Alford  : — 

Year.  Xumber  of  Calves  at  a  birth. 

1842     1— first  Calf. 

1843  ...  ...  ...     3 — came  to  maturity. 

1843  ...  ...  ...  4 — one  died  ;  seven  in  one  year. 

1844  ...  ...  ...  2 — came  to  maturity. 

1845  ...  ...  ...  3 — came  to  maturity. 

1846  ...  ...  ...  6 — died  prematurely. 

1847  ...  ...  ...  2 — came  to  maturity. 

1848     4.'" 

Eueff  says  that,  with  the  Simmenthalei-  breed  of  cattle  at  Hohen- 
heim,  during  an  interval  of  ten  years,  there  were  four  per  cent,  twin 
births. 

Triple  gestation  is  of  course  much  more  uncommon,  but  the  instances 
on  record  are  numerous. 

Dupuy  mentions  a  very  unusual  instance  of  fecundity  in  a  Cow  which,  at  three  birth.< 
in  successive  years— 1817,  1818,  and  1819— brought  forth  nine  Calves,  only  two  of  which 
were  not  reared  by  the  mother  ;  these  Calves  afterwards  had  only  one  offspring  at  each 
birth.  Rainard  speaks  of  one  of  his  pupils  delivering  a  Cow  of  three  Calves  in  the 
neighbourhood  of  Lyons  ;  and  Roche-Lubin  gives  two  similar  instances.  In  one  of  these 
the  first  two  Calves  were  born  alive  and  reared  by  their  mother,  but  the  third,  which  wa^i 
in  a  bad  position,  was  removed  dead  six  days  later.  In  the  second  instance,  the  Cow, 
after  producing  a  living  and  properly-developed  Calf,  continued  to  strain  and  make  fruit- 
less efforts  to  get  rid  of  the  other  foetuses,  until  she  died  five  days  afterwards,  when  two 
Calves  attached  to  each  other  by  the  sternum  were  found  in  the  uterus.  Sperling  records 
the  case  of  a  Dutch  Cow  which  produced  three  Calves  ;  the  first  was  a  male,  the  second 
a  heifer,  and  the  third  a  heifer  in  a  wrong  position.  In  England  Mr.  Snowdon  has  seen 
a  Cow  which  brought  forth  a  living  Calf  some  hours  after  a  dead  one,  and  in  a  few  minutes 
an  anidian  monster. 

In  the  Ip-'iwich  Journal  for  October,  1875,  mention  is  made  of  a  Cow  which  produced 
six  Calves  in  twenty  months,  all  living  :   first  three  fine  Calves,  then  one,  and  again  two. 

The  Liverpool  Mercury  (April  9,  1847)  mentions  a  Cow  which  produced  sixteen  Calves 
in  eight  years— two  Calves  at  six  births,  three  at  one  birth,  and  one  at  another  birth.  The 
Mark  Lane  Express  (May  11,  1852)  alludes  to  a  Cow  which  brought  forth  three  Calves  at 
a  birth — making  eleven  calves  before  she  was  seven  years  old.  A  similar  instance  is 
reported  in  the  Hartford  Times  of  Connecticut  for  1881.  The  Cow  was  a  three-fourths 
Durham.  On  April  16,  1877,  she  gave  birth  to  twins,  one  male  and  one  female  ; 
March  19,  1878,  she  gave  birth  to  triplets,  two  male  and  one  female,  making  five  Calves 
in  eleven  months  and  three  days  ;  July  9,  1879,  she  gave  birth  to  twins,  both  males  ; 
October  7,  1880,  she  gave  birth  to  triplets,  two  males  and  one  female,  making  ten  Calves 
in  the  three  years  five  months  and  twenty-one  days.  The  Calves  were  all  of  good  size, 
healthy  and  handsome,  and  were  raised  on  the  farm. 

In  1888,  a  Cow  at  Braceborough,  Stamford,  gave  birth  to  twins.  Her  former  yearly 
calvings  were  twins,  a  .single  one,  a  single  one,  twins,  triplets,  and  then  the  above- 
mentioned  twins. 

The  Chester  Chronicle  (February  18,  1865)  reports  the  birth  of  three  full-sized  Calves 
by  a  Cow,  all  of  which  did  well ;  and  the  Shrewsbury  Chronicle  (July  5,  1844)  gives  a 
similar  instance,  but  the  Calves,  born  during  the  night,  were  found  dead  in  the  morning. 
In  the  Eield  for  June  17,  1876,  the  birth  of  three  Calves— a  Bull  and  two  Cows— i.s. 
reported.     They  were  alive  and  doing  well. 

Quadrigemellar  gestation  is  also  sometimes  observed  in  the  Cow. 


OEMELLIPARUUS  A.\l>  Mri/J'l r.inoUS  rUE'iyjM'Y.  157 

Rainard  ^'ives  two  instances  ;  and  Haiuon  mentions  a  littli-  lireton  C<>\v  which,  in  l.SfiS, 
I«roductd  four  Calves  -two  male  and  two  female,  tin-  last  two  dyinir  soon  after  hirth. 
(lellti  jjive."  a  remarkable  instance  of  a  Cow  which,  in  1S37,  had  three  Calves,  in  IS.'iS  two, 
in  183y  two,  in  I^IO  two,  and  in  IMl  four  1  One  of  the  last  was  a  heifer  ;  all  were  well 
develoj)ed  and  successfully  reared,  and  the  last  four,  at  five  weeks  old,  weighed  about 
forty-five  pounds  each. 

The  Ji'ttue  Wtaiitaire  of  Toulouse  (February,  1876)  gives  a  case  of  (|uadrigemellar 
parturition  in  a  Durham  Cow,  ai;;fd  twenty-two  montha,  near  Kochefort.  Birth  occurred 
naturally  in  an  hour  ;  two  cow-cnlves  were  first  born,  then  two  males  ;  three  did  not  live 
l>eyond  an  hour,  the  other  survived  thirty-six  hours. 

In  the  Ettit  Saiiilain  of  the  Domestic  Animals  in  Belgium  for  1877  (p.  87)  mention  is 
made  of  a  Cow,  seven  months  pregnant,  which  for  eighteen  days  had  fallen  into  such  a 
state  of  tlebility  that  she  could  not  rise,  and  she  hail  also  com[)letelv  lost  her  appetite. 
She  was  killed,  and  at  the  autopsy  fourf<etuses  were  found.  Thesn  weighed  re-pectively 
10.]j,  ll.\,  I'J^,  and  14  kilogrammes.      Three  were  females. 

An  instance  is  given  by  Saint  Cyr  as  occurring  at  Beaujeu  in  1881.  Tliis  was  a  Cow 
which  had  pnniuced  one  calf  at  each  of  three  births,  three  Calves  twice,  and  at  last  four 
Calves  ;  all  were  strong  and  lively,  and  were  reared. 

The  I'fli  rinariitn  (vol.  xiii.,  p.  ">7iM  gives  an  account  of  a  delivery,  with  assistance,  of 
four  dead  Calves.  This  journal  also  (vol.  xiv.,  p.  1.".)  records  a  case  in  which,  with 
assistance,  a  Cow  was  delivered  of  four  Calves— two  dead  at  birth  and  two  alive,  though 
these  soon  expired.  They  were  properly  developed,  and  appeared  to  have  been  healthy 
up  to  parturition  ;  they  weighed,  respectively,  '25\,  24,  17f,  and  17}  lbs.  From  the 
structure  of  the  placenta,  it  was  concluded  that  each  fietus  had  been  contained  in  a 
t-eparate  membrane  and  fluid.  The  birth  was  premature  by  two  months  and  nine  days. 
In  the  same  journal  (vol.  xvii.,  p.  421)  another  (piadruple  birth  is  described  ;  the  Calves 
Were  well  developed  and  all  born  alive,  though  tliey  soon  after  died. 

According  to  the  Che.idr  Chronicle  (March  [>,  1  "<  17),  a  Cow  brought  forth  three  Calves, 
and  in  three  days  a  fourth.  All  died  soon  after.  The  Field  (December  7,  1872)  describes 
the  birth  of  four  Calves  by  a  Cow  about  four  years  old,  and  which  had  twins  at  a  previous 
calving.  One  Calf  died,  but  the  others  did  well.  The  Lirerpool  Mtrriiry  (March  28, 
1S45)  reports  a  Cow  as  having  proluced  four  Calves — full-sized,  but  dead.  Kddow's 
ShreirMbuti/  Journal  (July  29,  1846)  alludes  to  a  Cow  which  gave  birth  to  four  bull-calves, 
three  of  which  lived. 

Mr.  Cartwright,  of  Whitchurch,  gives  an  instance  of  four  Calves  at  a  birth.  The  Cow 
and  Calves  died  soon  after. 

In  the  Field  for  March  29,  1879,  mention  is  made  of  a  shorthorn  Cow  which  produced 
four  Calves  at  a  birth — two  male  and  two  female  —all  alive,  and  five  weeks  old  when 
reported.  She  was  six  years  old,  and  lost  condition  very  consideralily  for  .'«ome  time 
before  calving  :  she  was  almost  ho{)ele3.sly  weak  for  weeks  after  that  event,  but  ultimately 
did  well.      .\11  the  C.ilves  were  white. 

.\  farmer  at  Nttherseal,  England,  owned  a  Cow  that  gave  birth  to  four  Calves,  two  of 
them  bulls,  all  w  ell  developed.  The  next  day  one  died,  but  the  others  lived  and  did  well, 
a.s  did  also  their  dam. 

A  Cow  in  Norfolk,  eleven  years  old,  was  delivered  of  four  full-grown  Calves,  but  none 
of  them  survived. 

Quintuple  pre^'nancy  is,  of  course,  more  rare  in  tlie  Cow. 

In  the  (liornnlf  di  Vrte_riiiari<i  for  June.  iS.'i.'i,  Professor  Lessona,  of  Turin,  de«cril)e« 
a  (|uintuple  l>irthin  a  Cow  in  Piedmont.  The  animal  was  twenty  days  frcmi  its  full  time. 
The  abdomen  was  very  voluminous,  but  Ix-yond  the  premature  delivery  there  was  nothing 
unusual  attending  the  liirth.  The  progeny  consi?>te  I  of  three  females  and  two  males,  and 
each  weighed  about  37  A  psxinds.  They  were  healthy  ;iud  fully  developed  ;  but  the 
mother,  either  through  her  premature  delivery  or  from  age,  was  unable  t<j  suckle  them, 
and  they  were  put  to  another  Cow  whose  milk  pmved  unsuitable  for  them,  as  tliey  had 
sn  attack  of  indigestion,  and  in  about  eight  days  after  birth  all  were  dead.  Les.sona 
thinks  two  were  lodged  in  the  same  envelope  in  each  horn,  and  that  the  fifth  fietiH,  with 
a  single  placenta,  <K;cupied  the  body  of  the  uterus  with  iti  proper  envelopes.  A  singular 
fact  was  their  Ix-ing  all  presented  for  delivery  in  a  normal  jxisition — a  very  extraordinary 
circumstance.     The  Cow  had  pro<luced  twin  Culves  the  preceding  year. 

Schumann,  in  18.")4,  rejKirts  a  quintuple  birth — all  males,  and  deafi -bom.  RuefT  records 
another,  in  which  all  the  Calves  lived— and  one  which  r>cciirred  at  Havingen,  in  a  five- 
year-old  Cow.  Baron  also  refers  to  a  similar  instance.  Mr.  'iarrard,  of  Ticknall,  how- 
ever, has  a  more  favourable  report  of  a  birtb  of  this  kind.     In  1854  a  Cow  gave  birth  to 


158  OBSTETRICAL  I'HYSKJlJJdY. 

five  living  healthy  Calves,  all  of  which  were,  when  he  wrote  (a  week  after  birth),  alive 
and  vigorous,  and  likely  to  continue  so.  They  were  nearly  all  of  one  size,  and  larger 
and  stronger  than  could  be  supposed.  Four  were  bull-calves.  The  Cow,  by  no  means 
a  large  one,  was  eleven  years  old  and  of  a  mongrel  breed,  and  had  never  produced 
more  than  one  Calf  at  previous  gestations.  She  did  not  manifest  any  unusual 
symptoms  of  exhaustion  ;  the  first  four  Calves  presented  naturally ;  the  fifth  was  a  breech 
presentation. 

About  sixteen  years  ago  a  Cow  at  Hohenniath,  Bavaria,  dropped  five  Calves,  ranging 
in  weight  from  sixteen  to  twenty  pounds.  They  were  all  of  the  same  colour  and  all  dead, 
the  dam  dying  soon  after  giving  birth  to  them. 

In  1S7S,  Professor  Freytag,  of  Halle  University,  saw  a  Cow  at  Zeit,  Saxony,  which 
gave  birth  to  four  Calves  in  rapid  succession,  and  very  shortly  afterwards  dropped  another. 
Parturition  proceeded  normally,  and  the  Cow  did  not  appear  to  suffer  more  than  usual  ; 
but  the  Calves,  though  well  developed,  were  born  dead.  The  case  is  recorded  in  the 
Deutsche  Landwirthschaftliche  Pre-fxe  for  1878. 

But  the  most  wonderful  instance  of  fecundity  yet  mentioned  is  that  of  a  Cow  which  was 
seen  by  Ferrari,  who  reports  the  case  in  the  Journal  de  Med.  Veterinaire  et  dt  Zoottchnii'^ 
for  1883.  She  brought  forth  fourteen  Calves  at  foxtr  births.  At  her  first  delivery,  in 
1879,  she  had  twins,  which  lived  ;  in  1880  she  had  five — two  females  and  three  males- 
only  two  of  which  survived  and  were  sold  ;  in  1881  there  were  four — two  males  and  two 
females — only  two  of  which  were  alive  ;  at  the  fourth  parturition,  in  1882,  .she  gave 
birth  to  two  males  and  a  female,  one  of  the  former  dying,  but  the  other  two  lived  and 
grew  well. 

Kurds  speaks  of  a  Cow  which  aborted  seven  fretuses  ;  while  Kleinschmeid  {ila<jazinfi'ir 
ThitrlttUkundt,  1857)  mentions  having  found  fifteen  embryos  in  the  uterus  of  an  animal 
of  this  species  ! 

In  the  Veterinarian  (vol.  xxxii.,  p.  200),  Mr.  Forbes,  of  Keigate,  mentions  a  Cow,  six 
years  old,  which  at  her  third  calving  produced — three  weeks  premature — five  Calves  at  a 
birth — four  males  and  one  female.  Three  of  the  Cdlves  died  in  a  few  hours,  the  fourth  in 
a  day,  and  the  fifth  two  days  after  they  were  born. 

The  Che-Hter  Chronicle  (February  11,  1854)  reports  a  Cow,  between  ten  and  eleven 
j-ears  old,  producing  five  Calves— four  males  and  one  female — all  of  which  lived.  The 
Calves  were  nearly  of  the  ordinary  size,  and  were  strong  and  livelj'.  In  Eddow's 
Shrewahury  Journal  (September  9,  1874),  mention  is  made  of  a  Cow  which  had  been 
purchased  as  barren,  but  which  in  due  course  produced  a  dead  Calf,  on  the  following  day 
another,  and  so  on  until  four  were  born.  The  Cow  then  died,  and  on  being  opened  a  fifth 
Calf  was  found.  Mr.  Litt,  of  Shrewsbury,  in  the  same  journal  gives  the  particulars  of 
the  case  of  a  Cow  which  died  within  a  fortnight  of  calving,  and  on  being  opened  no  fewer 
than  five  fully-developed  Calves  were  found  in  the  uterus.  They  were  nearly  uniform  in 
size,  and,  with  the  exception  of  one,  which  was  rather  emaciated,  they  were  in  a 
remarkabh-  well-nourished  condition.  They  consi.sted  of  four  females  and  a  male,  and 
were  very  little  smaller  than  ordinary  Calves  at  birth,  being  about  the  usual  size  of 
twins.  !NIr.  Litt  was  of  opinion  that,  had  they  been  born  at  the  proper  time,  they  would 
have  lived.  The  Cow  had  not  thriven  so  well  as  its  companions  for  some  time,  but  up 
to  the  morning  of  the  day  previous  to  decease,  it  appeared  to  be  in  perfect  health.  Death 
was  probably  due  to  the  excessive  drain  upon  the  animal's  .system  produced  by  so  many 
young. 

Sliee'p. 

With  the  Sheep,  twins  are  a  very  common  occurrence  ;  and  it  is  a 
saying  that  in  a  good  flock  there  should  be  as  many  Lambs  as  Ewes, 
the  double  births  compensating  for  the  losses.  Instances  of  extra- 
ordinary fecundity  are  also  by  no  means  rare,  and  would  appear  to 
pertain  to  particular  breeds.  Daubenton  states  that  in  the  counties  of 
Julhers  and  Cleves,  every  Sheep  brings  forth  two  or  three  Lambs  twice 
a  year — five  Sheep  producing  twenty-five  Lambs  in  twelve  months. 
In  French  Flanders,  according  to  Magne,  who  cites  Corneille  as  his 
authority,  there  is  a  very  prolific  breed  of  Sheep,  each  ordinarily  pro- 
ducing three,  sometimes  four,  five,  and  six,  rarely  seven  Lambs,  at  two 
births  during  the  year.  Tessier,  speaking  of  this  breed,  while  admitting 
that  twin  Lambs  are  not  an  ordinary  occurrence  with  Sheep,  assures  us 
that  in  a  flock  composed  of  371  Ewes  there  were  22  double  births  ;  and 


nKMKI.UI:ii:nls  AM>  .\fl/.T/J:i/:<>ts  rniCHXASry  yyj 

ho  mentions  liaving  seen  a  Sheep  tliat  was  twenty  years  old,  which  had 
bred  every  year.  A  Ewe  at  Hohenheim,  in  1845,  hroiif,'lit  forth  one 
Lamb,  the  first  ;  m  184G  two;  in  LS47  live;  in  1848  four;  1841)  three  ; 
1M50  two  —in  all  seventeen  Lambs  at  six  births.  Four  of  these  were 
males,  and  thirteen  females. 

In  our  own  country  such  fecundity  is  not  very  uncoiimion. 

For  instaiicf,  in  the  Cha»il>er  of  Aiirlntlliire.  Joiinia/  for  Maidi,  1>71,  there  is  a 
notice  of  extraordinary  proliticacy  related  by  Mr.  An^nis,  of  Lowthorpe,  Hull,  who 
saya  : — "  Last  3'ear  i-ne  of  my  E*es,  of  tl>e  Jjincohi  lireeti,  broiiglit  forth  .six  Lanilis,  ail 
living.  I  had  great  ditticulty  in  persuading  my  neighbours  to  believe  this,  although 
the  fact  was  tjuite  elear  and  well  attested.  I  gave  her  a  private  ear-mark,  and  last 
Michjvelmas  a  separate  red  mark  also.  As  we  naw  this  spring  that  she  was  getting  heavy, 
we  kept  her  ipiite  separate  from  the  rest  of  the  Ewes,  and  last  Thursday  she  produced 
another  six  Lambs.  Some  of  these  will  not  survive,  as  they  were  a  few  days  belore  their 
prop«'r  time  ;  but  all  are  complete  and  well  fornn-d,  and  the  ICwe  is  now  suckling  one 
Lamb."  "  The  especial  wonder  about  this  woolly  mother,"  adds  the  editor  of  the  journal, 
"is  tliat  she  belciMns  to  a  breed  in  which  it  is  rare  for  a  l-'we  to  drop  more  than  three 
L«nib.s,  while  good  luck  among  the  Lincoln  Hocks  is  'one  half  pairs,'  with  occasionally  a 
three." 

The  Carmarlhi  u  Journal  (March,  1844)  alludes  to  foiir  Ewes  in  that  county,  which  in 
one  week  yeaned  fourteen  Lambs  ;  one  had  five  Lambs,  and  these  all  did  well.  The 
Che.iler  C/ironirle  (May  '2.'),  1867)  mentions  that  a  little  Welsh  Kwe  at  I'irkenhead  had 
two  Lambs  in  the  spring  of  ]S»;i  ;  in  ISGfi  three,  all  alive;  Ibtiti,  four,  all  living  ;  and  in 
1876  five,  fiiur  of  which  lived,  and  were  in  good  health.  Jidl's  WkUij  Mtssiuijer 
(June  "29,  l'<14)  sUites  that  a  farmer  in  Kent  had  a  Ewe  which  dropped  the  extranrdinary 
number  of  six  Lambs,  four  of  which  it  reared,  and  the  other  two  were  brought  up  by 
hand.  The  previous  season  the  aanie  Ewe  produced  four  Lambs,  all  of  which  were 
reared  and  turned  out  well.  .According  to  tho  C/iesfir  C/ironiilc  (Aprd  11,  1S68),  a  farmer 
at  Otlej-,  Yorkshire,  had  a  Ewe,  five  years  old,  which  had  produced  fifteen  Lambs.  AVhen 
one  year  old  it  had  two,  at  two  years  four,  at  three  \'ears  two,  at  four  years  four,  and  at 
five  years  three.  The  SaJo/nun  (April  li,  l.'^7-)  speaks  of  a  Ewe  at  Wem,  Salo]),  which 
gave  birth  at  one  time  to  five  Lambs  the  previous  year,  and  these  were  all  reared,  and  in 
thi^  year  six  were  born,  five  of  which  lived.  The  Chfsfir  Chronicle  (April  l!',  1873) 
alludes  ti>  a  Ewe  which  produced  an  annual  average  of  three  Ijambs  for  seven  years  ;  the 
animal  itself  was  one  of  three.  The  Slirtwihitri/  C/irouicle  (June  "20,  1874)  reportn  that 
a  Shn>pshire  Kwe  lambed  twice  in  six  months,  producing  twins  each  time  ;  and  the  Fii-ld 
(May  \'l.  187-'5)  gives  an  instance  of  a  Ewe  having  five  Lambs,  one  of  which  died  in  a  few 
days,  but  the  others  did  well.  The  Oxirfslri/  AilrtrliMr  (October  2,  1S72)  instances  a 
Ewe  which  gave  nine  Lambs  in  two  seasons — -three  and  six — all  fine  I^ambs,  anil  in  perfect 
health.  And  in  the  Cnmliridu  newsj>aper  for  the  same  month,  it  is  mentioned  that 
"Mr.  .1.  M.  Harding,  of  the  TownHill  Farm,  .Swansea,  has  just  h>»<l  an  extraordinary 
piece  of  goo<l  luck  in  Innibing.  From  a  small  flock  of  seventeen  Ewes,  he  has  had  no 
le.«s  than  thirty-seven  Lambs,  all  alive  and  doing  well.  Every  Ewe  has  bnuight  'doubles,' 
and  three  have  brought  '  triplets.'  It  i.s  not  only  the  numl»-r  of  I.,ambs,  but  they  are  all 
strong  and  healthy.  .  .  .  There  is  no  reiuson  to  doubt  that  the  remainder  of  the  flock 
will  be  e<|ually  prolific." 

In  the  yo'.tiniiham  Jnnrnnl  for  18  UI,  it  is  stated  that  a  Ewe  in  that  loeality  brought 
forth  five  Lambs  .at  a  birth,  all  alive  and  likely  to  continue  so. 

Mr.  Lite,  already  ((uoted,  mentions  the  case  of  five  Ewes  which  ha<l  been  attacked 
with  symptoms  of  brain  disorder  shortly  before  lambing,  and  soon  died.  Each,  when 
opened,  was  found  to  have  four  I>anil>s,  making  twenty  in  all. 

The  Lynn  yl(/iy»7i.scr  for  February,  187"_',  states  that  a  Ewe  in  that  locality  lambed 
on  the  11th  of  that  month,  the  Lamb  living  twenty-four  hours;  again  on  Junt'  '28,  and 
on  January  21,  1872,  bringing  fi>rth  twin  I^ambs  on  the  last  occasion.  The  Ewe  thus 
lambed  three  times  in  a  year  and  ten  days. 

In  1875  Mr.  Rol>ert  P.  Oreenhill,  of  Elmbridge,  near  Droitwich,  wa.s  in  jx>sses.siiiii  ,,f 
a  Ewe,  seven  years  old,  which  had  product-d  no  fewer  than  20  Lnnd)s  -a  small  flock.  In 
the  first  year  she  gave  birth  to  2  ;  in  the  second,  1  ;  third,  •$  ;  fourth,  "  ;  fifth,  4  ;  sixth,  4  ; 
and  seventh,  3. 

And  at  Shafte.«bury,  it  is  recorded  in  M.iy,  1876,  that  a  farmer  had  some  Ewes 
fatting,  and  a  neighbour's  ram  gf)t  with  them  ;  consequently,  13  of  thtm  jin>ved  to  be 
j)r»gnant,  and  produced  no  le.ss  than  31  Lambs,  all  born  alive  (a  few  dead  since),  ai 
follows  : — 


160  OBSTETRICAL  PHYSIOLOGY. 

1  single  ...         ...         ...         ...         ...  1 

8  twins  ...         ...         ...         ...         ...  16 

3  threes 9 

1  five  ...          ...          ...          ...          ..  5 

13  ewes.  31  lambs. 

The  Field  for  March  29,  1S79,  states  that  a  Ewe  at  Adderstone  Hall,  Belford, 
Northumberland,  produced  five  Lambs,  all  of  which  were  alive  and  thriving  some  time 
afterwards. 

The  Live  Stock  Journal  fur  April,  1878,  mentions  that  a  Ewe  at  St.  Mary's,  Orton, 
dropped  six  tine  healthy  Lambs— four  males  and  two  females ;  two  of  these  were 
adopted  by  other  Ewes,  the  others  being  suckled  by  the  mother,  an  extraordinary-sized 
Leicester. 

The  London  Farmer  tells  of  a  Border-Leicester  Ewe  that  produced  six  Lambs  at  a 
birth,  all  living  and  doing  well.  Another  Ewe,  of  mixed  breed,  had  the  same  number  at 
Meldon  Park,  Morpeth — all  living.  This  animal  had  produced  twenty-eight  Lambs  in 
six  years — 4  in  1873,  4  in  1874,  4  in  1875,  4  in  1876,  6  in  1877,  and  6  in  1878. 

Other  similar  instances  might  be  quoted. 

It  may  be  remarked,  that  extraordinary  fecundity  in  Sheep  is  seldom 
observed  in  the  highest-bred  races,  which  are  usually  uniparous  ;  it 
appears  to  pertain  more  to  the  common  breeds.  Not  only  this,  but 
certain  years  are  more  remarkable  than  others  for  double,  treble,  and 
quadruple  births  in  this  species. 

Goat. 

The  Goat  is  generally  considered  a  uniparous  animal,  but  it  would 
appear  that  this  is  a  mistake,  as  double  and  triple  births  may  be  said 
to  be  the  rule  ;  not  at  all  infrequently  four  are  produced.  But  usually 
with  three  or  four  at  a  birth,  one  or  more  are  feeble  or  born  dead.  It 
is  looked  upon  as  exceptional  for  only  one  kid  to  be  produced  at  a  birth. 

The  question  has  been  much  discussed  as  to  whether  these  multiple 
l)irths  in  animals  ordinarily  uniparous,  are  the  result  of  one  or  successive 
copulations.  The  majority  of  the  authorities  in  such  matters  are 
certainly  of  opinion  that  a  single  copulation  will  suffice  to  fecundate 
several  ova  ;  and  they  doubt  if,  after  a  fruitful  copulation,  it  is  possible 
for  the  spermatozoa  to  reach  the  ovary,  supposing  a  second  ovum  to  be 
developed,  unless  the  second  impregnation  takes  place  very  soon  after 
the  first,  and  before  the  fertilised  ovum  has  descended  into  the  uterus. 
The  well-authenticated  instances  of  superf station,  though  rare,  never- 
theless rather  militate  against  this  opinion  ;  and  it  would  appear  to  be 
impossible  to  explain  why  one  animal  among  several  hundreds,  perhaps 
thousands,  should  alone  bring  forth  "doubles"  or  "  triplets,"  while  all 
the  others,  placed  in  the  same  hygienic  conditions,  have  only  one 
offspring.  It  is  a  fact,  however,  that  with  certain  breeds  of  Sheep  an 
abundance  of  nourishment  and  plentiful  years  dispose  to  these  multiple 
births. 

Cornevin,  as  the  result  of  inquiry  in  and  beyond  France,  comes  to 
the  conclusion  that  in  the  Mare  there  are  twins  in  every  thousand 
births  ;  in  the  female  Ass  twins  in  every  hundred  births ;  and  in  the 
Cow  twins  in  every  ninety  births.  He  considers  it  exceptional  to  have 
multiple  gestations  in  primipane,  and  that  a  Cow  which  has  produced 
twins  will  frequently  continue  to  do  so,  or  sometimes  even  to  drop  three 
at  subsequent  pregnancies. 

What  has  been  said  of  uniparous  animals  does  not  at  all  apply  to 
those  which  are  multiparous  ;  for  although  the  latter  may  be  impreg- 


nEMELLIPAliUi-S  AXI>  .WrLTH:l/;nfs  J'J:Jy;.\.l\r)\  101 

nated  at  a  siii^'le  copulation,  unci  brin-,'  forth  suvcral  youn^'.  yet,  as  a 
rule,  they  are  fecundated  more  than  once,  and  in  fact  do  not  cease  to 
seek  the  male  until  after  several  copulations.  And  yet,  even  in  these 
creatures,  there  are  instances  of  extraordinary  fecundity  often  recorded. 
With  rej^ard  to  the  Sow,  for  example,  I  have  notes  of  a  case  in  which 
24  young  were  produced,  but  the  mother  died  soon  after  ;  another  case 
in  which  a  Sow  brought  forth  48  in  two  succeeding  litters — 22  in  the 
first  and  21  in  the  second  ;  and  another  case  of  a  Sow  that  had  21 
living  Pigs  in  a  litter,  she  having  tlien  produced  more  than  eighty  young 
in  less  than  two  years.  Then  with  respect  to  the  liitch,  I  have  the 
record  of  a  St.  Bernard's  that  gave  birth  to  17  Puppies  in  one  litter,  and 
in  the  succeeding  litter  tliere  were  23. 

In  these  cases  of  multiple  gestation  in  creatures  naturally  uniparous, 
one  of  the  fetuses  occupies  the  ordinary  situation  of  single  gestation — ■ 
the  head  towards  the  cervix  uteri,  the  larger  portion  of  the  trunk  in  the 
body  of  the  uterus,  and  the  hind  (juarters  and  limbs  in  one  of  the  coruua. 
The  second  fo'tus  occupies  the  whole  of  the  other  cornu  ;  with  the  head 
turned  back,  or,  as  occurs  not  infrequently,  in  the  opposite  direction, 
and  so  on. 

The  duration  of  gestation  in  these  cases  is  generally  shorter  than  that 
of  single  pregnancy  in  the  same  animal,  probably  in  consequence  of  the 
unusual  distention,  as  well  as  derangement  of  the  principal  functions  in 
the  mother.  The  weight  of  the  young,  individually,  is  usually  less  than 
the  average ;  but,  collectively,  it  may  be  very  much  greater  than  that  of 
one  young  creature  produced  at  a  birth.  Thus,  in  the  quadruple  birth 
recorded  by  Magdinier  each  fcutus  weighed  ten  to  eleven  kilogrammes; 
in  that  by  13ouchard  tliey  only  weighed  from  eight  to  nine  kilogrammes; 
in  the  quintuple  birth  descrilied  by  Cassina,  each  calf  weighed  seventeen 
kilogrammes,  or  eighty-five  for  the  entire  birth— an  enormous  weight. 
Lignatia,  another  Italian  veterinary  surgeon,  mentions  that  in  a  double 
birth  in  a  Cow,  one  of  the  Calves  which  was  born  dead,  though  at  full 
time,  weighed  twenty  kilogrammes  ;  and  the  other  Calf,  which  was 
alive,  weighed  forty-three.  In  the  double  birth  observed  at  Saulsaie,  in 
which  both  Calves  were  born  alive,  one  was  twenty-eight  kilogrammes 
and  the  other  thirty-one. 

Free-martins. 

A  curious  fact  in  connection  with  this  subject  in  the  Bovine  species, 
is  that  when  the  young  are  of  both  sexes,  the  female  is  in  general 
unproductive.  John  Hunter  drew  special  attention  to  this  subject/ 
which  has  since  received  the  notice  of  many  veterinaiy  surgeons  and 
agriculturists.  Though  the  anomaly  has  been  particularly  remarked  in 
Bovine  animals,  yet  some  authorities  assert  that  it  also  pertains  to  Soli- 
peds,  but  it  would  seem  that  the  Ovine  species  is  exempt.    Even  of  the 

'  "  It  ia  a  fact  known,  and  I  believe  almost  universally  underHtood,  that  when  a  Cow 
brings  forth  two  Cnlve-i,  one  of  them  a  I'ull-calf  and  the  other  to  appearance  a  Cow,  that 
the  Cow-calf  is  unfit  for  propagation,  but  the  I'.ull  calf  grows  into  a  very  pro]Hr  Bull. 
Such  a  Cow-calf  is  called  in  this  country  a  Free-martin,  and  is  commonly  xs  well  known 
amon|;r  the  farmers  as  either  Cow  or  Bull.  It  ha«  all  the  external  marks  of  a  Cowcalf 
namely,  the  teats,  and  the  external  female  parts,  called  by  farmers  the  bearing.  It  does 
not  show  the  least  inclination  for  the  Bull,  nor  does  the  Bull  ever  take  the  least  notice  of 
it.  In  form  it  very  much  resemblea  the  Ox  or  ipayed  Heiftr,  being  considerably  larger 
than  either  the  Bull  or  the  Cow,  having  the  h'>m4  very  similar  to  the  horni  of  an  Ox. 
The  bellow  of  the  Free  martin  is  similar  to  that  of  an  Ox.  having  more  resemblance  to 
that  of  the  Cow  than  that  of  the  Bull." — Ob'iirvationj*  on  the  Animal  Economy. 

11 


162  OBSTETRICAL  PHYSIOLOGY. 

human  species,  it  has  been  asserted  that  twins  are  less  prolific  than 
those  born  single  at  a  birth,  and  their  vitality  is  also  diminished. 

The  fact  that  twin  Calves  are  sometimes  unfruitful  is  well  known  in 
many  countries,  where  the  female  Calf  receives  a  particular  designation : 
as  "  Free-martin  "  in  Britain  ;  in  Holland,  "  Queenen  ";  in  Germany, 
"  Zwitter,"  or  "Zwilling";  in  Swabia,  "  Z wicker  ";  in  Piedmont, 
"  Mugne  ";  in  France,  "Loures,"  "  Taures,"  etc.  The  old  Eoman 
agriculturists  knew  these  animals  as  "  Taurae."  It  is  generally  believed 
that  the  defect  is  only  present  when  both  Calves  are  females,  and 
certainly  it  is  very  rare  indeed  that  the  male  is  infecund.  Baumeister, 
however,  gives  an  instance  in  which  a  Bull — a  twin — was  put  to  a 
hundred  Cows,  none  of  which  produced  a  Calf.  In  Switzerland  it  is 
the  belief  that  when  the  Cow-calf  is  born  first,  it  will  not  be  sterile  ; 
and  that  when,  on  the  contrary,  the  male  is  born  before  the  female,  it 
will  be  unproductive.  The  female  twin  is  generally  a  hermaphrodite, 
and  in  form  more  of  a  male  than  a  female  ;  the  vulva  is  excessively 
contracted,  and  the  vagina  a  cul-de-sac.  The  mammae  are  also  feebly 
developed,  sometimes  appearing  as  a  mere  trifling  fold  of  skin,  at  others 
as  a  voluminous  sack.  The  animal  is  usually  long-legged,  with 
muscular  hind  quarters.  Internally,  in  some  instances,  the  uterus  is 
undeveloped  ;  in  others  the  ovaries  are  absent,  and  instead  of  them  there 
are  testicles.  With  others,  again,  there  is  no  trace  of  a  uterus,  the 
vagina  ending  in  an  infundibulum — a  condition  which  is  readily  ascer- 
tained in  the  living  animal  by  introducing  the  finger.  The  clitoris  is 
sometimes  enormously  developed,  and  not  unusually  the  urine  is  ex- 
pelled powerfully  backwards.  Ordinarily,  the  "free-martin"  evinces 
sexual  desire  very  rarely,  if  at  all.^ 

1  One  of  the  recorded  e.xaminations  of  these  creatures  is  given  in  the  (Esterreichische 
Viertcljahre^fichrift  for  1875  (p.  78),  and  was  brought  to  the  notice  of  the  Gresnter 
Land  and  Forest  Society  of  Austria,  the  veterinary  surgeon  to  which  furnished  the 
anatomical  details.  The  society  purchased  the  Calf  three  and  a  half  years  previously, 
and  it  had  never  exhibited  any  signs  of  sexual  instinct  during  that  period.  It  was 
therefore  killed.  It  was  in  good  condition,  and  of  the  Miirzthaler  breed.  The  head  and 
physiognomy  had  a  most  singular  appearance,  resembling  that  of  a  Monkey,  though  the 
horns  were  strongly  developed.  The  udder  was  little  and  hard,  and  the  vulva  small  and 
contracted,  although  normal ;  on  opening  the  labia  no  trace  of  a  clitoris  could  be  found. 
The  vagina  was  nine  to  ten  centimetres  in  length,  and  instead  of  extending  forward  to 
the  cul-de-nac,  which  is  often  very  dilated  in  Cows,  it  terminated  abruptly  in  a  funnel- 
shaped  aperture,  and  here  the  genital  organs  ended,  for  the  cervix  uteri  was  absent,  as 
was  the  uterus  and  Fallopian  tubes,  and  it  was  only  in  the  vicinity  of  the  external  angle 
of  the  ilium  that  were  found  small  ovaries  closely  and  curiously  enveloped  in  fat,  so  that 
they  could  scarcely  be  recognised.  The  glands  of  Bartholin  in  the  vagina  were  almost 
as  large  as  an  egg,  and  were  full  of  blood  ;  instead  of  the  valve  in  the  vagina  there  was 
a  small  impermeable  opening.  On  incising  the  mammte  the  gland  substance  was  foimd 
to  be  absent,  and  in  its  stead  was  fibrous  and  adipose  tissue.  In  fine,  this  twin  was 
destitute  of  uterus  and  oviducts,  and  the  vagina  was  short  and  constricted. 

In  the  Q^titerreichisrhes  Landivirthscha/tlkhe  Worhcuhlatt  for  1878,  the  observations 
of  Professor  F.  Mliller  are  published.  These  are  based  on  the  examination  of  three 
twin  Calves.  The  first  was  a  female  in  an  early  stage  of  uterine  development,  and  in  it 
he  found  testicles  in  conjunction  with  external  feminine  organs.  The  other  two  were 
full-grown,  sterile  Cow-calves  ;  one  was  aged  three  years  and  two  months,  the  other  being 
more  than  two  years.  In  both  cases  the  external  pudenda  were  normal,  the  labia  firm, 
puffy,  and  well  closed,  and  the  clitoris  not  unduly  prominent.  The  udder  and  the  four 
teats  were  small  in  development.  Both  animals  had  in  some  degree  a  male  appearance 
generally,  and  neither  of  them  had  ever  been  observed  to  be  in  "  rut."  Examination  of  the 
internal  genital  apparatus  revealed  almost  exactlj'  the  same  state  of  affairs  in  each  case. 
The  female  generative  organs  were  not  fully  developed  in  either.  In  both  of  them  two 
gland-like  bodies  connected  with  the  sexual  apparatus  were  present,  viz.,  small  bodies  in 
place  of  normal  ovaries,  and  larger  bodies  further  back  in  the  neighbourhood  of  Giirtner's 
duct.     Whether  these  latter  bodies,  which  Midler  is  inclined  to  consider  remnants  of 


<;EMEi.i.ii'Ai:i>rs  a\i>  MrLTiF.inors  ri:t:i:.\A\rY.  103 

Tilt'  rule  doeis  not  always  hold  ;^'oocl,  howevt'r,  as  to  the  infecundity 
of  twill  Calves,  as  many  instances  are  on  record  in  whicli  they  have 
bred.  For  instance,  in  the  Veterinarian  (vol.  ix.,  p.  22)  there  is  an 
authenticated  case  in  which  the  female  of  a  twin  birth,  when  five 
months  old,  became  prej^nant,  and  in  due  course  produced  a  Calf.  The 
next  birth  was  twin  Calves.  And  a  few  years  ago,  a  Shorthorn  ('ow 
belonging  to  Mr.  James  Harrison,  Water  Stratford  (1  rounds,  near 
Buckingham,  dropped  twin  Calves- — a  Bull  and  a  Cow-calf.  As  the 
Cow  was  well  descended,  Mi-.  Harrison  decided  to  keep  both  Calves  for 
breeding  purposes,  and  tlie  experiment  was  quite  successful,  for  the 
Heifer  had  a  strong  Cow-calf,  and  the  Bull  was  the  sire  of  three 
Calves. 

Diaijnuais  of  Multiple  rrcijuancij. 

The  (liatjnosis  of  multiple  pregnancy  in  animals  ordinarily  uniparous, 
is  not  very  certain.  It  is  usual  to  say  that  the  signs  are  only  those  in- 
dicative of  a  single  ftrtus,  but  exaggerated.  The  belly  is  more  volumin- 
ous than  wlien  there  is  but  one,  especially  in  the  early  months  ;  the 
respiration  is  more  than  usually  embarrassed;  the  animal  lies  frequently, 
and  soon  moves  lazily  and  heavily,  while  the  posterior  limbs  become 
ccdematous.  These  signs,  it  will  be  remarked,  are  obscure,  as  a  lai'ge 
Foal  or  Calf,  or  some  morl)id  condition,  may  occasion  the  disproportionate 
size  of  the  abdomen  and  alteration  in  breathing;  so  that  at  best  they  only 
afford  a  vague  presumption  as  to  the  condition  of  the  mother.  It  is 
also  said  that  the  belly  is  larger  on  the  side  on  which  it  is  usually  least 
enlarged — the  left  ;  in  others,  both  sides  are  enlarged  at  the  same  time, 
and  there  the  movements  of  the  young  are  most  evident.  But  tliissign, 
in  addition  to  being  far  from  constant,  depends  upon  the  relative  posi- 
tion of  the  progeny  ;  as  when  there  are  two  one  may  occupy  the  body, 
the  other  the  cornu,  of  the  uterus.  Neither  does  an  examination  per 
rectum  or  vatjinani  art'ord  any  certain  indication  of  multiple  gestation  ; 
as  the  number  of  young,  supposing  there  are  more  than  one,  cannot  be 
sufficiently  distinguished. 

Auscultation,  if  it  could  be  successfully  applied  to  the  larger  animals 
— which  are  usually  uniparous — would  doubtless  greatly  aid  in  diagnos- 
ing whether  a  gestation  was  single  or  multiple.  The  distinct  pulsation 
of  the  foetal  hearts,  especially  if  at  a  distance  from  each  other,  and  if 
the  number  of  pulsations  were  ditTt-rent  in  the  respective  situations, 
should  be  conclusive  proof  of  multiple  pregnancy.  It  would,  of  course, 
b<'  important  to  note  the  different  situations  of  the  pulsations,  as  the 
action  of  the  fci-tal  hearts  might  be  at  times  synchronous.  Care  would 
also  have  to  be  observed  not  to  confound  tlie  beating  of  the  maternal 
heart  with  that  of  the  fditus. 

Wolffian  bodi(«,  are  to  be  regarded  aa  rudiments  of  testicles  cannot  be  determined,  but 
he  admits  that  there  is  much  in  favour  of  such  a  view.  The  general  re«tj!t  of  hii« 
examination,  which  is  in  >;reat  measure  corroborative  of  former  ((b^ervations,  Mullcr 
i,'i ves  as  follows  :  (1)  From  a  practical  point  <»f  view,  female  twin  f'alves  should  never  be 
used  for  breeding  purpo.ses,  because  they  are  generidly  barren  in  consequence  of  mal- 
flevelopment  of  the  internal  genital  ori;ans.  Kxceptinns  to  this  rule  are  few  and  far 
between  :  one  such  is  recorded  in  Krarf't's  JoHninl  a<t  having  been  noticed  in  187.1. 
(-)  The  cau?e  of  such  sterility  depends  on  an  arrested  development  of  the  genital  glands 
in  the  earliest  stage  of  their  development  from  the  Wolffian  bodies,  at  which  jKiriod  the 
sex  is  indifferent.  The  view  that  the  incomplete  female  is  really  a  m.ile  not  fully 
developed,  is  not  supported  by  the  two  cases  under  notice.  Neither  can  it  be  assumed 
with  certainty  that  it  is  a  hermaphrodite,  although  there  are  some  grounds  for  justification 
of  the  latter  opinion. 


164  OBSTETBICAL  PHYSIOLOGY. 

Fosition  of  the  Fcetiises  in  Multijjle  Pregnancy. 

The  relative  position  of  the  young  in  the  uterus  in  the  cases  already 
briefly  alluded  to,  is  important  to  remember.  With  regard  to  each 
other,  it  may  be  said  that  they  usually  occupy  four  different  positions  : 
1.  Each  foetus  may  be  isolated  and  enveloped  in  its  own  proper  mem- 
branes ;  2.  If  there  are  two  foetuses  they  may  have  a  common  envelope 
in  the  chorion,  and  otherwise  have  a  second  separate  sac ;  3.  Both  may 
be  developed  in  the  same  cavity  and  the  same  amniotic  fluid,  their 
membranes  being  common,  and  no  partition  existing  between  them  ; 
4.  One  foetus  may  be  contained  within  the  other  by  "  inclusion,"  as  in 
some  of  the  monstrosities  of  which  \Ye  will  speak  hereafter.  It  may  be 
necessary,  however,  to  state  that  the  included  foetus  may  be  contained 
in  the  abdominal  cavity  of  the  other  individual,  constituting  deep  and 
ahdominal  inclusion ;  or  it  may  be  enveloped  in  a  subcutaneous  tumour 
■ — when  it  is  superficial  and  cutaneous. 

In  the  first  variety  of  gestation,  the  envelopes,  where  they  are  in 
contact,  adhere  together  by  means  of  fine  connective  tissue;  the  placentae 
are  often  confounded  (in  Ruminants),  or  united  by  a  kind  of  membran- 
ous connection,  though  their  circulation  remains  distinct.  In  such  a 
case  the  young  may  be  expelled  from  the  uterus  together — a  frequent 
occurrence  in  the  Goat,  according  to  Eainard  ;  but  more  commonly, 
after  the  birth  of  the  first  foetus,  the  uterus  contracts  on  itself,  enclosing 
the  remaining  progeny,  which  may  not  be  born  until  some  days  after 
—  long  enough  sometimes  to  give  rise  to  the  belief  that  it  is  a  case  of 
superfoetation.  This  apparently  prolonged  retention  of  the  second  foetus 
is  generally  due  to  the  fact  that  the  first  is  expelled  prematurely, 
because  of  the  excessive  distention  experienced  by  the  uterus ;  this 
organ,  having  thus  got  rid  of  its  embarrassment  and  become  relieved, 
can  then  maintain  the  second  foetus  until  the  usual  time  expires.  An 
illustrative  case  is  given  in  the  Memoires  de  la  Societe  du  Calvados  for 
1831-32.  A  Mare  gave  birth  to  a  dead  Foal  after  four  months'  gesta- 
tion, and  at  the  ordinary  time  a  living  Foal. 

If  one  of  the  Foals  dies  in  the  uterus,  the  other,  being  contained  in  a 
separate  envelope,  may  continue  to  live  and  grow.  In  somewhat  rare 
cases,  the  dead  foetus  remains  in  the  uterus,  becomes  desiccated,  and 
is  not  expelled  until  the  birth  of  its  companion  at  the  usual  period  ;  or, 
which  is  more  common,  it  acts  in  the  uterus  as  a  foreign  substance,  the 
presence  of  which  is  irritating,  and  by  inducing  contractions  of  that 
organ  it  is  extruded,  while  the  living  foetus  is  retained  and  grows  until 
the  normal  time  for  delivery. 

The  foetus  that  has  died  during  pregnancy  may  be  kept  in  the  uterus 
for  a  long  time,  through  close  adhesions  existing  between  that  organ 
and  the  placenta.  A  case  is  on  record  in  which  a  foetus  was  retained 
in  this  manner  for  two  years.  Eainard  gives  an  instance  of  a  Mare 
which  retained  a  dead  foetus  for  a  year  ;  the  animal  was  then  fecundated 
again,  but  having  died  while  pregnant  with  the  second  Foal,  an  exami- 
nation of  the  uterus  was  made,  and  the  two  foetuses  were  found — the 
first  being  mummified. 

Death  of  the  foetus  in  these  multiple  cases  appears  to  be  due,  either 
(1)  to  the  stronger  vitality  of  the  one  which  lives,  and  which,  by  attract- 
ing to  itself  a  larger  share  of  nutriment,  starves  the  other ;  (2)  to  the 
too  considerable  increase  in  volume  of  one  foetus,  which  compresses  and 
atrophies  the  other ;  (3)  or  to  the  separation  of  the  foetal  from   the 


HKMKI.I.irAliors  ASh  Mf l.Tl I'.l i;i its  l'i;h:ilXA\cy. 


1  •;.' 


maternal  placenta,  which,  of  course,  causes  an  interruption  to  the  cir- 
culation of  the  younj^  animal,  and  a  suspension  of  nourishment  and 
oxygenation  of  its  blood. 

In  the  second  variety  of  gestation,  in  which  the  chorion  is  connnon 
to  the  two  f(rtuses,  but  which  are  yet  separated  by  the  amnion,  there 
is  only  one  placenta  ;  the  two  having  a  circulation  in  common,  tlu-ougli 
their  placenta*  and  the  umbilical  vessels  connnunicating  l)y  their  vascu- 
lar ramifications.  In  this  case  the  expulsion  of  one  fcrtus  necessarily 
brings  about  that  of  the  other.  This  also  occurs  when  both  are  con- 
tained in  tile  same  envelopes. 

I  believe  only  two  instances  are  on  record  of  inclusion  :  that  of  the 
first  mentioned  variety,  in  which  one  fcetus  was  found  in  the  abdominal 


Fig.  ti6. 

Twi.N    pKKtiNANCY  :    CoW. 


cavity  of  the  other,  Bartholin,  the  celebrated  anatomist,  at  the  com- 
mencement of  the  seventeenth  century  described  the  case  of  a  Mare 
which  brought  forth  a  Mule,  in  the  abdomen  of  which  was  found  an- 
other :  and  Gurlt'  mentions  an  instance  in  which  one  fcrtus  was 
developed  within  the  abdominal  cavity  of  a  Calf,  and  consisted  of  an 
incomplete  left  hind  leg,  a  membranous  organ  representing  the  uterus, 
and  the  skin  and  some  vessels.  It  may  be  remarked,  however,  that 
Rainard  witnessed  an  instance  of  this  abdominal  inclusion  in  a  Goose. 
The  egg  was  double  tlie  ordinary  size,  and  it  had  another  inside  of 
about  the  ordinary  dimensions ;  each  had  a  perfectly  formed  shell. - 
The  subcutaneous  tumours  of  young  animals,  containing  either  a  whole 
foetus  or  portions  of  a  pre-existing  one,  are  connnon, 

'  .\fagazin/iir  rhifrheilhinde,  1860.  p.  347. 

•  In  the  Vfhrinanj  Journal  for  1891  (p.  88),  Mahon  de«crib<'«<  an  iriHtanw  of  inclusion 
in  a  male  Hare. 


16i!  OBfir ETHICAL  PHYSIOLOGY. 

CHAPTEE  VI. 
Hygiene  of  Pregnant  Animals. 

The  hygienic  measures  to  be  observed  in  the  management  of  animals 
during  gestation  are,  in  general,  those  which  should  prevail  always, 
irrespective  of  this  condition.  But  beside  these  there  are  a  few  par- 
ticular precautions  to  be  attended  to,  in  order  that  this  period  may  be 
safely  and  successfully  passed  through,  and  these  precautions  are  all 
the  more  necessary  as  the  period  of  birth  approaches.  Unlike  the 
human  female,  pregnant  animals  do  not  require  those  careful,  numerous, 
and  minute  attentions  so  essential  to  her  health  and  the  welfare  of  her 
offspring ;  indeed,  too  much  nursing  and  pampering,  by  removing 
animals  further  from  their  natural  condition,  are  unnecessary,  and 
likely  to  do  more  harm  than  good. 

When  an  animal  is  believed  to  have  been  fecundated,  it  should  not 
be  allowed  near  the  male  again  ;  as  in  the  artificial  state  in  which 
domesticated  creatures  are  usually  kept,  attempts  at  coitus  may  do 
harm  ;  though  it  must  be  confessed  that  among  Cows  the  Bull  often 
remains  in  the  same  pasture  with  them,  and  they  calve  as  regularly  and 
as  safely  as  if  they  were  not  so  exposed. 

With  those  animals  which  are  employed  in  labour — as  the  Mare,  and 
sometimes  the  Cow — it  is  well  not  to  work  them  severely  nor  fatigue 
them  much,  and  particularly  as  pregnancy  is  advanced ;  and,  on  the 
other  hand,  absolute  repose  is  pernicious.  Exercise  is  most  beneficial, 
and  the  most  difficult  cases  of  parturition  occur  among  animals  to  which 
this  is  denied.  The  pregnant  Mare  will  accomplish  ordinary  and  accus- 
tomed work,  particularly  if  it  be  slow,  without  any  harm,  perhaps  with 
benefit,  until  the  seventh,  eighth,  or  ninth  month,  when  more  care 
must  be  observed  ;  but  moderate  exercise  should  always  be  allowed  up 
to  the  period  of  parturition.  Harness  is  preferable  to  saddle  work  for 
pregnant  Mares  ;  and  fast  trotting,  galloping,  jumping,  travelling  over 
broken  ground,  or  severe  and  sudden  exertion,  injuries,  or  shocks  of 
any  kind,  are  to  be  avoided — in  fact,  extremes  should  be  guarded 
against. 

If  the  animal  must  be  employed  for  riding,  the  use  of  spurs  should 
be  interdicted,  because  of  the  sudden  contraction  of  the  abdominal 
muscles  which  their  application  induces,  and  which  may  lead  to 
abortion. 

Should  the  animal  not  be  usefully  employed  in  this  way,  then  it  ought 
to  be  regularly  exercised  in  hand,  or  placed  in  a  paddock  provided  with 
shelter  from  inclement  weather. 

The  Cow,  if  employed  in  labour,  may  be  worked  moderately  until  the 
sixth  or  seventh  month.  If  kept  for  milk  production,  the  milking 
should  also  cease  about  this  period  ;  though  with  well-fed  Cows  it  is 
often  prolonged  until  near  parturition.  Nevertheless,  there  can  be  no 
doubt  that  this  practice  is  prejudicial  to  the  foetus,  by  arresting  or 
retarding  its  development,  through  diverting  into  the  mammary  glands 
the  materials  which  should  be  disposed  of  in  the  uterus. 

Exercise  at  pasture  is  beneficial  to  all  animals  ;  even  the  Pig  and 
Bitch  are  greatly  benefited  by  movement. 

The  food  of  pregnant  animals  is  an  important  consideration. 
Creatures  in  this  condition  should  be  well  fed,  and  especially  if  they 
have  to  accomplish  a  certain  amount  of  labour  or  yield  milk.     The 


IIVUlKXt:  (>F  I'ltECXAXT  AXIMALS.  167 

appetite  is  generally  increased,  and  there  is,  as  has  heen  already  observe<l, 
a  tendency  to  fatten.  This  tendency  should  he  somewhat  guarded 
against,  as  it  may  prove  troublesome,  particularly  if  it  is  allowed  to  pro- 
ceed to  an  extreme  degree  ;  when  it  may  retard  the  development  of  thn 
faHus,  induce  abortion,  cause  ditlicult  parturition,  or  give  rise  to  serious 
after-consequences.  This  precaution  is  more  to  be  observed  in  the 
second  than  the  first  half  of  pregnancy,  when  the  food  should  bu 
plentiful,  but  not  in  excess,  and  llesh  more  abundant  in  the  animal  than 
fat.  The  food  should  also  be  of  good  quality,  very  nutritious,  easy  of 
digestion,  and  not  likely  to  induce  constipation. 

Indigestion  should  be  carefully  guarded  against,  and  unaccustomed, 
hard,  damp,  bulky,  fermentable,  mouldy,  or  otherwise  hurtfully  altered 
food,  should  be  avoided,  as  it  is  likely  to  prove  indigestible,  occasion 
tympanitis,  and  produce  other  injurious  results. 

Grazing  on  pastures  is  favourable  to  the  pregnant  condition  of  her- 
bivorous animals,  and  especially  if  the  land  is  not  too  broken,  or  sloping, 
and  the  herbage  is  good  ;  as  they  take  their  own  exercise,  and  breathe 
a  purer  atmosphere  than  tliat  of  stables  or  sheds.  But  it  must  be  re- 
membered that  they  should,  if  possible,  be  protected  from  damp,  fogs, 
cold  rain,  stormy  weather,  etc.  If  the  herbage  is  not  sutViciently  abun- 
dant and  nutritive,  it  should  be  supplemented  by  an  additional  allow- 
ance of  food. 

In  connection  with  food,  it  may  be  well  to  observe  that,  besides  the 
ordinary  saline  matters  which  it  is  beneficial  to  add  to  the  ration,  espe- 
cially when  it  is  prepared  for  the  animals,  in  those  regions  where 
inflammation  of  the  joints  of  young  creatures,  and  other  morbid  con- 
ditions due  to  the  deficiency  of  certain  mineral  constituents  in  the 
economy  are  noted,  it  may  be  necessary  to  add  these  constituents  to  the 
food  of  tlie  pregnant  animal. 

The  ])hosphates  so  necessary  for  the  formation  of  certain  tissues  of 
the  body,  for  instance,  may  be  deficient  in  the  herbage  ;  and  this  may 
be  compensated  for  by  giving,  in  addition  to  bran,  meal,  oil-cake,  etc., 
and  even  properly-prepared  bone-dust. 

The  inttcr  should  be  pure,  and  jjlentiful  at  all  times  ;  as  then  the 
animals  will  drink  only  moderate  quantities,  and  when  necessary. 

.A.  point  to  be  particularly  attended  to,  is  not  allowing  pregnant 
animals  to  drink  very  cold  water,  nor  eat  food  at  a  low  temperature. 
We  have  seen  that  the  fu-tus  is  extremely  susceptible  to  the  action  of 
cold,  and  abortion  is  by  no  means  unusual  tlirougli  the  operation  of  this 
susceptibility. 

Very  cold  water,  fro/en  food — such  as  i*oots,  or  herbage  covered  with 
white  or  hoar  frost — should  therefore  be  withheld  fron^.  pregnant 
animals,  as  they  are  likely  to  induce  abortion,  metritis,  and  other 
serious  accidents,  either  through  their  direct  action  upon  the  ftrtus,  or 
indirectly  through  the  derangement  they  may  set  up  in  the  digestive 
apparatus. 

^\  ith  regard  to  dwcUiwjti,  the  hygienic  rules  which  should  always  be 
observed  in  buildings  in  which  animals  are  kept,  ought  to  be  rigorously 
enforced  with  regard  to  those  in  which  pregnant  creatures  are  lodged. 
Cleanliness  is,  above  all  things,  necessary  to  be  observed.  Near  foaling 
time — three  weeks  or  a  month — the  Mare  should  be  kept  apart  in  a 
roomy  loose-box,  and  when  convenient,  within  sight  of  the  other  Horses 
with  which  it  has  been  accustomed  to  associate.  The  Cow  is  usually 
allowed  to  remain  in  its  ordinarv  stall  in  the  cow-shed  ;  but  overcrowd- 


168  OBHTETRICAL  PHYSIOLOGY. 

ing  and  want  of  space  should  not  be  allowed,  and  every  Cow,  towards 
the  end  of  gestation,  ought  to  have  plenty  of  room  in  its  stall,  if  a 
separate  box  cannot  be  allotted.  Stables,  sheds,  and  loose-boxes  should 
have  wide  doors,  to  prevent  injury  to  the  females.  With  stalls,  the 
floor  should  slope  very  little  indeed,  from  before  to  behind  ;  as  if  the 
inclination  is  at  all  marked,  the  weight  of  the  gravid  uterus  is  thrown 
backwards,  and  this  may  lead  to  abortion,  prolapsus  of  the  vagina,  and 
even  eversion  of  the  uterus.  The  cow- shed  ought  to  be  kept  very  clean 
and  free  from  bad  smells,  and  have  plenty  of  fresh  air.  The  stalls 
should  have  plenty  of  litter,  so  as  to  prevent  the  Cows  soiling  them- 
selves. Should  a  case  of  abortion  occur  in  a  stable  or  shed,  among 
pregnant  Cows,  the  one  which  has  aborted  ought  to  be  removed  at  once, 
and  the  place  it  occupied  thoroughly  cleansed  and  disinfected,  every 
trace  of  the  accident  being  most  scrupulously  obliterated. 

Cows  which  afford  indications  of  approaching  abortion,  ought  also  to 
be  removed  from  the  vicinity  of  other  pregnant  animals,  and  kept  apart 
from  them  so  long  as  there  is  any  vaginal  discharge  ;  the  same  precau- 
tions which  must  be  adopted  with  regard  to  thorough  disinfection  and 
cleansing,  are  likewise  necessary  here.  It  is  not  advisable  to  have 
Cows  bring  forth  among  others  whose  period  of  gestation  has  not 
arrived. 

The  cleanliness  of  the  animals  themselves  is  not  to  be  overlooked  ;  as 
neglect  of  grooming  and  freeing  the  skin  from  dirt  must  operate  per- 
niciously not  only  on  the  mother,  but  also  on  the  foetus. 

Mental  and  physical  tranquilUti/  are  essential  conditions  of  successful 
gestation.  Harsh  or  ci'uel  treatment  on  the  part  of  grooms,  cow-keepers, 
shepherds,  and  others,  should  be  sternly  suppressed  ;  and  fear,  gener- 
ally produced  by  young  dogs  hunting  the  animals,  and  particularly 
pregnant  Sheep,  is  especially  to  be  averted,  if  possible.  It  is  advisable 
not  to  have  animals  of  other  species  in  the  same  field  or  pasture  with 
those  that  are  pregnant,  more  especially  towards  the  period  of  parturi- 
tion. 

With  an  irritable  or  timid  primipara  of  the  larger  animals,  it  is  well 
to  be  gentle,  and  to  accustom  it  to  manipulation,  particularly  about  the 
udder,  in  order  that  it  may  the  more  readily  allow  its  progeny  to 
approach  it  without  danger. 

Surgical  operations,  and  medication  in  general,  should  be  proscribed, 
as  they  may  be  hurtful  during  this  state,  unless  they  are  urgently 
needed  for  the  cure  of  disease.  Above  all,  it  is  necessary  to  guard 
against  the  use  of  drastic  purgatives,  or  even  laxatives,  for  the  relief  of 
constipation  which  may  not  exist ;  as  with  some  animals  these  agents, 
by  increasing  the  peristaltic  action  of  the  bowels,  indirectly  excite  con- 
traction of  the  uterus.  If  there  is  constipation,  suitable  diet  is  a  safer 
remedy  than  purgatives.  Powerful  narcotic,  sedative,  and  other 
medicinal  agents,  if  they  do  not  injure  the  mother,  may  imperil  the 
life  of  the  foetus. 

We  have  no  sufficiently  trustworthy  facts  to  prove  that  female  animals 
are  amenable  to  those  mental  influences  which,  in  the  human  species, 
and  known  as  "  maternal  impressions,"  have  such  a  marked  effect  on 
the  development  or  characteristics  of  the  foetus. 


Sf  ■l'h:nF(KT.  I  Tins.  1  »J0 

BOOK    ill. 

PATHOLOGY  OF  PHEGNAXC'Y. 

The  patholo(i!/  of  prej,'nancy  may  be  said  to  include  those  diseases  and 
accidents  which  constitute  deviations  from  the  regular  or  normal  scries 
of  physiological  phenomena  ctiaractcristic  of  this  condition.  Tliese 
deviations  are  somewhat  numerous  and  various,  and  we  will  follow 
Saint-C'yr  in  classing  them  under  three  distinct  heads  :  anomalies, 
diseases,  and  acvidents.     They  will  be  studied  in  this  order. 


CHAPTER  I. 
Anomalies  in  Pregnancy. 

The  anomalies  occurring  in  gestation  are  super fietation,  extra-uterine 
jjregnanci/,  and  spurious  pregnancy. 

SECTION  I.-SUPKRr«ETATIOX. 

The  term  supcr/a'tation  {fa'tus  super  firtuni — one  fci'tus  on  another) 
has  been  employed  to  designate  these  cases  of  conception  in  wliich  an 
animal,  already  pregnant,  has  been  supposed  to  conceive  a  second  time 
before  the  termination  of  the  primary  gestation.  In  ordinary  double  or 
triple  gestation,  the  same  copulation  has  produced  the  young  at  once ; 
but  in  superfu'tation  they  are  supposed  to  be  formed  at  a  more  or  less 
wide  interval  of  time,  and  of  course  by  different  copulations. 

The  belief  in  the  possibility  of  such  an  occurrence  in  woman  was 
common  among  the  old  writers,  and  cases  are  adduced  in  support  of 
this  view  ;  but  its  correctness  has  been  nmch  disputed  by  some  recent 
authorities. 

Aristotle  admitted  the  likelihood  of  superfcrtation  taking  place  in 
woman,  because  during  pregnancy  she  was  always  with  her  imsband  ; 
but  he  denied  its  possibility  in  the  Mare,  although  he  was  aware  that 
it  might  receive  the  male  several  times.  In  all  probability,  he  imagined 
that  the  instinct  of  the  Mare  would  repel  tlie  Stallion  after  impregna- 
tion. The  naturalists  and  hippiatrists  who  succeeded  him,  have  also 
denied  that  such  an  abnormal  occurrence  could  take  place  in  the  Mare  ; 
because,  they  declared,  after  conception  the  orifice  of  the  uterus  is 
closed,  so  that  the  semen  of  the  male  cannot  be  introduced ;  every 
double  birth,  they  also  maintained,  was  due  to  two  ova  being  impreg- 
nated at  the  one  copulation. 

But  numerous  facts  recorded  by  competent  authorities  would  go  to 
prove  that  superfoetation  is  not  only  probable,  but  possible  ;  and  that  if, 
generally,  there  is  only  one  successful  copulation  possible,  on  the  other 
hand  there  are  instances  well  vouched  for,  in  which  two  successive 
copulations  have  been  followed  by  two  independent  impregnations.  In 
uniparous  animals  such  cases  have  been  frequently  observed,  the  most 
convincing  of  which  is  the  production  of  a  Mule-foal  and  a  Horse-foal 
by  the  same  Mare  at  one  birth. 

An  occurrence  of  this  kind  is  mentionefJ  in  thi-  Memoirf*  dr  VArnilfmif  Boi/alr  fjUn 
i><-ifurf.f  for  17o3  ;  a  Mare  «t  Ch;«tillon-«nr-.S«vr.   >)ronght  forth  a  H<>r^e  and  a  Mule-foal. 


170  PATHOLOdY  i>F  PRFJJXAXCY. 

Demoussy  speaks  of  a  M.  Maillard,  a  wealthy  farmer  and  breeder  of  horses,  who  had 
occasion  to  observe  a  similar  occurrence. 

In  the  Journal  Viterinaire  Pratique  for  1826,  there  is  an  account  of  a  ^Slare  which, 
covered  on  the  same  day  by  a  male  Ass  and  Stallion,  brought  forth  in  eleven  months  a 
well-formed,  though  weak,  Mule-foal,  and  a  full  developed,  but  dead,  Horse-foal.  In  the 
same  journal  for  1836,  there  is  another  case  of  this  kind  recorded.  A  Mare  had  been 
put  to  an  Ass  Stallion  at  St.  Maixent,  and  was  shut  up  in  an  enclosed  space  ;  into  this, 
however,  a  Horse  Stallion,  two  years  old,  broke,  and  covered  this  animal  several  times  in 
the  course  of  the  same  day.  The  Mare  obstinately  refused  to  be  covered  when  afterward* 
put  to  the  Horse,  according  to  custom.  At  the  usual  period  of  parturition  it  produced 
two  Foals,  one  evidently  belonging  to  the  Equine  species,  and  the  other  a  well-characterized 
Mule.  These  two  young  creatures,  when  three  months  old,  were  presented  to  M.  de- 
Vaublanc  ;  they  were  then  being  suckled  by  the  Mare,  and  were  in  perfect  health.  The 
fact  was  verified  by  the  Mayor  of  the  Commune,  and  communicated  to  the  administration 
of  the  Stallion  depot  of  St.  Maixent. 

In  Moll  and  Gayot's  "  Connaissance  General  du  Cheval,"  Ayrault  states  that  in  Poitou, 
France,  a  Mare  was  put  to  a  Stallion  Ass  on  March  7,  ISoo,  and  on  the  28th,  being  still 
"  in  season,"  was  put  to  a  Horse.  The  following  year,  during  the  night  of  April  14-15, 
this  Mare  produced  a  Colt-foal  at  eight  o'clock,  and  a  Filly-mule  at  eleven  o'clock  ;  so 
that  the  oldest  foetus  was  born  three  hours  after  the  youngest. 

In  the  Journal  dfs  Veterinairts  du  Midi  for  1859,  Dr.  Chabaud  relates  that  in  the 
Commune  of  Verniolle  (Ariege),  a  Mare  was  put  to  a  Stallion  Ass.  As  oestrum  con- 
tinued, it  was  put  to  a  Stallion  fifteen  days  afterwards.  Nothing  unusual  occurred  during 
gestation,  and  when  parturition  took  place,  a  fine  healthy  Foal  was  born,  and  after  ten 
minutes'  straining,  to  the  astonishment  of  the  owner,  a  good  well-formed  Mule.  The 
Mare  suckled  the  two,  and  they  did  well. 

In  the  Journal  des  Vete'rinaires  du  Midi  for  1864,  M.  Gilis  gives  a  similar  account  of 
a  Mare  that  had  been  covered  by  a  Stallion,  then  some  minutes  afterwards  by  an  Ass,  and 
in  twelve  months  had  two  Foals,  perfect  in  their  conformation — one,  a  Mule,  died  soon 
after  birth,  and  the  other,  a  Horse-foal,  did  well. 

Lanzillotti-Buonsanti  mentions  a  Mare  which,  on  March  28,  18.t1,  was  put  to  an 
English  Stallion,  and  on  April  5  to  a  Barb  ;  on  February  28.  1852,  it  produced  two  Foals, 
each  resembling  one  of  the  Stallions.  Lessona  speaks  of  a  Mare  which  was  put  to  a  Horse 
in  1852,  and  sixteen  days  afterwards  to  a  Persian  Stallion  ;  at  eight  months'  pregnancy  it 
dropped  a  Horse-foal,  and  in  two  hours  after  a  Mule-foal.' 

In  the  Veterinarian  (vol.  xxx.,  p.  78),  Mr.  Evans  refers  to  a  Mare  which  was  put- 
three  times  to  the  Horse,  about  six  weeks  intervening  between  each  time.  Two  months- 
prior  to  the  ordinary  period  of  parturition  from  the  last  coitu?,  two  Foals  were  pro- 
duced, one  alive  and  full  grown,  the  other  so  immature  that  it  died  immediately. 
The  same  journal  (vol.  xxxix.,  p.  444)  contains  another  instance,  in  which  a  Mare  was- 
put  to  a  Cart-Horse  on  May  20,  but  showing  symptoms  of  cestrum  subsequently,  was 
again  put  to  him  on  June  19.  At  the  commencement  of  the  following  April  two- 
foetuses  were  born,  each  being  in  a  different  stage  of  development,  and  one  of  them 
apparently  a  month  older  than  the  other.  The  same  Mare  had  aborted  the  previous- 
year. 

In  the  Mimoires  of  the  Veterinary  Society  of  Calvados,  vol.  ii.,  M.  Lemaitre 
describes  the  case  of  a  Alare  which  aborted  on  December  2,  and  in  the  following  June 
brought  forth  a  Foal  which  continued  to  live.  Trelut,  in  the  Journal  de><  Veterinaire-s- 
du  Midi  for  1844,  mentions  a  Mare,  eleven  years  old,  which  was  put  to  the  Horse  on 
April  23,  on  the  4th,  6th,  and  25th  of  May,  and  again  on  June  5,  1845.  In  December 
this  Mare  received  some  kicks  on  the  belly  and  flank  iroai  a  Horse,  but  this  did  not  impair 
her  health.     On  March  1  it  slipped  up,  and  on  the  15th  it  aborted  two  Foals  without 


^  All  these  instances  are  paralleled  in  the  human  female,  by  various  authorities. 
Buffon,  quoted  by  Fodere  and  Churchill,  mentions  a  woman  at  Charleston,  South  Caro- 
lina, who,  in  1714,  was  delivered  of  twins  within  a  very  short  time  of  each  other,  the  one 
being  blaok,  the  other  white.  On  examination  the  woman  confessed  that  on  a  certain 
day,  immediately  after  her  husband  had  left  her,  a  negro  entered  her  room,  and,  by 
threatening  to  murder  her  in  case  of  refusal,  obtained  connection  with  her.  Dr.  Moseley 
alludes  to  the  case  of  a  negro  woman  who  brought  forth  two  children  at  a  birth,  both  of  a 
size,  one  of  which  was  a  negro  and  the  other  a  mulatto.  On  being  interrogated  upon 
the  cause  of  their  dissimilitude,  she  said  she  perfectly  well  knew  the  cause  of  it,  which, 
was  that  a  white  man  belonging  to  the  estate  came  to  her  hut  one  morning  before  she 
was  up,  and  she  suffered  his  embraces  almost  instantly  after  her  black  husband  had 
quitted  her.  Similar  illustrations  are  quoted  by  De  Bouillon,  Trotti,  Guerarde,  Delmas,. 
Dunglison,  and  others. 


SUPEKFCETA  Tl<>\.  1 7  r 

suffering  any  ill  effeoU.  The  first  Kiml  had  the  tongue  protruding  from  the  mouth,  tht* 
mucous  meutbraneH  were  very  pale,  the  liair  of  lx>dy  and  mane  and  tail  were  pre.sent,  the 
eyes  were  closed,  the  skin  was  colourless  and  lookiug  as  if  macerated,  and  the  hair  was 
easily  removed  ;  the  bloodvessels  only  contained  a  few  dn)ps  of  pale  blood  ;  aiul  the 
muscles,  pale  and  Haccid,  did  not  show  any  signs  of  deconii)osition.  The  second  Foal 
had  the  skin  smooth  and  shining,  but  no  trace  of  hair  ;  the  eyes  were  open  ;  the  mucous 
membrane  bright  red  ;  the  muscles  tiini  and  red  ;  and  the  lieart  and  vessels  tilled  witli 
red  blood. 

Cauzit,  in  the  yoKnta/  dt  Mr'd.  Viteriimire  de  Lyon  for  1859,  gives  an  instance  of 
superfietation  in  a  Mare,  fecundation  having  occurred  at  an  interval  of  eight  days  ;  and 
Chabaud,  in  the  Journal  tits  \\t.  tin  Midi  for  IS")!',  mentions  another  case,  in  which 
fecundation  must  have  occurred  at  fifteen  days'  interval. 

An  instance  is  reported  from  the  United  States  of  America.  On  tlie  "iOth  of  February, 
1876,  a  five-year-old  Mare  belonging  to  William  Driesbach,  of  Sparta,  N.Y.,  foaled  a 
dead  Ci>lt,  fully  developed  and  otherwise  promising  in  those  points  which  go  to  make  \\\y 
a  good  Horse.  The  Mare  appeared  to  be  well,  and  tti  the  siirprise  of  her  owner,  on  the 
2nd  of  April  following,  six  weeks  after  the  birth  of  her  Foal,  gave  birth  to  another  Colt, 
which  was  sound,  healthy,  well  developed,  and  in  all  respects  as  promising  a  colt  as  could 
be  found  in  the  State. 

In  the  Joiirnal  Vtltrinaire  Pnttique  for  1828,  there  is  an  instance  given  of  what  was 
supposed  to  be  superfietation.  A  fine-woolled  Kwe,  impregnated  at  the  usual  season  in 
1S"23,  evinced  in  the  following  year,  at  the  period  of  parturition,  the  ordinary  signs  of 
giving  birth  ;  but  these  subsided  without  any  produce  being  born,  and  the  animal  ipiite 
recovered.  The  foetus  was  in  the  abdomen,  and  could  be  easily  felt.  In  18'24,  this  Kwe 
was  again  impregnated  ;  in  the  early  days  of  March,  1S25,  the  niamnue  contained  milk, 
and  soon  after  the  symptoms  of  parturition  became  manifest ;  but,  as  before,  they  dis- 
apjK'ared  without  any  result.  The  animal  then  lost  condition,  became  grailually  weaker, 
and  was  not  long  in  succumbing.  On  opening  it,  a  perfectly  developed  Lamb  was  found 
in  the  right  horn  of  the  uterus,  and  in  the  left  another  well-formed  fti-tus  of  the  male  sex 
was  discovered.  The  latter,  with  its  envelopes,  as  well  as  the  uterine  cavity,  were  normal, 
except  that  a  jwrtion  of  the  fluid  had  escaped  and  the  f<etus  was  dead  ;  the  cervix  uteri, 
however,  was  constricted  by  the  presence  of  a  newly-formed  mass  of  matter,  which  was 
so  hard  that  it  could  scarcely  be  cut  through — a  circumstance  that  appeared  to  explain 
the  impossibility  of  delivery. 

Hering  {lieperf.  t'iir  T/iitr/itlUcnnth,  .Tahrgang  ix.,  p.  1)  alludes  to  instances  of  super- 
fietation in  the  Cow  and  Sheep.  An  Knglish  breeder  recently  reported  a  remarkable  case 
of  sujierfietation  in  the  Cow,  as  follows  :  — "  I  have  a  Cow  that  on  August  !•  last  had  a 
Heifer  Calf,  apparently  at  full  time  ;  indeed,  so  fine  a  one  that  I  am  rearing  it.  The  Cow 
niilktd  well  for  about  a  month,  and  then  suddenly  lessened  the  i|uanlity,  and  shortly 
c-ased  to  give  any.  On  September  2*5  she  took  the  Bull,  and  from  that  time  I  noticed 
nothing  unustial  with  her,  though  constantly  seeing  her,  »intil  December  24,  when  she 
had  another  Calf,  a  Bull,  strong  and  fullsi/.ed,  and  certainly  not  premat>ire.  The  ('alf  is 
ni'W  alive  and  doing  well,  and  the  mother  is  giving  as  much  milk  as  after  any  of  her 
previous  calvinga.  She  was  running  with  a  Bull  during  la-st  .March  and  until  .•\i>iil  2.'>, 
when  the  Bull  was  castrated,  and  she  coidd  not  have  had  access  to  any  other  tintil 
Septemlier  2'J,  when  she  was  seen  to  be  in  season  and  sent  to  a  neiglibonr's  Bull  and 
served. 

From  the  facts  already  accumulated  it  may,  then,  he  concluded  that 
superfcctation  in  the  Mare  may  occur,  and  indeed  has  occurred,  several 
times.  It  has  heen  argued  against  these  facts  that  suj)erfa'tation  is 
impossible,  because  a  Mare  that  has  once  conceived  would  be  exceed- 
ingly liable  to  abortion  if  submitted  to  a  second  service  ;  but  it  is  more 
than  doubtful  that  abortion  should  be  the  inevital)le  consequence  of  re- 
peated copulation  ;  and  we  have  the  human  species  to  adduce  in  })roof 
of  the  comparative  innocuousness  of  sexual  intercourse  during  pregnancy. 
So  far  as  researches  have  gone,  however,  it  must  be  confessed  that  these 
double  conceptions  have  only  occurred  in  uniparous  animals  by  suc- 
cessive copulations  on  the  same  day,  or  within  a  few  days ;  and  we 
are  therefore  without  any  indication  that  this  could  occur  in  them  at 
longer  intervals.  This,  it  will  be  evident,  is  no  very  strong  proof 
of  superfcctation  having  taken  place  ;  for  in  the  case  of  the  Mule  and 
Horse  Foal,  it  only  proves  that  a  double  conception  may  occur  from 


172  rATHOLOGY  OF  PREGNANCY. 

intercourse  with  two  different  animals  within  a  very  short  period.  If 
a  longer  period — say  three  or  four  months — intervened,  then  super- 
fcetation  would  be  admissible,  and  would  perhaps  be  undeniable,  pro- 
vided there  was  nothing  abnormal  in  the  uterus — such  as  a  double 
organ. 

Rainard  remarks  that  torsion  of  the  neck  of  the  uterus  in  the  Cow, 
though  preventing  the  birth  of  the  foetus,  may  nevertheless  permit  new 
conceptions.  "With  inversion  of  the  uterus  and  torsion  of  the  cervix, 
parturition  is  impossible  ;  so  that  instead  of  attempting  to  deliver  by  a 
sanguinary  and  dangerous  operation,  the  success  of  which  is  very 
doubtful,  the  animal,  if  not  killed  for  consumption  as  food,  is  generally 
left  to  the  efforts  of  nature ;  should  the  season  be  favourable  it  is 
allowed  to  remain  at  pasture,  and  freqiaently  after  some  suffering  the 
creature  regains  its  condition,  even  becomes  fat,  and  may  then  be 
advantageously  sold  to  the  butcher.  Towards  the  spring-time,  such  an 
animal  might  conceive  again  without  having  been  delivered  of  the  first 
foetus. 

In  multijyarons  animals  there  can  scarcely  be  a  doubt  that  superfoeta- 
tion  may  take  place,  and  perhaps  of  all  those  which  have  been  domesti- 
cated the  Rabbit  furnishes  the  most  striking  example.  With  this 
creature  a  new  fecundation  may  occur  in  the  middle  of  pregnancy.  This, 
of  course,  can  be  accounted  for  by  the  anatomical  disposition  of  the 
generative  organs,  the  two  cornua  of  the  uterus  opening  into  the  vagina 
independently  ;  so  that  a  primary  fecundation  may  occur  only  from  one 
ovary  in  the  corresponding  horn,  the  other  remaining  open  and  un- 
occupied. 

In  the  Sow,  many  instances  are  published  in  favour  of  superfoetation. 
One  of  these  is  given  by  Miiller,  of  Hildesheim,  in  1887.  Twenty-one 
days  after  the  birth  of  a  litter  of  six  Piglings,  the  mother  Sow  became 
restless  and  irritable  and  refused  to  suckle  them.  Two  days  later,  that 
is  twenty-three  days  after  birth,  a  second  litter  of  eleven,  all  well-formed 
and  healthy,  appeared  upon  the  scene.  Five  of  the  first  and  nine  of  the 
second  litter  are  still  doing  well.  It  is  remarked  that  the  mother  had 
access  to  the  Boar  for  some  weeks  after  the  first  impregnation,  and  the 
authenticity  of  the  account  is  stated  to  be  beyond  dispute. 

In  the  Bitch,  many  observers  have  assured  themselves  that  super- 
foetation is  by  no  means  unfrequent.  Rainard,  Blaine,  and  others 
speak  of  it.  Blaine  says,  "  I  am  disposed  to  think  that  Bitches  are 
capable  of  superfoetation ;  that  is,  they  conceive  more  than  once.  If 
this  is  the  case,  a  Bitch  may  copulate  to-day,  and  become  impregnated, 
and  in  a  day  or  two  she  may  copulate  again,  and  again  become  impreg- 
nated. This  is  not  frequent,  I  believe  ;  but  it  certainly  does  happen,  or 
we  could  not  account  for  the  different  periods  at  which  the  progeny 
sometimes  appear.  I  have  known  a  week,  and  in  one  case  even  ten 
days,  intervene  between  the  puppings  ;  but  one  or  two  days  is  not  at  all 
uncommon.  As  a  still  more  convincing  proof,  the  whelps  often  appear 
of  different  kinds." 

It  must  be  remembered  that  the  bitch  remains  in  "  heat  "  for  three 
or  four  days,  and  will  seek  for  repeated  intercourse  with  the  male 
during  that  period.  It  must,  therefore,  either  be  concluded  that  the 
last  intercourse  was  the  successful  one,  or  that  one  or  more  ova  were 
impregnated  at  each  copulation. 

So  far  as  our  knowledge  at  present  extends,  we  can  neither  positively 
negative  nor  absolutely  admit  the  possibility  of  superfoetation  in  the 


SUPKlihWrA  TJo.y.  1 7  5 

larger  domesticated  animals.  The  cases  recorded  have  not  been 
sutliciently  investigated  to  convince  those  who  deny  the  likelihood  of 
two  conceptions  taking  place  after  a  certain  interval ;  and  it  must  be 
admitted  that  a  true  explanation  of  such  a  singular  occurrence  has  not 
yet  been  offered.  A  lapse  of  time  occurring  between  the  birth  of  two 
animals  is  no  strong  proof  of  a  second  impregnation  during  conception  ; 
for,  as  we  shall  see  hereafter,  when  twins  are  conceived  from  the  same 
intercourse,  it  may  and  does  happen  that  one  ovum  does  not  attain 
maturity  so  soon  as  the  other,  and  is  eitlier  rejected  or  retained  after  a 
more  or  less  lengthened  interval — a  circumstance  wliich  might  mislead. 
And  again,  with  regard  to  the  size  of  twins,  it  is  not  at  all  unusual  to 
find  one  larger  and  more  developed  than  the  other,  though  both  were 
produced  at  the  same  period.  Putting  aside  the  question  of  superfuita- 
tion  in  animals,  the  anatomical  disposition  of  whose  generative  organs 
evidently  permits  such  an  occurrence,  a  little  consideration  will  show 
tliat  usually  there  are  physical  obstacles  which  would  appear  to  offer  an 
insurmountable  barrier  to  a  second  impregnation,  after  conception  has 
been  achieved  for  a  short  time.  Soon  after  that  event  has  taken  place, 
the  entrance  to  the '  uterus  is  closed  by  the  shut  sac  enveloping  the 
embryo,  and  which  adheres  closely  to  the  inner  surface  of  the  organ 
throughout  its  entire  extent — covering  the  orifices  of  the  os  uteri  and 
Fallopian  tubes.  In  addition  to  tiiis,  the  canal  of  the  cervix  is  during 
gestation  rendered  still  more  impervious  by  the  thick  viscid  mucus 
secreted  by  its  glands.  Such  being  the  case,  it  w'ill  be  obvious  that  a 
second  impregnation  cannot  occur,  if  it  be  necessary  for  this  purpose 
that  the  spermatozoa  pass  into  the  uterus,  or  even  to  the  ovaries  ;  for 
the  whole  is  hermetically  sealed  after  a  certain  time.  For  a  second 
impregnation  to  occur  during  conception,  fecundation  must  take 
place  before  this  closing-up  of  the  uterus  and  Fallopian  tubes — an 
interval  too  brief  after  the  primary  impregnation  to  make  much 
difference  in  the  respective  developments  of  the  young  animals.  In 
cases  in  which  there  is  a  double  uterus,  or  in  which  conception  occurs 
in  only  one  horn,  superfcetation  is  possible,  and  one  parturition  may 
not  be  followed  by  another  for  some  consideral)le  time.  However  this 
may  be,  there  are  certain  facts  recorded  whicli  need  explanation  if  super- 
fcetation be  not  admitted  as  possible. 

SECTION  11.— EXTRAUTERINE  PKKCNANCV. 

In  studying  the  development  and  progress  of  the  ovum,  after  its 
escape  from  the  ovary  and  impregnation  by  the  spermatozoa  of  the  male, 
we  saw  that  a  peculiar  arrangement  existed  in  the  presence  of  the 
fringed  border  at  the  extremity  of  the  Fallopian  tube,  which  grasped 
the  ovum  and  permitted  it  to  be  conveyed  into  the  canal  on  its  way  to 
the  uterus.  From  certain  causes  which  are  not  yet  clearly  understood, 
it  sometimes  chances  that  the  ovum,  instead  of  taking  this  its  normal 
course,  either  remains  in  the  ovary,  is  arrested  in  its  progress  tlirough 
the  tube,  or,  escaping  the  fimbriated  extremity  of  the  latter,  falls  into 
the  peritoneal  cavity,  or  glides  between  the  folds  of  peritoneum  con- 
stituting the  broad  ligament,  or  between  the  serous  and  mucous  mem- 
brane of  the  uterus  ;  in  all  of  which  situations  nature  makes  an  effort  to 
afford  space  and  nutrition  for  the  embryo,  and  thus  supply  the  place  of 
the  uterus.  This  effort,  however,  as  might  be  anticipated,  is  only  par- 
tially successful,  and  after  attaining  a  more  or  less  imperfect  develop- 
ment, the  futus  perishes  from  lack  of  nourishment. 


174  PATHOLOGY  OF  I'llEGNAXCY. 

This  abnormal  deviation  from  ordinary  gestation,  happily  very  rare  in 
the  domesticated  animals,  has  received  various  names — such  as  Extra- 
uterine ijregnancji,  Exfcetation,  Conceptio  vitiosa,  etc.  The  first  is  that 
usually  employed ;  and  the  different  varieties  are  commonly  designated 
from  the  situation  the  ovum  occupies.  Thus  we  have  (1)  Ovarian 
fcetation ,  when  the  ovum  is  detained  in  the  ovary  ;  (2)  Ovario-tuhal, 
when  lodged  partly  in  the  Fallopian  tube  and  partly  in  the  ovary  ;'  (3) 
Tubal,  when  the  tube  is  the  situation;  (4)  Interstitial,  when  the  ovum 
■enters  the  parietes  ol^ie  uterus  at  the  termination  of  the  tube,  but  is 
arrested  between  the  uLres  before  it  can  reach  the  cavity  of  that  organ ; 
(5)  Utero-tubal,  a  compound  of  the  two,  the  ovum  being  partly  in  the  tube 
and  partly  in  the  uterus  ;  (6)  Utero-tuho-ahdominal,  when  the  foetus  is  in 
the  peritoneum,  the  umbilical  cord  passing  through  the  tube  to  the 
uterus  ;  (7)  Tuho-ahdominal,  when  the  foetal  envelopes  are  fixed  in  the 
tube,  but  the  foetus  is  developed  in  the  peritoneal  cavity ;  and  (8) 
Ventral  or  abdominal  fo'tation,  when  the  embryo  is  formed  and  develops 
in  the  abdomen  ;  (9)  Vaginal  ffMation,  when  the  ovum  is  implanted  and 
becomes  developed  in  the  vagina. 

Extra-uterine  pregnancy  is  extremely  rare  in  the  domesticated 
animals,  and  appears  to  be  much  more  so  in  them  than  in  woman  ; 
several  of  the  varieties  just  enumerated  have  never,  to  my  knowledge, 
been  observed  in  them.  This  ma}'  be  fully  accounted  for  by  the 
different  arrangement  of  their  generative  apparatus,  the  much  less 
tendency  of  these  to  disease,  functional  disorder,  or  deformity,  and  also, 
•doubtless,  to  their  function  being  only  that  of  reproduction.  With 
regard  to  anatomical  arrangement  as  averting,  to  some  extent  at  least, 
this  misplaced  gestation,  we  may  point  out  that  of  the  Mare  as  typical 
— though  the  same  indication  is  applicable  to  the  case  of  the  other  large 
animals.  In  this  creature,  the  escape  of  the  ovum  into  the  abdominal 
cavity  can  only  occur  through  some  malformation  or  anomaly  in  the 
-conformation  of  the  fimbriated  extremity  of  the  tube,  which,  in  the 
normal  condition,  is  applied  to  the  base  of  the  ovary,  and  envelops  it 
during  the  genital  excitement.  Neither  is  it  likely  that  its  course 
through  the  cavity  of  the  tube  can  be  checked,  as  this  is  short  and 
■direct  ;  and  the  comparative  thinness  of  the  uterine  walls  almost 
precludes  the  probability  of  the  ovum  lodging  itself  in  them. 

Ovarian  fcetation  has  very  seldom  been  observed,  so  far  as  my  re- 
searches have  led  me ;  though  its  occurrence  in  the  domesticated 
animals  is  far  from  being  impossible.  It  has  been  divided  into  two 
kinds — internal  ovarian,  when  the  embryo  is  developed  in  the  Graafian 
vesicle  or  interior  of  the  ovary  ;  and  external  ovarian,  when  the  ovum 
has  left  the  vesicle  and  grows  beneath  the  envelope  of  the  ovary.  The 
only  instances  on  record  are  given  by  Rohlwes,  Gurlt  and  Plot.  The 
first  observed  this  rare  form  of  gestation  in  a  Mare  which  had  been 
pregnant  twenty-one  days.  The  ovary  was  greatly  enlarged,  and  con- 
tained a  small  embryo  in  a  vesicle.  Plot  observed  it  in  a  Cow,  and 
also  in  three  Sows. 

Tubal  fcetation,  in  which  the  embryo  is  developed  in  the  Fallopian 
tube,  is  also  exceedingly  rare,  if  the  paucity  of  cases  reported  is  any 
criterion.  Rohlwes  mentions  having  found  the  bones  of  a  foetus  in  the 
left  Fallopian  tube  ;  and  Carus  says  this  form  has  been  noted  in  the 
Rabbit.  Carsten  Harms  speaks  of  it  as  causing  fatal  internal  haemor- 
rhage, by  rupture  of  the  tube,  through  the  incapacity  of  the  latter  to 
-distend  sufficiently  for  the  development  of  the  foetus. 


/•;.Y  TKA  ■  I '  TKI!  I  .\  K  I  'I!  KtlX.iyry,  17 ;-, 

Interstitial  fcetation  is  that  form  in  wliicli  the  cmhryo  is  developed 
between  the  nieinbranes  foriniti}^  the  walls  of  the  uterus  ;  the  muscular 
fibres,  at  the  point  where  this  occurs,  are  separated,  and  the  cyst  con- 
taining the  embryo  is  situated  between  the  serous  and  mucous  mem- 
brane. This  variety  has  not  been  noted  in  the  lower  animals,  I  believe; 
neither  have  the  remaining  forms,  except  the  abdominal,  some  very  rare 
cases  of  which  are  on  record. 

Abdominal  or  ventral  fwlation  may  present  two  varieties:  the  ovum 
may  graft  itself,  after  escaping  from  the  ovary,  directly  in  the  cavity  of 
the  abdomen,  and  there  be  developed  ;  or  it  may  be  developed  at  some 
other  point — the  ovary.  Fallopian  tube,  etc.,  and  fall  into  the  abdomen 
after  rupture  of  the  pouch  which  contained  it.  In  the  first  instance  it 
is  named  jirimar;/,  and  in  the  other  secundar//  abdominal  f'adation. 
E.\tremely  rare  though  both  varieties  are  in  animals,  yet  perhaps  the 
tirst  variety  is  less  frequent  than  the  second. 

Wojinal  fa'tation  has  been  recorded  as  occurring  in  animals,  and  the 
size  and  conformation  of  the  vagina  lends  itself  to  this  kind  of  abnormal 
pregnancy,  which  does  not  appear  to  be  possible  in  woman. 

Several  instances  of  these  different  kinds  of  fcetation  are  to  be  found 
in  veterinary  literature. 

The  length  of  time  during  which  these  extra-uterine  foetuses  may  be 
retained,  varies  according  to  circumstances.  In  the  human  species,  a 
case  is  recorded  in  which  the  fcetus  remained  in  the  abdomen  for  lifty- 
six  years  ;  and  a  great  many  instances  are  published  in  which  retention 
has  continued  from  three  months  up  to  the  last-named  period.  In 
animals  this  retention  of  the  misplaced  fd-tus  may  also  continue  for  a 
long  time  ;  and  though  death  usually  occurs  if  delivery  is  delayed  much 
beyond  the  usual  period  of  pregnancy,  yet  development  appears  to  pro- 
gress in  the  ordinary  manner,  and  subject  to  the  laws  of  normal  gesta- 
tion. It  is  indeed  astonishing  to  hnd  the  ovum  fix  itself,  and  become 
developed  into  the  embryo  and  f<etus,  by  drawing  nourishment  in  the 
strange  situation  in  which  it  chances  to  fall — the  placenta,  cord,  and 
envelopes  being  present  just  as  if  it  had  found  its  way  into  the  natural 
receptacle.  It  does  not  appear  to  be  (juite  decided  whether  the  ovum, 
in  primary  abdominal  f<etation,  receives  an  additional  covering  ana- 
logous to  the  decidua  ;  though  it  is  very  probable  that  it  does,  and  that 
this  membrane  may  perform  a  similar  otlice  in  the  nutrition  of  the 
fa'tus.  The  part  of  the  abdominal  or  other  surface  to  which  the  ovum 
adheres,  receives  an  increased  vascular  supply  for  the  occasion,  its 
vicarious  function  being  as  actively  carried  on  as  if  it  were  the  lining 
membrane  of  the  uterus. 

Not  infrequently  retention  is  brought  to  a  termination  by  the  death 
of  the  parent,  through  the  disordered  state  of  health  induced  by  the 
living  foetus,  or  through  absorption  of  the  septic  matter  it  engenders,  if 
putrefaction  sets  in  after  its  decease.  On  other  occasions — and  these 
are  comparatively  not  very  unusual  in  the  lower  animals— an  effort 
is  made  by  nature  to  get  rid  of  what  really  in  time  becomes  a  foreign 
body,  by  artificial  openings.  In  these  cases  the  fcntus  may  be  passed 
whole  or  by  fragments  through  the  al)dominal  parietes,  the  intestines, 
or  the  vagina — in  almost  every  case  the  former,  owing  to  tlie  quadru- 
pedal position  of  the  domesticated  animals.  Several  occurrences  of  this 
kind  are  to  be  found  in  the  literature  of  Veterinarv  Science. 


176  PATHOlJinY  OF  PRE'iXAXrV. 

Symptoms,  Course,  and  Terminations. 

The  symptoms  are  generally  those  of  conception  and  gestation.  The 
ovum  grafts  itself  on  some  part  with  which  it  chances  to  be  in  contact ; 
an  embryo  results,  the  placenta  being  attached  to  the  neighbouring  tex- 
tures and  developing  with  the  increase  of  the  young  creature  ;  these 
changes  being  accompanied  by  the  ordinary  external  signs  of  uterine 
pregnancy.  In  the  majority  of  cases,  when  parturition  should  occur  in 
the  usual  course,  the  premonitory  indications  of  that  phenomenon  are 
very  slight  or  altogether  absent  ;  though  the  animal  may  now  and  then 
make  expulsive  efforts,  which  continue  perhaps  for  a  few  days,  and 
then  subside  gradually,  or  recur  at  intervals.  In  the  most  favourable 
cases,  when  the  foetus  perishes,  it  becomes  encysted  and  mummified  ; 
the  fluids  and  soft  parts  are  absorbed,  and  the  remaining  portions 
become  dry  and  parchment-like  ;  or  the  creature  may  undergo  a  process 
of  calcification  by  the  deposition  of  carbonate  and  phosphate  of  lime  in 
its  tissues,  which  preserve  its  shape,  and  convert  it  into  a  "  lithopaedion  " 
or  "  osteopaedion."  In  this  condition  the  foetus  may  remain  for  an 
indefinite  period  in  the  abdomen  of  the  mother,  without  causing  much, 
if  any,  inconvenience  ;  indeed,  a  most  perfect  state  of  health  may  exist, 
and  the  animal  may  become  remarkably  fat,  or  it  may  again  conceive 
and  bring  forth  as  favourably  as  if  nothing  abnormal  existed  ;  the 
indications  of  anomalous  gestation  being  only  discovered  by  chance 
when  the  animal  dies  from  some  disease  which  has  no  relation  to  this 
accident,  or  is  killed  for  food. 

Such  a  happy  result  of  the  accident  is,  however,  very  far  from  being 
the  rule,  and  the  chances  are  many  that  a  fatal  termination  will  be  the 
consequence  of  extra-uterine  gestation.  Expulsive  efforts  or  other 
causes,  may  lead  to  rupture  of  the  cyst  in  which  the  foetus  is  contained; 
and  this,  with  the  fluids  and  debris  of  membranes,  falling  into  the 
abdominal  cavity,  may  give  rise  to  such  a  severe  form  of  peritonitis  that 
death  will  ensue  in  one  or  two  days.  In  other  instances  the  kyst 
inflames,  and  suppuration  is  established,  with  putrefaction  and  partial 
solution  of  the  foetus  ;  and  if  the  mother  does  not  at  once  succumb  to 
pyaemia  or  septik£emia,  adhesions  and  communications  are  formed 
between  the  kyst  and  neighbouring  organs,  and  the  remains  of  the 
young  animal,  chiefly  the  bones,  are  expelled  either  directly,  as  by 
ulceration  of  the  abdominal  walls  after  the  development  of  an  abscess, 
or  indirectly,  as  through  the  intestine,  etc.  After  the  foreign  matters 
have  been  completely,  or  even  only  partially,  eliminated  in  this  way, 
the  fistulous  openings  by  which  they  escaped  cicatrise  after  a  variable 
period  of  suppuration,  and  the  female  recovers — as  has  been  observed 
in  Sheep  and  Goats. 

More  frequently,  however,  it  loses  condition,  becomes  emaciated  and 
feeble,  and  perishes  in  a  state  of  marasmus  ;  or  it  succumbs  to  hectic 
fever,  septikaemia,  or  one  of  the  many  accidents  which  the  presence  of 
such  a  body  may  produce.  The  course  of  external  ovarian  gestation, 
which  has  been  stated  by  Gurlt  to  occur  in  the  domesticated  animals, 
appears  to  be  as  follows  :  the  envelopes  of  the  ovary  rupture  towards 
the  second  or  third  month  of  the  embryo's  development,  w^hen  the  latter 
falls  into  the  abdominal  cavity,  w^here  it  constitutes  what  we  have 
termed  "abdominal"  gestation,  leaving  only  a  cicatrix  on  the  ovary. 
With  regard  to  internal  ovarian  pregnancy,  the  ordinary  termination  is 
rupture  of  the  organ,  and  fatal  htemorrhage. 


EXTRAUTEIUXK  PREGNANCY.  177 

Diagnosis  and  Treatment. 

There  is  absolutely  nothing  in  the  early,  or  even  in  the  later  stages  of 
extra-uterine  pregnancy — especially  ovarian  and  tubal — to  indicate  the 
existence  of  any  deviation  from  normal  gestation  :  and  when  at  length 
the  animal  exhibits  indications  of  approaching  parturition,  there  may 
be  grave  doubts  as  to  the  actual  state  of  affairs,  though  the  absence  of 
certain  signs  may  give  rise  to  suspicion.  The  animal  is  uneasy  and 
strains,  yet  the  vulva  is  not  enlarged,  and  the  How  of  mucus  observed 
in  the  preliminary  stage  of  ordinary  parturition  is  not  apparent. 
Exploration  of  the  cervix  uteri  by  the  vagina,  will  prove  the  absence  of 
induration  or  morbid  tumefaction,  as  well  as  dilatation  or  contraction 
of  the  OS,  notwithstanding  tlic  length  of  time  that  has  elapsed  and  the 
expulsive  efforts.  Palpation  and  inspection  of  the  abdomen  may  also 
furnish  certain  information  with  regard  to  volume,  and  the  situation  of 
the  enlargement.  Careful  exploration  of  the  abdominal  cavity  by  the 
rectum  will  be  found  advantageous  in  cases  of  abdominal  gestation  un- 
complicated with  uterine  pregnancy.  Not  only  can  the  condition  of  the 
uterus  be  satisfactorily  determined,  but  perhaps  a  tumour  independent 
of  that  organ  may  be  discovered,  in  which  a  fa^tus,  or  parts  of  one, 
can  be  felt.  In  such  a  case,  efforts  must  be  made  to  check  the  attempts 
at  parturition,  though  it  must  be  confessed  that  they  are  not  likely  to 
be  successful.  Sedatives,  large  doses  of  opium,  chloral,  hot  water 
applications  to  the  abdomen,  and  other  measures  of  this  kind,  are 
indicated.  If  the  diagnosis  is  well  established,  and  the  animal  can  be 
utilized  for  food,  it  is  generally  better  to  have  it  destroyed  if  in  fair 
condition.  In  cases  in  which  the  period  of  parturition  has  passed,  and 
when  the  animal  has  been  unwell  for  some  time,  exliibiting  loss  of 
appetite,  with  marked  depression,  quickened  pulse  and  increased  tem- 
perature, and  nothing  else  to  account  for  these  symptoms,  then  we  may 
suspect  the  existence  of  extra-uterine  gestation  and  putrefaction  of  the 
fcetus. 

In  the  smaller  animals — such  as  the  Sheep,  Goat,  Bitch,  etc., 
abdominal  palpation  can  be  readily  resorted  to,  and  often  with  most 
satisfactory  results. 

When  elimination  of  the  fcrtus  has  commenced  in  any  of  the  modes 
just  described,  active  interference  may  or  may  not  be  necessary,  accord- 
ing to  circumstances.  The  fistulous  openings  which  may  be  occasioned 
by  the  eliminative  process,  must  be  dealt  with  as  ordinary  listuUc. 
Should  the  foetus  chance  to  be  alive,  it  is  scarcely  possible  that  it  can 
be  removed  by  operation  without  greatly  endangering  the  life  of  the 
mother.  If  in  abdominal  gestation  a  tumour,  simulating  an  abscess, 
fonns  on  any  part  of  the  abdomen,  this  may  be  carefully  opened,  and 
the  fcetus  extracted  with  a  successful  result.  The  accessory  treat- 
ment, sucli  as  careful  nursing  and  hygienic  measures,  must  not  be 
neglected. 

In  vaginal  pregnancy,  there  is  of  course  an  absence  of  the  usual  signs 
of  abdominal  gestation,  unless  this  is  going  on  concurrently.  The 
animal  shows  symptoms  which  should  lead  to  exploration  of  the  vagina, 
when  the  fcetal  tumour  will  be  encountered  ;  this  will  probably  be 
attached  to  the  floor  of  the  passage,  from  which  it  can  easily  be 
removed. 


12 


178 


PATHOLOGY  OF  PREGNANCY. 


SECTION  III.— SPURIOUS  OR  PSEUDO-PREGNANCY. 

Spurious  pregnancy  is  a  designation  applied  by  veterinary  obstetrists 
to  certain  accidents,  characterised  by  the  development  of  special  patho- 
logical productions,  which  may  probably  be  due  to  a  previous  conception, 
and  which  more  or  less  simulate  normal  pregnancy.  Such  cases  are 
far  from  common,  and  the  principal  of  them  are  described  as  moles, 
uterine  cysts,  and  hydrometra  or  hydrops  uteri.^  These  we  will  allude 
to. 

Moles. 

Moles,  or  more  correctly  speaking  perhaps,  anidian  monsters,  are  more 
or  less  voluminous  fleshy  masses  constituted  by  a  blighted  embryo,  the 


membranes  of  which  have  continued  to  perform  their  function,  and  to 
nourish  the  abnormal  growth.  They  are,  as  a  rule,  met  with  only  in 
Euminants,  and  especially  the  Bovine  species,  though  Eoell  mentions 
their  occurrence  in  the  Mare ;  and  in  nearly  every  case  they  appear  to 
be  one  of  twins,  the  development  of  which  has  been  arrested  at  a  certain 
period. 

The  mole  {viola  cruenta)  is  more  particularly  characterised  by  the 
persistence  of  an  umbilical  cord  which,  though  degenerated,  yet  seems 
in  the  majority  of  cases  to  maintain  relations  between  the  tumour  and 

1  I  am  not  aware  that  the  curious  and  obscure  form  of  pseudo-pregnancy  occurring  in 
woman,  and  designated  pseudo-cyesi^  by  the  late  Dr.  Simpson,  has  ever  been  observed  in. 
animals. 


SPURIOUS  OR  PSEUDOPREGXANCV. 


179 


the  uterus.  With  rej^ard  to  the  tumour  itself,  it  is  generally  easy  to 
distinguish  the  distorted  remains  of  an  embryo — sucli  as  skin,  bones, 
muscles,  and  even  organs  of  sense  in  some  cases.  These  anidian 
monsters  have  not  attracted  much  attention  ;  though  several  instances 
of  their  occurrence  are  publishfd  in  veterinary  literature. 

Kainard    and    others    mention    having    found    fibrous    moles    {inula 


Fig.  Q^. 

Hvi'ATui  Cyst  or  Molk  :  Himan. 

Thi-  f'y'<t,  which  filled  the  I'UruM,  has  bten  opened,  and  gives  exit  t<>  a  number 
of  Hydatid  Veaiclef.  The  Section  Hhown  two  Membranous  Layers,  the  first 
of  which,  a,  a,  a,  is  external,  and  is  analogous  to  the  Kpichorion  or  Decidua  ; 
while  the  second,  h,  h,  h,  is  a  fine  transparent  Membrane,  apparently  the 
remains  of  the  Chorion,  r,  r,  r,  flranular  Vesicles  ;  */,  >/,  il.  White  ^'ef*^<»•ls,  some 
of  which  appear  on  the  Surface  as  (Granulations,  and  others  act  as  Pedicles  to 
the  Globules  at  their  extremity  ;  f ,  r,  < ,  Oblong  Vesicles  which  app»'ar  to  Ije 
Constricted  or  Dilated  Vesicles  ;  f,f,f.  Budding  Vesicles. 


raceinosa)  in  the  uterine  comua  of  the  Bitch,  Pig,  and  some  other  mul- 
tiparous  animals  during  gestation,  and  most  frequently  in  the  last  dilata- 
tion of  one  horn,  rarely  in  both  ;  sometimes  they  were  between  two  of 
the  dilatations  which  contained  living  foetuses.  Tliey  are  spheroidal, 
soft,  irregular  in  shape,  and  look  like  flesh  ;  they  appear  to  be  composed 
of  fibres  running  in  every  direction.  In  the  dilatation  of  the  horn  con- 
taining them,  traces  of  a  zonular  uterine  placenta  have  been  obse^^•ed. 


180  PATHOLOGY  OF  PREGNANCY. 

Rainard  was  of  opinion  that  they  were  embryos  whose  development  was 
checked  by  disease. 

Demoussy  states  that  the  presence  of  foetal  mole  in  the  Mare  gives 
rise  to  the  same  phenomena  as  real  pregnancy — enlargement  of  the 
abdomen,  sinking  of  the  croup  and  flanks,  sluggish  gait,  and  altered 
respiration  ;  and  that  the  diagnosis  is  the  presence  or  absence  of  move- 
ment in  the  foetus. 

Uterine  Cysts. 

Uterine  cysts  are  pathological  productions,  somewhat  analogous  to 
the  vesicular  degeneration  of  the  human  placenta,  in  which  the  placental 
villi  are  distended  with  fluid,  enlarged,  elliptical,  transparent,  and 
loosely  connected,  while  their  vessels  become  obliterated  and  disappear. 
This  constitutes  what  has  been  designated  a  "  vesicular  mole,"  of  which 
many  cases  are  recorded  in  veterinary  annals. 

Hydatid  cysts  have  been  mentioned  as  occurring  in  the  domesticated 
animals,  and  simulating  pregnancy  ;  but  the  authorities  who  allude  to 
these  instances  have  not  offered  any  details.  They  appear  to  be  related 
to  conception  and  pregnancy,  and  in  some  instances  they  may  be  a 
deformed  embryo. 

The  Veterinarian  (vol.  xx.,  p.  187)  gives  an  interesting  account  of  an 
immense  tumour  in  the  uterus  which,  in  the  living  animal,  led  to  the 
belief  that  the  Mare  was  in  foal. 

Hydrops  Uteri  or  Hydrometra. 

Hydrops  uteri,  as  the  designation  implies,  is  a  collection  of  fluid  in 
the  uterus  ;  though  it  may  not  be  of  a  serous  character  in  every  case, 
but  may  sometimes  be  purulent.  There  are  many  instances  of  this 
condition  recorded  in  British  and  foreign  veterinary  literature,  as  occur- 
ing  in  the  Mare  and  Cow — the  animals  which  most  frequently  receive 
attention,  though  the  Sheep  and  Bitch  sometimes  suffer  from  the 
disease.  This  condition  appears  to  be  related  to  gestation  ;  it  is  allied 
to  mole  pregnancy,  and  sometimes  closely  simulates  real  pregnancy, 
though  it  may  also  be  a  symptom  of  metritis.  It  may  also  be  due  to 
injury  to  the  uterus. 

Eainard  says :  "  "When  this  collection  is  forming,  the  abdomen 
gradually  enlarges  as  in  ordinary  gestation  :  the  animal  looks  healthy, 
and  there  is  scarcely  any  difference  between  this  state  and  that  of 
pregnancy  before  the  second-third,  or  even  the  second-half  of  gestation. 
It  is  rare  that  these  collections  persist  more  than  five  or  six  months 
without  being  evacuated  at  least  once,  and  it  is  usual  to  see  this  evacua- 
tion take  place  every  month,  or  at  least  every  two  months.  The  fluid 
is  greyish  coloured,  and  it  is  often  as  much  as  an  ordinary  bucketful." 

Saint-Cyr,  in  alluding  to  the  cases  recorded  since  Rainard  wrote 
these  lines,  remarks  that  it  is  usually  after  a  copulation  which  is 
supposed  to  be  successful  that  these  collections  form.  They  are 
gradually  developed,  and  are  accompanied  by  all  the  signs  of  ordi- 
nary gestation,  with  the  exception,  of  course,  of  the  movements  of 
the  foetus.  Then,  at  a  certain  time,  there  appear  the  precursory  indi- 
cations of  parturition  or  abortion  :  expulsive  efforts— certainly  less 
energetic,  painful,  or  prolonged,  as  a  rule,  than  those  of  natural  parturi- 
tion, and  rather  resembling  those  of  micturition  or  defecation.  The 
cervix  uteri  slowly  enlarges,  though  the  hand  introduced  into  the 
vagina  discovers  the  os  to  be  almost  impervious,  and  neither  foetus  nor 


IXFLUEXCK  OF  PREGXAXCY  oX  dnDIXAin'  DISEASES.  181 

ineiiibranes  can  be  felt  ;  when  it  is  dilated,  there  is  at  once  a  gush  of 
tluid,  the  aspect  and  quality  of  which  varies.  It  is  often  greyish- 
coloured,  thick,  and  more  or  less  fa^tid  ;  though  it  may  also  be  clear 
and  serous.  Its  evacuation  may  occur  at  very  variable  periods — as  at 
one  hundred  and  eighty  days,  five  and  a  half  months,  thirty-two  weeks, 
or  forty-six  weeks,  after  the  supposed  successful  copulation,  according 
to  the  various  writers  who  have  described  these  cases. 

There  are  two  forms  of  hydrometra — (edematous  lij/dronietra  and 
ascitic  hifdrovu'tra.  The  former  exists  when  the  walls  of  the  uterus  are 
infiltrated  with  serum,  and  may  acquire  a  thickness  of  four  or  five 
inches  ;  the  latter  is  an  accumulation  of  tluid  in  the  cavity  of  the 
uterus.  Hydrometra  luis  been  observed  in  the  Mare,  Cow,  and  Bitch  ; 
rarely  in  the  Sheep. 

Recovery  has  often  followed  the  evacuation  of  the  fluid,  when  it  has 
been  in  the  uterine  cavity  ;  in  some  cases  the  condition  has  become 
so  aggravated  as  to  cause  death,  or  necessitate  the  destruction  of  the 
animal. 

The  diagnosis  is  arrived  at  by  manual  exploration,  and  by  the  absence 
of  some  of  the  most  characteristic  indications  of  pregnancy. 

When  the  condition  is  diagnosed,  and  there  is  reason  for  interference, 
the  indications  for  treatment  are  plain — carefully  dilate  the  os,  evacuate 
the  contents  of  the  uterus,  and  inject  astringent  and  antiseptic  fluids 
(as  carbolic  acid  1  to  20)  at  intervals  into  its  cavity.  Give  gentle  laxa- 
tives frequently  ;  guard  against  distention  of  the  bladder,  from  which 
the  urine  may  be  removed  by  means  of  a  catheter,  if  necessary ;  and 
give  nourishing  food,  with  tonics. 


Cri AFTER  II. 
Diseases  incidental  to  Pregnancy. 

Owing  to  animals  being  kept  in  a  more  natural  state,  generally,  than 
the  human  species,  when  pregnant  tliey  are  much  less  exposed  to  the 
risks  and  inconveniences  of  that  condition  than  woman.  The  difference 
in  the  attitude  of  the  body  may  also  tend  much  to  obviate  those  serious 
accidents,  and  prevent  those  unpleasant  consequences,  which  so  often 
attend  gestation  in  the  human  female. 

Nevertheless,  notwithstanding  this  inmiunity,  pregnancy  in  animals 
brings  about  certain  modifications  in  the  organism  which  may  some- 
times call  for  serious  notice,  either  when  it  leads  to  a  morbid  pre- 
dis{X)sition,  or  in  its  influence  on  the  progress  of  certain  diseases  already 
existing  at  the  time  of  conception,  or  which  have  developed  during 
pregnancy.  There  are  also  maladies  whicli  are  peculiar  to  this  condi- 
tion, some  of  them  of  much  importance. 

SF.CTI(1N  I.— INFLUENCE  OF  PREGNANCY  UN  ORDINARY  DISEASE.S. 

The  influence  of  pregnancy  on  the  course  of  the  ordinary  diseases  of 
animals  has  not  yet  been  well  ascertained,  though  it  has  been  long 
obsened  that  such  an  influence  exists,  and  has  often  been  productive 
of  marked  effects. 

.\nd  these  may  have  been  due,  directly  or  indirectly,  in  some  cases  at 
least,   to  the  condition  of  the  blood  in  the  female,  the  red  globules  of 


182  PATHOLOGY  OF  PREGXAXCV, 

which  are  greatly  dhninished,  and  the  proportion  of  albumin  is  also 
notably  decreased,  while  the  serum,  on  the  contrary,  is  much  above  the 
normal  standard.  The  amount  of  fibrine  likewise  varies,  though  this 
variation  is  neither  so  constant  nor  so  uniform  as  in  the  other  consti- 
tuents ;  but  it  generally  increases  towards  the  termination  of  pregnancy.^ 
Owing  to  this  decrease  in  the  solid  portion  of  the  blood,  and  particu- 
larly in  the  red  globules,  the  pregnant  female  is  more  anaemic  than 
plethoric.  It  is  none  the  less  exposed  to  inflammatory  attacks,  how- 
ever, owing  to  the  excess  of  fibrine  ;  but,  as  Saint-Cyr  justly  remarks, 
these  phlegmasitE  assume  a  particular  physiognomy,  and  run  a  very 
different  course  to  those  observed  in  ordinary  conditions,  and  more 
especially  with  I'egard  to  depletive  measures,  which  have  to  be  carefully 
resorted  to — or,  we  might  say,  abstained  from. 

The  mechanical  effects  of  the  foetus,  and  the  immense  volume  of  the 
uterus,  must  also  produce  disturbance  of  most  essential  functions, 
and  more  especially  those  of  the  abdominal  and  thoracic  organs.  There- 
fore it  is,  that  during  pregnancy  such  affections  as  indigestion,  colic, 
tympanitis,  enteritis,  or  pneumonia,  are  so  frequently  followed  by 
abortion  and  slow  convalescence,  or  death  of  the  animal. 

Chronic  diseases  have  in  general  but  little  influence  on  gestation.  It 
has  been  imagined  that  "  broken  wind  "  in  the  Mare  is  much  relieved 
during  pregnancy  ;  but  some  observations  would  go  to  prove  that  it 
is  rather  aggravated — though  the  troublesome  cough  does  not  appear 
to  prevent  the  fcBtus  reaching  its  full  period. 

Acute  diseases  are  more  serious,  and  especially  those  of  an  epizootic 
kind,  which  often  cause  abortion  or  induce  premature  labour.  Influenza 
very  often  leads  to  abortion  in  Mares,  and  the  contagious  pleuro- 
pneumonia of  cattle  has  frequently  the  same  result,  death  being  more 
frequent  as  pregnancy  is  well  advanced.  Sheep-pox  is  also  more 
serious  and  more  often  fatal  in  pregnant  Sheep,  and  most  frequently 
followed  b}^  abortion. 

A  number  of  observers— among  them  Saint-Cyr,  Bouley,  Eoll,  Lafosse, 
and  Eeynal — have  remarked  that  the  cattle-plague  does  not  appear  to 
have  any  very  particular  influence  on  gestation  :  and  the  same  has  been 
said  of  eczema  epizoutica  ("  foot-and-mouth  disease  ").  But  this  Con- 
tinental experience  does  not  harmonise  with  that  relating  to  these  two 
diseases  in  our  own  country.  Abortion  has  been  a  notorious  sequel  of 
both  maladies,  and  more  especially  of  "  foot-and-mouth  disease,"  in 
which  the  losses  from  this  cause  have  sometimes  amounted  to  twenty, 
thirty,  fifty,  and  even  more,  per  cent. 

Painful  and  nervous  diseases  are  also  more  serious  during  pregnancy 
than  at  other  times.  It  would,  however,  seem  to  be  an  error  to  attri- 
bute the  non-appearance  of  certain  disorders  during  pregnancy  to  the 
influence  of  this  condition,  as  Spinola  has  done  with  regard  to 
rabies,  etc. 

SECTION  II.— DISEASES  INCIDENTAL  TO  PREGNANCY. 

As  has  been  already  stated,  the  diseases  peculiar  to  the  pregnant 
condition  are  fewer,  not  so  frequent,  and  usually  much  less  serious  in 
animals  than  in   the  human  female.     The  chief  maladies  or  morbid 

'  In  woman,  it  has  been  noted  that  the  normal  proportion  of  red  globules  is  from  12fi 
to  127  per  1,000,  and  that  during  pregnancy  this  proportion  falls  to  120,  115,  95,  90,  and 
even  87  per  1,000  of  the  total  mass  of  the  blood  ;  while  the  albumin  descends  from  an 
average  of  70i  to  69,  •]*;,  and  62  per  1,000. 


UISKASKH  IXCIhKSTAL    TO  rRKGXAXCV.  183 

ooiulitions  which  have  been  noted  in  animals  are  pica  or  mnlacia, 
rickets  and  osteomalacia,  coiistipation,  vomitiny,  colic,  oidcvui,  hydrops 
amnii,  paraplegia,  cramp,  eclampsia,  cerebral  congestion,  atitaurosis, 
cough,  albuminuria,  mammitis,  and  red  colostrum,. 

Pica. 

We  have  ah-eady  noted  that  the  appetite  of  pregnant  animals  is  some- 
times depraved,  and  that  they  will  ingest  foreign  matters — such  as 
plaster  licked  from  the  walls,  wood  gnawn  from  their  stable-fittings, 
eartli,  etc. 

When  depending  on  derangement  of  the  digestive  functions — on  a 
neurosis  of  the  stomach — this  depraved  appetite  may  be  corrected  by 
the  careful  administration  of  tonics,  antacids,  and  attention  to  the 
quantity  and  quality  of  the  food.  The  Herbivora  should  be  allowed 
conmion  salt  in  their  food,  or  to  lick. 

Rickets  and  Osteomalacia. 

Disease  of  the  bones,  tending  to  softening  or  fragility,  has  been  fre- 
quently observed  in  pregnant  animals,  and  especially  those  which  are 
young  ;  the  two  conditions  being  observed  independently  or  coincident 
in  the  same  creature.  There  is  considerable  increase  in  the  organic 
matter  of  the  bones,  and  a  corresponding  decrease  in  the  inorganic 
constituents,  especially  of  calcium  phosphate ;  the  long  bones  are  more 
particularly  affected,  thougli  the  whole  skeleton  may  be  involved.  The 
bones  become  softened,  are  often  enlarged,  and  are  friable  and  brittle; 
so  that  in  advanced  cases  fractures  occur  readily,  while  deformity  is  not 
at  all  rare.  The  disease  has  been  witnessed  in  an  en/.oiitic  form  on  the 
Continent  in  large  breeding  establishments,  among  Mares  and  Cows  ; 
flocks  of  Sheep  have  also  been  artected,  and  it  is  not  uncommon  in 
Bitches  and  Swine.  It  is  generally  due  to  the  animals  receiving  insufli- 
cient  food,  or  eating  that  which  is  deficient  in  mineral  matters — such  as 
lime  and  phosphorus — as  well  as  in  nitrogenous  constituents.  When 
pregnant  animals  are  not  well  fed,  the  fa3tus  makes  such  demands  upon 
them  for  growth  materials  that  they  must  suffer,  and  that  speedily,  in 
their  osseous  structure. 

The  early  symptoms  are  often  those  of  pica,  the  animals  instinctively 
seeking  for  lime  salts.  But  frequently  the  first  indication  of  this  condi- 
tion is  the  occurrence  of  fracture  of  one  of  the  limb  or  pelvic  bones 
from  some  slight  cause — as  getting  up  from  the  recumbent  position, 
slipping,  or  a  blow.  The  pelvis  appears  to  be  very  liable  to  such  frac- 
tures, though  the  long  bones,  ribs,  scapula,  and  even  the  sternum,  are 
commonly  damaged  in  this  way.  Sometimes,  before  these  fractures 
occur,  the  animals  appear  to  be  stifT,  and  walk  as  if  suffering  from 
paresis  or  debility,  and  the  joints  begin  to  swell ;  then  the  recumbent 
position  is  assumed  and  maintained,  unless  strong  persuasion  is  applied. 
The  condition  is  always  more  or  less  serious,  though  there  may  be  difti- 
culty  in  diagnosing  it,  unless  careful  examination  and  inquiry  is  made. 
Prevention  lies  in  giving  pregnant  animals  good  food,  keeping  them  in 
a  healthy  state,  and  not  breeding  from  them  when  too  young.  The 
curative  treatment  is  simple,  and  is  mainly  centred  in  offering  nutri- 
tious food  rich  in  lime  salts — as  crushed  oats  and  beans  for  ^Fares,  and 
even  for  Bovines  (which  may  have  them  scalded  or  boiled),  with  green 
forage  or  good  hay  ;  nerve  tonics — as  strychnine  or  nux  vomica,  and 
preparations  of  calcium  phosphate,  may  also  be  administered  in  serious 


134  PATHOLOGY  OF  PREGNANCY. 

cases.  For  the  smaller  animals  the  same  drugs  may  be  prescribed, 
with  the  addition  of  cod-liver  oil,  and  milk-and-oatmeal  porridge  for 
food. 

Constipation. 

Constipation  is,  of  course,  due  to  many  causes,  some  of  which  have 
no  relation  to  pregnancy.  This  condition,  however,  is  not  at  all  rare, 
particularly  in  the  Carnivora,  during  gestation  ;  and  in  all  animals  it 
may  be  largely  remedied,  or  altogether  removed,  by  suitable  diet  and 
exercise.  Purgatives  should  be  avoided,  if  possible,  and  only  mild 
laxatives  resorted  to  if  necessary.  For  the  Bitch,  which  appears  to 
suffer  most  frequently  from  constipation,  Saint-Cyr  recommends  the 
administration,  every  day  for  eight  or  ten  days,  of  five  to  eight  grammes 
of  white  mustard ;  but  I  have  always  found  castor-oil,  witli  enemas 
when  the  constipation  was  very  obstinate,  quite  satisfactory.  Castor 
or  linseed  oil,  or  even  boiled  linseed,  answers  well  for  the  larger  animals. 

Vomiting. 

Contrary  to  what  occurs  in  woman,  vomiting  in  pregnant  animals  is 
so  unfrequent  that  I  have  been  able  to  find  mention  of  only  one  instance, 
and  that  is  in  the  Belgian  Etat  Sanitaire  des  Aniniaux  Domestiques  for 
1877. 

Colic. 

Colic  may  appear  in  some  instances  during  the  early  months  of 
pregnancy  in  the  Mare,  the  attacks  being  generally  slight,  and  occurring 
at  intervals.  It  may  be  due  to  indigestion,  and  only  require  simple 
treatment — as  warm  gruel,  friction  to  the  abdomen,  enemas  of  warm 
water,  and  laxative  food,  such  as  linseed  mashes. 

CEdenia. 

The  infiltration  of  serosity  into  the  connective  tissue  of  certain  parts 
of  the  body  of  pregnant  animals — almost  exclusively  the  Mare — is  some- 
what allied  to  the  anasarca  serosa  of  woman.  The  period  at  which  it 
is  manifested  depends  much  upon  breed,  conformation,  and  individual 
temperament,  as  well  as  upon  the  season  and  hygienic  conditions.  With 
common-bred,  lymphatic  Mares  deprived  of  sufficient  exercise,  it  appears 
at  an  early  period — from  the  eighth  month  of  gestation,  and  sometimes 
earlier — particularly  in  winter.  With  better  bred  animals  it  is  later, 
and  in  summer  may  not  appear  at  all  in  those  which  are  well  bred.  It 
is  most  marked  in  primiparas.  It  commences  usually  at  the  inferior 
part  of  the  hind  limbs,  gradually  ascending  to  the  hocks,  or  higher  ;  the 
fore  limbs  are  also  attacked,  though  not  so  markedly  ;  and  the  swelling 
extends  to  the  lower  surface  of  the  abdomen.  Here  it  commences  by  a 
soft  tumour  in  front  of  the  udder ;  this  increases  in  size  and  spreads 
over  that  gland,  as  high  as  the  vulva,  down  the  inner  surface  of  the 
thighs,  and  towards  the  chest,  sternum,  and  fore-arms.  It  readily  dis- 
appears or  diminishes  with  exercise,  and  is  probably  due  to  the  pressure 
exercised  by  the  foetus  on  the  pelvi-crural  vessels,  as  well  as,  perhaps, 
to  the  anaemic  condition  of  the  system.  The  exemption  of  the  Cow 
from  oedema  has  been  ascribed  to  the  great  development  of  the  mam- 
mary veins  in  this  animal,  and  their  free  communication  with  others, 
which  permits  a  ready  return  of  the  blood  from  the  hind  limbs. 

There  is  nothing  serious  in  this  oedema  of  pregnancy,  as  in  nearly 
every  case  it  can  be  counteracted  by  exercise  or  hand-rubbing,  and  it 
disappears  in  a  day  or  two  after  birth. 


DISEASES  INCIDENTAL  TO  l'i:EQNANCY.  185 

If  it  causes  inconvenience,  frictions  witli  soap  or  turpentine  liniments, 
bandaging,  or  even  slight  scarifications,  may  be  employed  ;  but  the 
occasions  for  these  must  be  very  rare  indeed. 

ni/dranniios,  or  Hydrops  Amnii. 
When  there  is  an  unusual  secretion  of  the  amniotic  and  allantoic 
fluids,  it  constitutes  what  has  been  termed  "  dropsy  of  the  amnion  " 
{hydrops  amnii  or  hydrainnios) ;  though,  as  Saint-Cyr  remarks,  as  there 
may  also  be  an  increase  of  the  allantoic  fluid,  it  would  be  more  exact 
to  designate  it  "  dropsy  of  the  fuetal  envelopes."  This  condition,  when 
very  marked,  is  serious  for  the  mother  as  well  as  the  foetus.  A  number 
of  cases  have  been  recorded,  and  Saint-Cyr  has  enumerated  sixteen, 
thirteen  of  which  occurred  in  the  Bovine,  two  in  the  Equine,  and  one  in 
the  Caprine  species  ;  one  has  also  been  observed  in  the  Bitch.  Gierer, 
who  has  published  an  interesting  account  of  several  cases,  observes 
that  it  is  most  frequently  met  with  in  poor,  badly  fed  animals — and 
particularly  in  Cows,  in  which  improper  hygiene  has  produced  a  morbid 
excitement  of  the  generative  organs ;  the  result  of  which  is  that 
exosmosis  and  endosmosis  do  not  take  place  equally  through  the  walls 
of  the  placentae  and  placentulie. 

Symptoms. — It  is  not  until  the  fifth  or  sixth  month  of  pregnancy,  or 
even  later,  that  indications  of  this  condition  are  evident.  Then  the 
abdomen  rapidly  enlarges,  especially  to  one  side — generally  the  right ; 
and  fn  a  short  time  it  has  acquired  a  greater  volume  than  it  has  towards 
the  end  of  gestation.  At  this  period  the  health  becomes  deranged,  and 
colic,  with  or  without  tympanitis,  is  not  unfrequent.  General  debility 
is  so  marked  that  the  animal  can  scarcely,  if  at  all,  stand ;  the  appetite 
is  lost,  rumination  is  suspended,  defecation  and  micturition  are  irregular, 
cedematous  swelling  of  the  limbs  and  abdomen  ensue,  with  dyspnoea, 
which  increases  so  quickly  in  intensity  that  asphyxia  is  often  innninent. 
The  muscular  parietes  of  the  abdomen  have  in  some  cases  been  rup- 
tured, and  the  entire  mass  of  the  uterus,  with  its  contents,  has  formed 
a  subcutaneous  liernia.  The  ordinary  period  of  gestation  may  be  com- 
pleted ;  or  abortion  may  occur  at  the  seventh  or  eighth  month,  when  all 
the  indications  of  such  an  occurrence  are  present.  The  uterine  contrac- 
tions, owing  to  the  relaxed  condition  of  this  organ,  and  its  distended 
and  paralysed  fibres,  are  weak,  the  pains  feeble  and  unsustained, 
the  OS  does  not  dilate,  and  the  act  of  parturition  is  consequently 
tedious. 

Diagnosis.— The  state  of  the  abdomen  miglit  lead  to  the  supposition 
that  the  case  was  one  of  tympanitis  or  twin  pregnancy,  .\bdominal 
percussion,  and  the  "  touch,"  as  well  as  auscultation,  should  aid  in 
diagnosing  this  condition.  Rectal  examination  will  reveal  the  immense 
size  of  the  uterus,  which  forms  a  great  globular  mass  in  the  abdominal 
cavity,  and  almost  completely  fills  the  pelvis,  though  nothing  of  a  fcrtus 
can  be  detected  ;  while  vaginal  exploration  discovers  the  cervix  uteri 
eff'aced,  the  os  closed,  and  the  posterior  part  of  the  uterus  projecting 
more  or  less  into  the  vagina  ;  pressure  on  this  prominent  portion  proves 
that  it  contains  fluid,  though  usually  no  fa-tus  can  be  felt,  as  it  is 
beyond  the  touch,  and  almost  lost  in  the  small  ocean  of  fluid  surrounding 
it.  In  rare  cases  the  os  is  partially  dilated,  and  the  fcctal  membranes 
protruding  more  or  less  into  the  vagina  ;  usually,  however,  scarcely  one 
or  two  fingers  can  be  introduced  into  it. 


186  PATHOLOGY  OF  FllEGXAXCY. 

Eesults. — The  occurrence  of  hydrops  amnii  is  nearly  always  fatal  to 
the  foetus.  In  none  of  the  cases  recorded  was  it  alive  ;  in  a  certain 
number  it  appeared  to  have  lived  up  to  the  period  of  parturition  or 
abortion ;  in  others  it  had  been  arrested  in  its  development,  and  was 
dead  for  some  time.  In  a  Goat,  the  two  foetuses  were  in  a  state  of 
general  anasarca,  being  completely  infiltrated. 

The  mother  may  or  may  not  survive.  Of  the  above  cases  four  perished 
from  the  disease  ;  one  was  killed  as  incurable  ;  another  recovered  after 
a  long  time  ;  one  was  subsequently  sold  for  food  ;  and  seven  or  eight  got 
well  so  rapidly  and  completely  as  to  be  bred  from  again.  The  results 
have,  as  a  rule,  been  more  favourable  as  assistance  has  been  prompt 
and  early. 

After  death  the  uterus  is  found  excessively  dilated,  its  walls  pale  in 
texture,  with  ecchymoses  on  its  surface.  The  foetal  membranes  vary, 
sometimes  being  thickened  and  dense,  and  at  other  times  attenuated 
and  friable.  The  fluid  has  been  found  contained  in  alveoli  or  cells, 
formed  by  the  processes  uniting  the  allantois  to  the  amnion ;  so  that 
the  membranes  might  be  torn  in  several  places  without  all  the  fluid 
escaping — in  this  respect  resembling  the  vitreous  humour  of  the  eye. 
The  liquor  is  usually  limpid  and  transparent,  or  of  a  pale  citron  colour, 
with  a  slightly  sweetish  taste  ;  its  quantity,  as  has  been  remarked,  is 
always  considerable  :  as  much  as  50,  70,  100,  120,  150,  and  even  200 
litres  having  been  found. 

The  digestive  organs  are  nearly  empty,  even  in  Bovines. 

Etiology. — As  in  woman,  so  in  animals,  the  etiology  of  this  condi- 
tion is  not  well  understood  ;  but  it  would  appear  that  it  may  be  due  to 
several  very  diverse  causes.  Multiparae  are  much  more  frequently 
affected  than  primiparae,  and  it  nearly  always  occurs  during  the  early 
months  of  pregnancy ;  the  foetus  is  generally  little  developed,  and  in 
the  majority  of  instances  is  dead  before  it  is  expelled.  It  has  been 
supposed  that  obstruction  to  the  foetal  circulation,  induced  by  torsion 
of  the  umbilical  cord,  may  act  in  producing  it,  or  imperfection  in 
function  of  the  heart  or  liver  of  the  foetus ;  the  death  of  the  foetus,  de- 
formities, monstrosities,  twin  pregnancies,  ascites,  and  other  causes 
have  been  enumerated  as  concomitant  or  exciting  causes.  But  until 
we  know  how  the  amniotic  and  allantoic  fluids  are  formed,  and  what 
their  normal  quantity  is,  it  is  not  probable  much  progress  will  be  made 
in  elucidating  the  etiology  of  this  pathological  condition. 

Treatment.  — The  chief  indication  is  to  evacuate  at  least  a  portion  of 
the  fluid,  by  rupturing  the  membranes,  as  medical  treatment  has  always 
proved  inefficacious.  It  must  be  remembered  that  the  foetus  is  always 
dead  ;  and  even  if  alive,  with  the  view  of  saving  the  life  of  the  mother, 
it  should  be  sacrificed.  Though  opening  the  amniotic  sac,  and  removing 
a  certain  quantity  of  the  liquor,  need  not  necessarily  compromise  the 
existence  of  the  foetus ;  as  a  case  has  been  published  by  Lhomme^ 
in  which  a  portion  of  the  foetal  membranes,  protruding  beyond  the 
vulva,  was  excised  without  interfering  with  the  ordinary  progress  of 
gestation  ;  for  when  parturition  occurred  three  months  afterwards,  a 
well-formed  Mule  was  born  and  continued  to  live. 

The  chances  of  success  are  greater  as  intervention  takes  place  early, 
and  before  the  abdomen  is  excessively  distended,  the  respiration  not 
seriously  affected,  and  debility  not  great. 

'  Journal  de  Vtttririairt  du  Midi,  1869. 


DISEASES  ISClDKyTJL   T<>  rnEnX.i.MY,  187 

The  evacuation  should  be  etTected  through  the  vagina,  though  it  has 
been  made  through  a  puncture  in  the  flank.  If  the  fatal  membranes 
are  in  the  vagina,  they  may  be  ruptured  by  the  fingers  there;  if  not,  and 
the  OS  is  sufficiently  dilated  for  the  admission  of  the  hand,  they  may  be 
ruptured  in  the  uterus  ;  if  it  is  closed  it  should  be  gently  dilated,  and 
the  envelopes  punctured,  if  necessary,  by  means  of  a  trocar  and  canuula. 
As  soon  as  the  membranes  are  pierced,  a  gush  of  Huid  takes  place,  the 
abdomen  diminishes  in  volume,  the  uterus  becomes  retracted,  and  in  this 
retraction  the  fct'tus  and  membranes  are  sometimes  expelled.  Sliould  this 
expulsion  not  take  place  soon,  they  must  be  removed  in  the  ordinary  way. 
Afterwards,  the  animal  is  to  be  carefully  attended  to  and  generously  fed. 

Paraplegia. 

What  has  been  termed  paralysis  of  the  posterior  extremities  is  not 
rare  in  the  Cow  during  gestation,  especially  when  near  parturition,  and 
often  even  when  that  act  has  commenced.  Antc-partum  paresis  would 
perhaps  be  .a  better  designation,  as  in  the  great  majority  of  cases  the 
debility  which  compels  the  animal  to  remain  in  a  recumbent  position, 
is  merely  the  efi'ect  of  pregnancy  and  the  increased  weight  the  creature 
is  called  upon  to  support.  It  has  also  been  witnessed  in  the  Sheep  and 
Goat,  and,  though  very  rarely,  in  tlie  Mare.  (Generally,  however,  it 
appears  six,  eight,  ten,  or  twenty  days,  rarely  a  month  or  two,  previous 
to  parturition,  and  attacks  animals  in  the  most  diverse  hygienic  con- 
ditions—  those  which  are  well  fed  and  tended,  as  well  as  those 
which  receive  the  opposite  treatment.  It  is  not  rare  to  observe  in 
a  cow-shed,  two  or  three  cases  occurring  a  short  distance  from  each 
other,  and  even  in  a  locality  we  may,  in  certain  years,  meet  witli  a 
number  of  cases  ;  then  several  consecutive  years  may  elapse  without 
any  being  noted,  though  it  would  be  a  manifest  exaggeration  to  say  that 
it  was  eitlier  an  epizootic  or  enzootic  malady.  It  must  not  be  con- 
founded with  what  has  been  termed  "  parturient  fever,"  or  "  parturient 
apoplexy,"  in  which  we  have  paralysis,  but  from  wliich  it  differs  greatly, 
as  the  sympton)s  and  results  will  show. 

The  paralysis  of  gestation  generally  appears  suddenly  and  without 
any  premonitory  symptoms,  manifesting  itself  with  tiic  same  intensity 
at  the  outset  as  at  a  later  period  ;  though  in  rare  cases  the  animal 
shows  a  weakness  and  unsteadiness  of  the  posterior  part  of  the  body 
and  hind  limbs  for  a  short  time  before  it  drops,  and  the  end  of  the  tail 
is  said  to  be  remarkably  flaccid.  When  paralysis  has  really  set  in,  the 
Cow  is  forced  to  lie,  but  it  does  not  appear  to  suffer  ;  the  position  is 
natural,  the  head  carried  as  usual,  the  eye  bright  and  clear,  the  muffle 
damp  and  cool,  and  rumination  in  the  majority  of  instances  is  not 
suspended ;  the  pulse,  res])iration,  and  appetite  are  unaltered,  and 
sensation  does  not  seem  to  be  impaired,  even  in  the  hind  limbs — it  may 
be  exalted.  Constipation  is  frequently  present.  It  is  only  when  the 
animal  attempts  to  rise  that  its  condition  is  evident  ,  the  fore  limbs 
and  neck  can  be  moved  to  accomplish  this,  but  the  hinder  extremities 
are  powerless,  or  can  only  be  raised  to  a  slight  extent  ;  though  with 
help  it  may  be  lifted  up  and  can  then  stand,  but  unsteadily. 

Ordinarily,  the  paralysis  persists  until  parturition,  when  it  disappears  ; 
though  Saint-Cyr  mentions  an  instance  in  which  a  Cow  became  para- 
lysed twenty-eight  days  before  that  event,  and  lay  on  the  litter  for  two 
days  after  calving,  without  being  able  to  move  its  hind  extremities  ; 
but  it  arose  spontaneously  on  the  third  day,  and  did  well.     The  same 


1 88  PA  THOLOG  Y  OF  PIlEGNANCY. 

authority,  however,  states  that  he  has  occasionally  witnessed  the  para- 
lysis persist  for  a  longer  time  after  calving,  and  either  cause  death  or 
necessitate  slaughter.  I  have  seen  a  Sheep  which  eventually  died  from 
this  ante-partum  paralysis.  When  the  paresis  appears  towards  the 
seventh  or  eighth  month  the  prospect  of  recovery  is  not  so  favourable  ; 
though  the  prognosis  must  to  a  large  extent  depend  upon  the  cause. 
If  the  animal  is  old  or  debilitated  there  is  less  hope  for  recovery.  "When 
it  can  move  the  hind  limbs  after  a  day  or  two,  and  change  its  position 
from  one  side  to  another,  a  favourable  issue  may  be  predicted. 

The  cause  is  somewhat  obscure,  but  is  supposed  to  be  due  to  com- 
pression, or  rather  straining,  of  the  nerves  and  vessels  of  the  posterior 
extremities  by  the  heavy  uterus.  In  five  or  six  cases  there  has  been 
found,  on  ])ostmortem  inspection,  infiltration  of  the  dorso-lumbar  and 
gluteal  muscles,  and  discoloration  of  the  muscular  fibres.  The  spinal 
canal  has  also  contained  a  large  quantity  of  serum,  and  the  membranes 
of  the  spinal  cord  are  injected.  From  the  rapidity  with  which  recovery 
generally  takes  place,  it  is  obvious  that  the  lesions  cannot  be  serious  in 
many  cases.  Debility  from  insufficient  or  poor  quality  of  food  may 
induce  this  condition ;  getting  jammed  and  unable  to  get  up  in  the  stall 
may  also  bring  it  about,  as  well  as  slipping  or  falling  down  and  injuring 
bones  or  muscles. 

Treatment. — The  first  thing  to  be  done  is  to  ascertain,  if  possible, 
upon  what  the  paresis  depends,  as  upon  this  treatment  must  be  based. 
It  is  advisable  in  most  cases  to  get  the  animal  up,  either  with  or  without 
help  ;  but  if  it  cannot  stand,  and  slinging  is  not  advisable,  then  it  must 
be  made  comfortable  in  the  recumbent  position,  and  turned  over 
frequently  ;  peat-moss  makes  the  best  litter.  In  the  majority  of  cases, 
and  especially  before  parturition,  little  treatment  is  necessary.  The 
principal  indication  is  to  avert  or  get  rid  of  constipation  by  means 
of  laxatives  and  enemas,  and  to  pay  attention  to  the  diet  and  cleanli- 
ness, while  enjoining  quietude.  If  the  paralysis  is  due  to  debility,  then 
highly  nutritious  food  and  tonics  should  be  given.  If  congestion  of  the 
spinal  cord  is  suspected,  then  stimulating  applications  to  the  spine 
should  be  resorted  to.  Should  the  paralysis  persist  and  the  time  for 
parturition  be  some  months  distant,  it  may  be  necessary  to  induce 
abortion,  as  protracted  recumbency  generally  produces  superficial  sores 
of  large  extent.  Should  the  paralysis  continue  for  any  length  of  time 
after  parturition,  then  more  energetic  treatment  may  be  adopted.  In 
these  cases,  the  subcutaneous  injection  of  strychnine  is  nearly  always, 
attended  with  success. 

Crmnp. 

Cramp — by  which  is  meant  a  tonic,  involuntary,  and  extremely 
painful  contraction  of  one  or  more  voluntary  muscles — is  sometimes 
observed  in  the  Mare  and  Cow  during  the  second  half  of  gestation,  the 
muscles  of  the  thigh,  and  chiefly  the  principal  extensor  of  the  meta- 
tarsus, being  almost  exclusively  involved.  When  affected,  the  animal 
either  suddenly  and  rapidly  flexes  and  extends  the  limb — striking  the 
ground  hurriedly  and  energetically  with  the  foot,  as  if  a  fly  had  settled 
on  the  leg,  or  the  whole  limb  is  gradually  and  rigidly  elevated  without 
flexure  of  the  joints,  except  those  of  the  phalanges,  which  are  half 
flexed,  the  anterior  aspect  of  the  hoof  being  directed  towards  the  ground; 
at  the  same  time  the  muscles  of  the  leg  are  hard,  tense,  and  painful  to 
manipulate,  and  the  animal  betrays  the  torture  it  experiences  by  its 


DISEASES  INCIDEyrAL    To  I'llEOXAXCV.  189 

expression  and  attitudes.  This  manifestation  is  increased  if  the  Mare 
is  compelled  to  walk,  its  first  steps  being  extremely  dillicult ;  while  the 
limb  is  maintained  in  a  perfectly  rigid  condition,  and  the  indications  of 
pain  most  marked.  In  a  short  time  these  symjjtoms  disappear,  and 
movement  is  restored.  The  cramp  may  pass  from  one  hind  limb  to 
another  alternately,  and  appears  to  be  due  to  the  compression  exer- 
cised on  the  sciatic  nex've  in  its  course  over  the  sacro-sciatic  ligament. 
This  cramp  has  much  analogy,  in  its  symptoms,  to  luxation  of  the 
patella ;  from  this  it  may  be  distinguished,  however,  by  the  latter 
occurring  most  frequently  in  young  animals,  by  the  displacement  of  the 
patella,  and  by  the  total  inability  to  flex  the  limb  until  the  patella  has 
been  replaced. 

Cramp  is  of  no  moment,  and  can  be  relieved  by  walking  the  animal 
for  a  few  paces,  or  by  smart  friction.  It  disappears  altogether  after 
parturition. 

Eclampsia. 

Saint-Cyr  speaks  of  a  report  by  Lafitte,  in  which  three  Bitches  are 
stated  to  have  been  affected  with  eclampsia  during  pregnancy.  The 
symptoms  were  acute  clonic  convulsions,  which  were  at  times  remittent, 
with  unsteadiness  of  the  limbs,  but  without  total  loss  of  sensibility, 
hearing  or  vision.  The  successful  treatment  was  milk  diet,  ten  centi- 
grammes of  fucsine  morning  and  evening  in  milk,  and  at  the  same 
periods  enemata  of  chloral  hydrate. 

Cerebral  Cnnrjestion. 

Saint-Cyr  and  Violet  speak  of  cerebral  congestion  as  one  of  the  con- 
comitants of  pregnancy,  and  they,  as  well  as  some  English  and 
foreign  veterinary  surgeons,  consider  it  identical  with  the  condition 
known  as  "  parturient  apoplexy."  But  it  would  appear  that  this  ante- 
partum cerebral  congestion  is  very  rare,  and  is  due  to  a  plethoric  condi- 
tion and  lack  of  exercise  ;  though,  as  has  been  observed,  and  as  will  be 
again  remarked,  this  and  other  affections  of  the  nervous  system  some- 
times witnessed  during  this  period,  may  be  due  to  uncmia  and  albumin- 
uria, which  are  not  unfrequently  the  cause  of  similar  disturbances  in 
woman. 

Reference  to  the  symptoms  and  treatment  of  this  brain  congestion 
will  therefore  be  deferred  until  post- part  tun  congestioii  or  apoplexy  is 
dealt  with. 

7///.s7r /•/</. 

This  would  appear  to  be  a  very  infrequent  concomitant  of  pregnancy, 
as  I  can  only  find  one  instance  recorded. 

Olver  ( Veterinary  Journal,  vol.  vii.,  p.  36")  dc-icnla's  the  cane  of  n  thoroii^jhhred 
Mare,  four  months  pregii.int,  which  was  suddenly  attacked  with  trrt-at  nervcuis  excite- 
ment, accompanied  by  profuse  pi-rsjiiration,  great  difficulty  in  walking,  straddlintr  gait, 
continual  micturition,  etc.  The  8li^;htcst  noise  increased  the  excitement.  There  wa"* 
great  rigidity  of  the  muscles,  particularly  those  of  the  gluteal  region,  and  at  a  later 
period  volition  appeared  to  he.  abolished,  the  limbs  acting  merely  as  mechanical 
props  ;  the  eyes  were  turned  upwards  as  if  in  a  trance,  and  the  animal  was  quite  blind  ; 
there  was  frequent  neighing,  and  continual  o]>ening  and  closing  of  the  viilva,  with 
the  expulsion  of  small  qu.'intities  of  urine,  and  a  highly  congested  condition  of  the 
vaginal  mticou.i  membrane  ;  the  pulse  was  eighty-two  f)er  minute,  and  the  respirations 
Were  accelerated.  There  wa-s  every  symptom  of  nostrum.  .\b  there  was  difficulty  in 
swallowing,  coniie  wa-<  injected  subcutaneously,  and  with  the  most  satisfactory  effect. 
Next  day  she  was  still  perfectly  blind,  and  even  more  nervous  ;  but  she  had  gradually 
recovered  consciousness,  and  took  a  little  f<K>d.     The  pulse  in  the  evening  was  n'>rmal. 


190  PATHOLOGY  OF  PREGXANCY, 

and  the  muscles  had  lost  much  of  their  rigidity,  while  the  aervous  excitement  had  sub- 
sided ;  there  was,  however,  great  thirst  and  obstinate  constipation.  The  latter  were 
relieved  by  suitable  remedies,  but  some  days  elapsed  before  vision  was  regained.  She 
did  well  subsequently,  and  proved  to  be  in  foal. 

Amaurosis. 
The  only  instances  of  amaurosis  occurring  in  connection  with  preg- 
nancy, are  two  given  by  Eiss.^ 

A  Mare,  nine  years  old  and  in  good  condition,  when  advanced  in  pregnancy  became 
blind.  On  the  eyes  being  examined  by  Riss,  the  humours  and  lens  were  found  to  be 
quite  healthy,  but  amaurosis  was  complete.  A  blister  was  applied  to  each  cheek,  and 
other  treatment  adopted,  but  without  success.  The  day  following  parturition,  which 
occurred  about  a  month  afterwards,  vision  was  perfectly  restored. 

A  seven -year- old  Mare,  when  near  parturition,  and  which  had  never  exhibited  any- 
thing the  matter  with  its  eyes,  suddenly  became  blind  from  amaurosis.  Remembering 
the  other  case,  Riss  abstained  from  treatment.  The  Mare  foaled  in  thirteen  or  fourteen 
days  after  loss  of  sight  had  been  noted,  and  on  the  third  day  after  this  occurrence  it  was 
able  to  see  as  well  as  ever. 

CoUfjll. 

We  have  mentioned  hydramnios  as  a  cause  of  disturbance  in  the 
respiration,  the  obstacle  to  which  is  often  a  marked  symptom  of  that 
condition.  But  even  without  the  existence  of  this  kind  of  dropsy,  the 
breathing  is  not  unfrequently  impeded  in  pregnant  animals,  and  this 
obstruction  is  sometimes  accompanied  by  a  very  harassing  nervous 
cough,  which,  in  the  larger  animals,  and  particularly  in  the  Mare,  may 
lead  to  injury.  For  the  relief  of  this  cough,  Zundel  recommends  the 
cyanide  of  potassium,  but  other  drugs  will  also  act  in  allaying  it. 

Albumimiria. 
The  existence  of  albuminuria  in  pregnant  women  has  long  been 
known,  and  Zundel  gives  it  as  one  of  the  complications  or  accompani- 
ments of  gestation  in  animals  ;  though  he  does  not  look  upon  it  as  a 
pathological  condition.  Others,  on  the  contrary,  think  that  this  is  a 
matter  well  deserving  further  investigation;  for  as,  as  has  been  mentioned, 
various  kinds  of  nervous  disturbance — eclampsia,  paraplegia,  amaurosis, 
etc. — are  probable  consequences  of  albuminuria  in  the  human  female, 
there  is  no  reason  why  they  may  not  be  so  in  animals. 

Mamviitis. 

Mammitis  is  another  very  rare  occurrence  during  pregnancy,  and  the 
cases  recorded  by  Saint-Cyr  and  Violet  only  number  three — two  Heifers 
five  or  six  months  pregnant,  and  a  Mare.  In  the  former  the  udder  was 
much  swollen,  and  from  one  or  two  of  the  teats  a  reddish  serous  fluid 
could  be  extracted,  while  it  was  thick  and  syrupy  in  the  others  ;  there 
was  also  fever,  loss  of  appetite,  and  sluggishness.  By  means  of  appro- 
priate treatment  all  the  symptoms  were  subdued  ;  but  for  a  considerable 
time  it  was  necessary  to  withdraw  the  fluid  from  the  teats.  One 
Heifer  went  to  the  end  of  her  pregnancy,  but  the  other  aborted  some 
weeks  before.  The  Mare  had  already  produced  Foals,  but  the  udder 
had  regained  its  natural  size  before  she  again  became  pregnant.  The 
inflammation  of  the  udder  was  not  severe,  though  a  large  abscess  formed 
in  it ;  this  was  opened,  and  recovery  quickly  ensued,  without  permanent 
damage  to  the  gland. 

Bed  Colostrum. 

Saint-Cyr  speaks  of  red  colostrum  appearing  in  the  Cow  during  the 
last  two  weeks  of  pregnancy ;  it  may  suddenly  disappear,  or  it  may  con- 
^  Recueil  de  Medecine  Veterinaire,  1831. 


ACCIDEXTS  OF  r/!K';.\.l.\ry.  19! 

tinue  until  after  parturition.  It  docs  not  demand  any  attention,  unless 
the  udder  is  very  large  and  hard,  when  it  would  be  beneficial  to  draw 
the  teats  frequently. 


CHAPTER  III. 
Accidents  of  Pregnancy. 

Though  a  distinction  between  the  diseases  and  accidents  of  pre^'nancy 
cannot  always  be  readily  drawn,  yet  for  convenience  we  follow  Saint- 
Cyr  in  allotting  to  a  separate  chapter  those  conditions  or  diseases  which 
may  be  due  to  accidental  causes,  operating  either  externally  or  inter- 
nally. These  are  prolapsus  of  the  vagina,  henna  of  the  uterus,  rupture 
of  the  uterus,  metrorrhagia,  abnormal  retention  of  the  fn'tn-o  and  abo7-- 
tion. 

Antk-i'Aktim  Pholapsuk  or  thk  Vagina. 

Prolapsus  vagiuie,  or  itivcrsio  vagi)ue,  has  been  observed,  so  far  as 
I  can  ascertain,  most  frequently  in  the  Cow  and  Sheep  ;  rarely  in  the 
Mare  or  Bitch.  It  consists  in  the  protrusion,  or  i^ushing  backwards,  of 
the  vagina  by  the  uterus  and  its  contents  during  pregnancy,  the  tumour 
it  forms  appearing  between  (inversio  vagime  incompleta),  or  external  to 
(invcrsio  vagime  completa),  the  labia  of  the  vulva.  It  must  not  be  con- 
founded with  post-partum  prolapsus.  This  accident  is  peculiar  to 
pregnancy,  and  may  occur  in  well-shaped  Cows,  but  whose  tissues,  and 
especially  those  of  the  genital  organs,  are  soft  and  relaxed — animals  of 
a  lymphatic  temperament,  good  milkers,  with  a  wide  pelvis,  and  which 
are  fed  on  an  abundance  of  bulky  but  innutritions  food.  Keeping  such 
Cows  on  a  floor  sloping  too  much  to  the  rear,  as  well  as  falls,  injuries 
of  different  kinds,  distention  of  the  rumen,  fatigue,  etc.,  arc  all  likely  to 
lead  to  this  accident  in  such  animals,  when  pregnant.  It  is  observed, 
though  very  rarely,  in  primiparu',  and  occurs  most  frequently  after  the 
third  or  fourth  gestation,  the  period  of  its  appearance  during  tliat  state 
varying  ;  in  certain  Cows  manifesting  itself  so  early  as  the  fifth  month 
(though  this  is  rare),  and  oftenest  at  the  end  of  the  seventh  or  eighth 
month,  and  even  so  late  as  twenty  or  fifteen  days  before  delivery. 

The  occurrence  of  the  accident  is  made  known  by  the  appearance,  at 
the  vulva,  of  a  circular,  bright-red  tumour,  depressed  in  the  centre,  and 
of  a  variable  but  gradually  increasing  si/e  as  gestation  advances,  or  the 
exciting  causes  remain  in  operation — from  the  volume  of  a  fist  to  that 
of  the  head  of  a  child  or  man,  or  even  larger.  At  first  it  is  only  visible 
when  the  animal  is  lying,  and  disappears  when  it  gets  up  ;  but  when  of 
considerable  volume  it  never  entirely  vanishes  in  the  latter  attitude,  and 
even  when  reduced  by  the  hand  the  vulva  renuiins  larger  than  usual. 

If  existing  for  some  time,  however,  in  certain  cases  infiltration  takes 
place  and  inflammation  may  ensue,  when  a  large  ajid  somewhat  dense 
tumour  projects  permanently  outside  the  vulva,  the  circumference  of 
the  latter  constricting  it  and  rendering  matters  worse.  The  colour  now 
becomes  a  darker  red,  and  even  dark  brown  ;  the  tumour  may  be 
abraded  on  the  surface  from  the  rubbing  of  the  tail  and  contact  with 
the  faDces  and  urine,  while  at  its  upper  part  can  be  seen  the  neck  of  the 
uterus.  The  animal  does  not  seem  to  be  incommoded,  unless  it  be  of  an 
irritable  disposition,  when  straining  Jiay  take  place,  and  this  increasing 
in  intensity,  the  cervix,  and  even  a  portion  of  the  body  of  the  uterus, 


192  PATHOLOGY  OF  PREGNAXCY. 

will  follow  the  everted  vagina,  and  a  spontaneous  reduction  can  no 
longer  take  place,  while  manipulation  increases  the  straining.  This  is 
in  reality  now  a  case  of  ijrolcqMiis  uteri,  and  an  examination  of  the 
voluminous  mass  may  lead  to  the  detection  of  some  portion  of  the  foetus 
in  its  midst.  Not  only  this,  but  the  prolapsus  of  vagina  and  uterus 
will,  in  all  probability,  produce  displacement  of  the  bladder,  and  when 
this  is  distended  with  urine  it  will  gravely  complicate  the  case  and 
render  reduction  more  difficult. 

According  to  Cox,i  Sheep,  when  heavy  in  Lamb,  frequently  evert  a 
double  fold  of  the  vaginal  mucous  membrane.  This  happens  when 
they  are  in  a  recumbent  position,  and  it  is  in  some  animals  of  such 
frequent  occurrence  as  to  cause  excoriation  and  ulceration. 

Tkeatment. — This  prolapsus,  in  the  majority  of  cases,  does  not  appear 
to  cause  the  slightest  inconvenience  to  the  animal,  and  offers  no  obstacle 
to  parturition — indeed,  it  has  been  noted  that  such  Cows  calve  more 
easily  than  others  ;  neither  does  it  predispose  to  chronic  eversion  of  the 
vagina,  as  has  often  been  supposed.  After  calving,  the  vaginal  tumour 
disappears  without  any  treatment  being  required.  But  if  treatment  is 
necessary,  the  first  thing  to  be  done,  should  the  floor  of  the  stall  be  lower 
behind  than  in  front,  is  to  level  it,  or  even  raise  it  a  little  behind.  This 
may  be  readily  accomplished  by  means  of  the  litter.  The  diet  may 
also  require  attention,  giving  that  which  contains  sufficient  nutriment 
in  small  bulk ;  constipation  should  be  guarded  against  or  remedied. 
This  treatment  will  be  sufficient  in  the  majority  of  cases.  In  others,  a 
bandage,  to  be  hereafter  described,  may  be  required,  and  especially  if 
the  tumour  is  liable  to  become  soiled  and  irritated  when  the  animal  is 
lying. 

In  serious  cases,  when  the  tumour  is  large  and  the  Cow  strains,  and 
spontaneous  reduction  does  not  occur  in  the  standing  position,  the  mass 
must  be  returned.  This  is  readily  enough  accomplished  ;  but  it  some- 
times happens  that  reduction  does  not  prevent  a  continuation  of  the 
straining,  and  even  with  the  bandage  the  everted  vagina  again  appears. 
This  is  due  to  the  mucous  membrane,  which,  not  having  been  properly 
smoothed  down  when  introduced  into  the  pelvic  cavity,  is  ridged,  and 
these  rugae  give  rise  to  an  uncomfortable  sensation,  and  induce  expul- 
sive efforts. 

It  is  necessary,  therefore,  in  reducing  the  part,  to  cleanse  it  well  with 
tepid  water,  and  to  smooth  the  vaginal  mucous  membrane  by  gentle 
pressure  forward  as  far  as  the  cervix  uteri,  in  order  to  efface  any  folds 
which  may  excite  uneasiness.  After  this  the  bandage  may  be  applied 
with  a  view  to  keeping  the  vulva  closed,  until  its  labia  have  retracted 
somewhat.  Wire  sutures  through  these  have  been  recommended,  but 
they  are  very  rarely  required. 

In  very  exceptional  instances,  we  may  have  not  only  complete  pro- 
lapsus vaginae,  but  also,  as  has  been  said,  partial  protrusion  of  the 
uterus  itself.  Then  the  case  is  very  serious,  owing  to  the  excessive 
straining  and  the  weight  and  bulk  of  the  foetus,  which  has  to  be 
returned  beyond  the  inlet  of  the  pelvis. 

But  in  the  majority  of  cases  reduction  may  be  successful,  and  appar- 
ently desperate  cases  may  be  saved  by  the  exercise  of  patience  and  tact. 
The  Cow  must  be  made  to  stand,  with  the  hind  quarters  as  high  as 
possible,  and  to  prevent  straining  the  loins  should  be  pressed  upon 
'    Veterinary  Journal,  vol.  i.,  p.  267. 


ACCIDENTS  OF  JPJiEGXJXCV.  103 

in  a  forcible  manner,  as  recommended  by  Saint-Cyr,  by  means  of  a  stick 
placed  transversely,  a  man  at  each  end,  another  pulling'  out  the  tongue 
and  pinchin«;  the  septum  of  the  nose.  Attempts  at  reduction  can  only 
be  made  in  the  intervals  of  strainim,',  and  during  the  straining  all  that 
can  be  done  is  to  resist  further  expulsion.  Having  returned  the  dis- 
placed organs  into  the  pelvis,  the  arm  and  list  must  follow  them,  and  by 
pressing  on  the  cervix  of  the  uterus  so  act  on  the  mucous  membrane  of 
the  vagina  as  to  leave  no  folds  or  ridges  in  it ;  when  the  straining  has 
ceased,  which  usually  occurs  very  soon,  the  arm  may  be  withdrawn, 
though  the  practitioner  must  be  on  the  outlook  for  its  recurrence,  and 
prepared  to  prevent  another  extrusion.  This  may  be  guarded  against 
by  the  use  of  a  pessary  consisting  of  a  wooden  rod  from  one  to  two  feet 
long,  furnished  with  a  head  several  inches  in  diameter  and  covered  with 
some  soft  material,  or  a  ring  fixed  horizontally  at  the  end  sufficiently 
wide  to  go  over  the  cervix  ;  this  end,  well  greased,  is  to  be  inserted  in 
the  vagina  in  such  a  manner  as  to  keep  the  uterus  in  the  pelvic  cavity, 
the  other  end  being  fixed  by  a  cord  at  each  side  to  a  girth  round  the 
body  or  elsewhere.  An  ordinary  quart  bottle  with  a  concave  bottom 
may  be  employed  on  an  emergency,  a  round  piece  of  wood  driven  into 
the  neck  making  it  sufliciently  long.  So  long  as  this  pessary  is  worn — 
and  it  may  be  allowed  to  remain  in  the  genital  canal  for  a  considerable 
period — the  vagina  should  be  syringed  daily  with  warm  water  and  a 
mild  astringent.  Death  is  often  the  result  of  such  an  accident ;  and 
to  prevent  a  fatal  termination,  it  has  been  suggested  that  artificial 
delivery  should  be  effected  without  delay.  Premature  delivery  has  been 
counselled  in  those  cases  in  which  the  Cow  continues  to  strain  and  evert 
the  vagina,  notwithstanding  bandages,  sutures,  and  other  means,  and 
when  grave  consequences  are  likely  to  follow  ;  more  especially  is  this 
advice  to  be  adopted  when  pregnancy  has  reached  the  2G0th  day,  and 
the  Calf  is  alive.  Perforation  of  the  membranes  may  be  effected  by  the 
fingers  after  they  have  dilated  the  os.  There  is  no  difficulty  in  parturi- 
tion, as  a  rule  ;  but  care  is  necessary  for  some  days  afterwards  to 
prevent  inversion. 

With  ^leep,  according  to  Cox,  it  is  a  common  custom  to  return  the 
partially  prolapsed  vagina,  and  to  tie  the  wool  across  the  vulva  ;  on 
other  occasions  a  truss,  similar  to  that  used  for  cattle,  is  employed. 
Both  metiiods  frequently  fail,  and  in  these  cases  nothing  answers  so 
well  as  the  ring-shaped  pessary  of  a  small  size. 

Hernia  of  the  Utehus  (IIystekocele). 

Ilernia  of  the  uterus  is  not  uncommon  in  the  domesticated  animals, 
and  has  been  observed  in  the  Mare,  Cow,  Sheep,  Goat,  and  Bitch.  In 
the  latter  animal  the  organ  is  often  displaced  before  conception,  and 
the  fcctus  is  developed  in  the  hernia  ;  but  with  the  larger  creatures  the 
empty  uterus  is  too  far  removed  from  the  abdominal  parietes  to  escape 
from  the  cavity  ;  and  it  is  only  when  its  volume  is  increased  as  gestation 
advances,  that  it  may  form  a  hernia,  should  there  exist  an  accidental 
opening  in  the  muscles  wliich  enclose  the  cavity.  In  the  Bitch  the 
hernia  may  be  inguinal ;  in  the  other  animals  it  is  always  accidental 
and  ventral,  and  usually  towards  the  inferior  part  of  the  abdomen — on 
the  right  or  left  side,  or  in  the  pubic  region. 

Its  ordinary  cause,  when  accidental,  is  due  to  the  natural  or  spon- 
taneous relaxation  of  the  abdominal  aponeuroses  ;  or  to  traumatism,  as 

13 


194  PATHOLOGY  OF  PREGNANCY. 

contusions  or  strains,  the  viscus  being  generally  only  covered  by  the 
skin.     It  is  rare  in  young  animals. 

In  the  Cow  it  is  not  at  all  unusual  to  observe  the  hernial  tumour  in 
front  of  the  pubis,  towards  the  attachment  of  the  rectus  muscle,  and  near 
the  udder  ;  here  it  may  be  of  a  great  size,  extending  as  low  as  the  hocks, 
pushing  the  mammary  gland  to  one  side,  reaching  as  far  forward  as  the 
floating  ribs,  and  containing,  in  addition,  other  of  the  abdominal  viscera 
than  the  uterus  and  its  contents.  This  tumour  impedes  movement ;  the 
hind  limbs  are  kept  widely  separated,  and  the  animal  is  much  incon- 
venienced. 

With  the  Bitch,  ventral  hysterocele  has  been  noted  in  two  regions — 
above  the  mammae,  where  it  might  be  mistaken  for  a  scirrhus  tumour  ; 
and  in  one  of  the  labia  of  the  vulva,  beneath  the  skin. 

In  the  larger  animals,  the  foetus  may  sometimes  be  felt  in  the  tumour, 
and  its  movements  may  be  noticed  ;  though,  owing  to  its  being  so  low, 
it  cannot  be  reached  from  the  rectum. 

Very  often,  excepting  the  inconvenience  to  the  female,  hysterocele 
does  not  interfere  with  gestation,  nor  give  rise  to  any  serious  symptoms ; 
though,  in  some  cases,  it  may  render  parturition  laborious  and  protracted, 
if  not  impossible.  In  other  cases  this  act  may  be  accomplished  without 
difficulty  or  extraneous  aid ;  Cows  which  have  been  ruptured  from  the 
perineum  to  the  ribs  have  calved  easily  enough  ;  and  Leconte  alludes  to 
a  Mare  which  had  a  uterine  hernia  nearly  as  extensive  as  this,  and  yet 
brought  forth  four  living  Foals  in  succession. 

Nevertheless,  it  is  somewhat  of  a  risk  to  attempt  to  breed  from  such 
animals.  When  treating  of  difficult  parturition,  we  shall  have  occasion 
to  return  to  this  subject.  In  the  meantime,  it  is  only  necessary  to  say 
that  in  order  to  obviate  serious  consequences,  the  hernia  should  be 
supported  by  a  wide  bandage  until  the  uterine  contents  are  expelled. 
Should  circumstances  render  it  necessary,  abortion  may  be  artificially 
induced,  or  hysterotomy  may  be  performed. 

It  may  be  observed  that  care  is  necessary  in  diagnosing  mammary 
uterine  hernia  in  the  Bitch,  so  as  not  to  mistake  it  for  a  mammary 
tumour.  I  have  known  of  one  blunder  of  this  kind,  and  have  heard  of 
another  in  which  an  operation  was  performed  for  the  removal  of  the 
tumour,  in  which  two  foetuses  were  found,  and  the  Bitch  subsequently 
died.  In  my  case  no  operation  was  attempted,  and  though  the  hernia 
was  somewhat  large,  yet  the  animal  brought  forth  her  Puppies  without 
any  apparent  difficulty. 

Ante-pabtum  Euptuee  op  the  Uterus. 

Rupture  of  the  uterus  may  happen  before  and  during  parturition,  or 
in  attempts  to  reduce  the  organ  when  inversion  has  occurred  during 
that  act.  The  accident  has  been  observed  in  the  Cow,  Sheep,  Goat, 
and  Bitch ;  it  is  not  very  common  before  gestation  has  terminated,  and 
the  symptoms  by  which  it  can  be  diagnosed  are  not  very  reliable. 
Spontaneous  rupture  of  the  uterus  usually  occurs  at  the  anterior  part  of 
the  organ,  between  the  two  cornua,  or  even  in  the  cornua  themselves  ; 
the  direction  of  the  rupture  generally  depending  on  the  direction  of  the 
muscular  fibres — being  sometimes  diagonal,  at  other  times  transversal, 
and  more  rarely  longitudinal.  The  size  of  the  rupture  also  varies  con- 
siderably ;  though  it  must  be  remembered  that  in  the  dead  animal 
ruptures  only  appear  in  their  original  dimensions  when  the  uterus  had 


ACCIHEXTS  OF  PJ{KC!XJ.\'CV.  105 

ost  its  contractility  before  death,  and  ininiediatoly  after  their  produc- 
tion ;  when  the  organ  has  contracted  after  the  accident,  the  extent  of 
the  laceration  is  much  diminished.  The  Hps  of  tlie  wound  are  in  some 
cases  thin  and  ragged,  in  others  swollen  and  inflamed.  The  texture  of 
the  uterus  itself,  in  the  vicinity  of  the  rupture,  may  be  quite  healthy,  or 
it  may  be  inflamed,  softened,  or  gangrenous ;  while  the  peritoneum  is 
normal  or  inflamed.  The  blood  elTused  into  the  abdominal  cavity  may 
be  in  large  quantity  or  scarcely  noticeable,  and  it  may  or  may  not  be 
decomposed. 

According  as  the  tissue  of  the  uterus  is  more  or  less  completely  torn, 
the  ruptures  have  been  divided  into  those  which  are  "  complete"  and 
"  incomplete."  In  the  first,  the  cavity  of  the  organ  communicates 
freely  with  that  of  the  abdomen  ;  while  in  the  second,  the  peritoneum, 
or  sometimes  a  portion  of  the  muscular  layer,  is  intact. 

The  foregoing  remarks  refer  to  longitudinal  rupture  of  the  uterus,  but 
Saint-Cyr  alludes  to  w^hat  the  Italian  veterinarians  designate  as  semi- 
mobile  nterus,  and  which  he  believes  to  be  allied  to  rupture.  This  is  a 
condition  in  which  the  uterus  has  been  completely  divided  across, 
either  at  the  body  or  the  cornua,  and  remains  floating  in  the  abdominal 
cavity,  being  only  suspended  by  the  broad  ligaments.  The  most 
singular  fact  connected  with  these  cases  is,  that  although  the  uterus  is 
torn  in  this  manner,  its  contents— the  foetus  and  membranes — do  not 
escape ;  the  wound  cicatrises,  and  the  organ  appears  as  a  large  cystoid 
tumour.  Ercolani,  Veterinary  Professor  at  the  Bologna  University,  has 
met  with  four  instances  of  this  extraordinary  accident,  the  pathological 
specimens  being  deposited  in  the  museum  of  that  institution.  Their 
history  and  description  are  as  follows  : 

1.  The  utenis  of  a  Cow  which  contained  in  one  of  tlie  cornua  a  fa>tus  beyond  its  term, 
and  in  the  other  horn  such  a  great  ([uantity  of  mucus  that,  so  far  as  volume  is  concerned, 
it  Would  be  difficult  to  say  which  cornu  was  the  largest.  This  uterus  is  completely 
divided  at  thect-rvix  and  Huats  in  the  nl>dominal  cavity,  being  attache<l  only  by  the  broad 
li(;aments,  which  are  thin  and  distended.  The  detached  portion  of  the  uterus  has  a 
globular  form,  and  its  perfectly  smooth  surface  is  everywhere  covered  by  peritoneum  ; 
where  the  separation  has  taken  place,  the  organ  is  closed  by  tlie  cicatricial  union  of  the 
border  of  the  rupture.  The  mucous  membrane  in  the  left  cornu  of  this  portion  is  loose, 
and  nhows  numerous  radiating  cicatrices  ;  the  ftrtus  in  the  right  cornu  is  indurated,  and 
apjiears  to  have  lived  bej'ond  the  ordinary  pt-riod  of  gestation,  to  judge  by  the  hoofs,  as 
Weil  aa  by  the  teeth,  which  are  cut.  The  nose  did  not  correspond  to  the  opening  of  the 
cornu,  as  the  head  was  doubled  on  the  left  side  of  the  neck.  The  vertex  and  occiput  were 
turned  tipwards,  ami  closed  a  vast  circular  opvning  resulting  from  llie  <lestruction  of  the 
partition  separating  the  two  cornua.  The  head  adhered  to  the  entire  border  of  this 
opening — unequal  and  ragged  as  it  must  have  been  ;  and  all  that  portion  which  projects 
int(»  the  left  cornu  presents  a  large  toumire.,  where  not  only  is  the  skin  abtsent,  but  even  the 
p«;ri>j9teum  itself.  Lying  flat  on  one  of  its  sides  and  curled  uj>,  the  limbs  twined  towards 
the  head,  and  the  muffle  placed  between  the  thighs,  the  f<itu-t  represents  a  kind  of  great 
discoid  IkkIv. 

"2.  Cornu  of  the  utenu  of  a  pregnant  Cow,  containing  a  completely  develojjcd  foetus, 
markedly  indurated.  This  cornu,  j)erhaps  ruptured  during  jiarlurition,  is  detached,  and 
hangs  almoiit  free  in  the  ab<lomen  ;  while  the  rupture  has  cicatrised,  and  there  is  formed 
a  large  kyst,  evt-rywhere  closed,  ani>  containing  the  fietus.  The  walls  of  the  iiterus  are 
for  the  most  part  fibrous,  and  the  fietal  envelopes  coriaceous.  Like  the  precetling  case, 
this  specimen  w.-vs  found  in  a  Cow  which  had  l>een  slaughtered  by  the  butcher  ;  the  cornu 
fell  on  the  ground,  after  some  few  fibrous  bands  which  attached  it  to  the  subdumbar 
region  had  been  cut  through. 

:{.  The  uterus  of  a  Sheep  arrived  at  the  termination  of  pregnancy  ;  the  organ  ha.s  been 
torn  in  the  vicinity  of  the  vagina,  anil  remains  free  in  the  abiJominal  cavity.  In  this 
instance,  also,  the  uterus  forms  a  completely  closed  kyst,  which  contains  a  very  much 
indurated  lamb.  In  d^-taching  this  organ,  an  irregular  cicatrix  is  seen,  which  leads  to  the 
supposition  that  the  accident  was  due  to  torsion  of  the  cervix. 


196  PATHOLOGY  OF  PREGNANCY. 

4.  Posterior  portion  of  the  body  of  a  Guinea-pig,  which  shows  the  right  cornu  of  the- 
iiterus  detached,  and  cicatrised  where  separation  has  occurred.  This  cornu,  whicli  was 
half  free,  was  tilled  with  fluid  blood  ;  the  distension  caused  by  the  blood  has  been  so 
great  that  the  cornu  is  ruptured  in  the  middle,  and  the  fcEtus  must  have  died  from 
hajmorrhage. 

Other  examples  of  a  similar  kind  have  also  been  recorded. 

Causes. — Thinning  of  the  uterine  walls,  hydramnios,  and  distention 
by  the  gas  evolved  from  a  putrefying  foetus,  have  been  said  to  predispose 
to  longitudinal  rupture,  as  well  as  contusions  of  different  kinds  to  the 
exterior  of  the  abdomen  :  the  latter  may  cause  immediate  rupture,  or 
this  may  only  occur  after  the  lapse  of  days  or  weeks.  Energetic  con- 
tractions of  the  muscular  tunic  may  also  lead  to  this  result.  Transverse 
rupture,  Saint-Cyr  presumes,  is  a  consequence  of  torsion  of  the  uterus 
on  itself,  or  at  a  limited  point  where  the  circulation  is  interrupted. 

Symptoms. — The  symptoms  of  rupture  of  the  uterus  are  not  well 
defined.  If  the  accident  is  due  to  external  violence,  the  signs  will  be  in 
accordance  with  its  severity,  and  the  more  serious  indications  may 
appear  very  soon  after  the  contusion,  or  not  for  a  considerable  time. 
After  showing  symptoms  of  colic  for  a  short  time,  the  animal  appears  to 
be  quite  well  until  parturition  is  due,  when  after  manifesting  signs  of 
that  act  the  straining  ceases,  and  those  of  peritonitis  commence — 
hurried,  short  and  plaintive  respiration,  quickened  pulse,  inappetence 
and  suspension  of  rumination,  insensibility  to  surroundings,  coldness  of 
body,  looking  round  to  the  sides,  etc.  Examination  of  the  abdomen 
will  detect  the  presence  of  fluid  in  its  lower  third ;  while  vaginal 
exploration  may  reveal  an  empty  uterus,  or  only  a  portion  of  the  foetus 
in  it — the  rupture  itself  may  be  discovered.  Or  if  the  rupture  has  only 
ensued  when  parturition  is  advanced,  the  foetus  may  be  expelled  in  the 
usual  way,  and  the  symptoms  of  rupture  only  recognised  when  the  birth 
has  been  accomplished. 

Similar  symptoms  are  observed  when  transverse  rupture  of  the  uterus 
has  taken  place,  except  that,  owing  to  the  twisting  or  torsion  of  the 
uterus,  the  hand  cannot  explore  its  cavity ;  the  vaginal  walls,  however, 
are  found  very  relaxed,  and  the  uterine  cervix  extremely  movable  in 
every  direction.  If  the  animal  survives,  the  straining  soon  passes  ofl", 
the  external  genitals  resume  their  ordinary  appearance,  and  every 
indication  of  pregnancy  disappears  except  the  enlarged  abdomen,  on  the 
floor  of  which  the  foetus  lies,  and  there  it  may  become  mummified,  or 
in  the  course  of  time  be  eliminated  by  an  ulcerative  process  set  up  in 
the  abdominal  walls  ;  or  it  may  even  live  and  grow  for  some  time  after 
leaving  the  uterus,  but  unless  removed  artificially  it  must  die.  The 
mother  may  thrive,  especially  if  the  foetus  does  not  cause  any  incon- 
venience or  is  expelled  in  some  way  ;  and  if  only  one  uterine  cornu 
was  involved  in  the  rupture,  she  may  again  become  pregnant. 

Tkeatment. — But  little  can  be  said  as  to  this.  Looking  at  the 
serious  nature  of  the  accident,  it  must  be  a  question  whether,  if  preg- 
nancy is  about  complete  and  the  foetus  is  alive,  it  may  not  be  advisable 
to  kill  the  mother  and  preserve  the  young  one.  On  the  chance  of  the 
mother  surviving,  attempts  might  be  made  to  treat  the  case  as  one  of 
peritonitis,  and  resort  had  to  surgical  interference  if  there  are  any  out- 
ward signs  of  abdominal  abscess,  for  the  elimination  of  the  dead  foetus. 
With  regard  to  the  smaller  animals,  gastro-hysterotomy  might  be 
practised  with  some  chance  of  success  in  favourable  cases. 


ACCIDEXTS  OF  rREONANCY.  197 

Though  the  accident  is  generally  of  a  most  serious  character,  yet, 
remembering  that  recovery  does  sometimes  take  place,  there  need  not 
be  undue  haste  in  destroying  the  animal.  When  the  organ  contracts 
the  dimensions  of  the  rupture  are  reduced,  and  tears  in  the  upper 
portions  are  very  much  less  serious  than  tliose  in  the  lower  surface,  for 
obvious  reasons. 

Metuoruhagia. 

Accidental  haemorrhage  from  the  uterus  during  pregnancy,  appears  to 
be  somewhat  rare  in  animals,  judging  from  the  paucity  of  instances 
recorded.  Carsten  Harms*  has  observed  this  accident  in  cattle  ;  it  was 
accompanied  by  a  small  discharge  of  blood  from  the  vagina,  particularly 
during  micturition,  and  resulted  in  the  death  of  the  fcctus.  Some 
observers  have  not  noticed  this  discharge  ;  the  blood  has  always  re- 
mained in  the  uterus,  where  it  has  been  sometimes  found,  as  a  clotted 
mass,  to  the  amount  of  more  than  four  gallons.  In  the  majority  of 
cases  it  would  seem  to  be  occasioned  by  a  spontaneous  separation — 
more  or  less  extensive — of  the  placental  capillaries  from  the  uterine 
surface.  Zundel  has  seen  it  occur  in  an  animal  which  showed  signs  of 
<:cstrum  while  pregnant.  The  following  cases  may,  to  some  extent, 
illustrate  this  accidental  uterine  haemorrhage. 

1.  Egli  (Journal  dest  V^(erinaircs  (hi  Midi,  IS.IO,  p.  13."])  wxs  called  to  see  a  Cow 
which  staggered  about  in  walking,  and  did  not  eat.  He  found  it  lying,  and  had  great 
<litticulty  in  getting  it  up,  when  it  kept  alternately  lifting  the  hind  legs.  The  pulse 
was  slow  and  very  weak,  and  the  heart's  beats  were  loud.  There  were  no  other 
-symptoms.  It  was  bled,  but  during  the  operation  it  staggered  and  trembled  ;  the  bleed- 
ing was  stopped.  It  then  lay  down  without  appearing  to  suffer,  and  was  dead  in  a  few 
minutes.  At  the  autopsy  the  uterus  was  observed  to  be  considerably  distended  and  of 
a  violet  colour,  and  an  enormous  (piantity  of  blood  was  effused  between  the  muscular 
and  serous  layers,  so  that  the  wall  of  the  organ  was  about  six  inches  thick  ;  there  was  no 
«xtravasation,  either  in  the  abdomen  or  the  cavity  of  the  uterus.  No  cause  was  a-scribed 
for  the  accident. 

2.  Zundel  (Journal  de  Mt!il.  Vet.  de  Lyon,  1861)  describes  the  case  of  a  Mare  which 
suddenly  presented  the  following  symptoms  during  pregnancy  :  Anxious  countenance, 
<lrooping  head,  rigidity  of  the  loins,  staggering  gait  andjaraencss  of  the  left  bind  leg,  as 
if  from  a  sprain  ;  the  respiration  3<3  per  minute,  and  pulse  60  and  small.  Treatment 
was  of  no  avail  ;  prostration  gradually  set  in,  the  animal  .-ippeared  extremely  anxious, 
soon  it  could  not  stand,  and  when  it  fell,  death  ensued  almost  immediately  without  much 
agony.  There  were  never  any  symptoms  of  colic  or  discharge  of  blood  per  rulvam.  Un 
examination,  a  five-months-old  ftetus  was  discovered  in  the  right  cornu,and  the  placenta 
was  detached  nearly  throughout.  The  left  liom  was  the  seat  (»f  sub-acute  inflammation, 
and  its  volume  exceeded  that  of  the  right ;  an  enormous  blood-clot,  me.asuring  about  four 
gallons,  occupied  ttiia  horn  and  the  body  of  the  uterus.  The  bloodvessels  were  nearly 
empty.  Zundel  asks  whether  the  lamene.ss,  which  had  already  V)ecn  noted  as  a  symptom 
of  metrorrhagia  by  some  (Jerman  atithorities,  may  not  be  explained  by  the  arrangement 
of  the  lumbar  jilexus,  which  send.s  nerves  to  the  limbs  and  the  generative  organs. 

3.  In  a  pregnant  Mare,  Schmidt  (Aiuialrs  lU  Mid.  Vit.  di  JirujrtJl) .i,  1862)  witnessed 
the  following  symptoms  :  Sudden  inappetence  ;  he.ad  low  and  "beneath  the  manger"; 
reeling  gait  ;  extreme  feebleness,  and  hind  limbs  widely  separated  ;  Ifwking  first  towards 
one  flank,  then  the  other;  pulse  110,  regular  but  sinking;  heart's  beats  <iuite  audible, 
and  venous  pulsation  in  neck  ;  mucous  nicmbranes  very  pale,  and  the  body  temperature 
low.  Dark-coloured  bloo«l  flowed  in  a  pasisive  manner  frtim  the  uterus.  The  Mare  died 
on  the  same  day,  and  an  autopsv  revealed  all  the  organs,  except  the  ntenis,  almost 
bloodless  ;  that  viscus  was  found  to  be  considerably  distended  with  blood — nearly  two 
pailsful — which  w.vs  partly  coagulated.  It  contained,  in  afidition,  a  seven-months  foetus 
surrounded  by  the  liquor  amnii,  and  entirely  separated  from  the  uterine  walls. 

4.  Macgiliivray  (Vrferinary  Journal,  1881,  p.  177)  waa  asked  to  attend  a  Mare 
more  than  nine  months  pregnant,  because  she  was  discharging  mnch  blood.  Nothing 
was  done  to  check  the  flow,  which  was  arterial  blood,  and  continued  rather  more  than  a 

'  Lthrburh  dtr  I'/iifrdrztlichen  O'eburtJihiil/e,  p.  60. 


198  PATHOLOGY  OF  PliEGXANCY. 

day,  when  it  entirely  ceased.  The  Mare  subsequently  produced  a  strong  healthy  Foal 
at  the  usual  time.  The  author  had  no  doubt  that  this  was  a  case  of  jjlacenta  j^rcwia,  and 
the  result  of  some  distention  or  looseness  about  the  cervix  or  os  uteri,  whereby  the  parts 
immediately  within  these  became  detached,  and  allowed  a  flow  of  arterial  blood  at  that 
point. 

5.  The  same  observer  {Ibid.)  saw  a  young  Cow  within  a  fortnight  of  second  calving, 
which  for  two  days  had  been  discharging  large  quantities  of  clotted  blood.  It  began 
with  the  escape  of  arterial  blood,  but  changed  to  venous,  and  finally  became  mixed  with 
some  of  the  uterine  fluid.  The  Cow  ultimately  gave  birth  to  a  living  Calf  soon  after, 
and  did  well.  There  was  an  entire  absence  of  labour  pains  up  to  a  short  time  before 
delivery,  the  os  uteri  being  only  partially  dilated.  The  same  animal  had  suffered  from 
severe  post-paitum  haemorrhage  at  her  first  calving  the  previous  year. 

6.  Kotelmann  records  the  case  of  a  Mare,  seven  months  pregnant,  which  suddenly  lost 
about  half  a  pound  of  blood  by  the  vagina  ;  this  happened  again  during  three  or  four 
days,  then  the  discharge  changed  to  a  yellow  serum  and  ceased  on  the  seventh  day,  when 
the  animal  regained  its  health  and  brought  forth  a  Foal  in  due  course,  but  died  after- 
wards of  paralysis. 

7.  Vogel  speaks  of  a  Mare  which  had  four  regular  parturitions,  and  had  reached  the 
thirty-seventh  week  of  her  fifth  pregnancy,  when,  without  any  precursory  symptoms, 
thfre  was  an  emission  of  blood  from  the  vulva  ;  this  could  not  be  checked,  though  cold- 
water  compresses  were  applied  to  the  loins  for  two  hours.  The  blood  continued  to  flow 
until  the  vagina  was  plugged  ;  after  some  hours  the  plugging  material  was  removed, 
when  it  was  found  that  the  03  uteri  was  dilated.  The  hemorrhage  having  recommenced, 
it  was  deemed  advisable  to  induce  abortion.  The  membranes  were  therefore  ruptured 
and  the  fcetus  extracted.  But  the  Mare  died  immediately  afterwards,  and  at  the  autopsy 
a  fibroid  tumour  was  found  in  the  uterus,  the  pedicle  of  which  was  two  and  a  half  inches 
long,  and  near  which  the  fcetal  placenta  had  become  adherent  to  the  mucous  membrane. 
Vogel  was  of  opinion  that  the  hemorrhage  was  due  to  rupture  of  the  placenta  caused  by 
movements  of  the  foetus. 

8.  Anacker  refers  to  the  case  of  a  Cow  which,  when  six  months  pregnant,  exhibited 
symptoms  of  severe  colic,  during  which  she  emitted  strange  bellowings.  Some  days 
afterwards  a  considerable  quantity  of  blood  was  expelled  from  the  vulva,  and  the  follow- 
ing day  there  was  another  quantity,  blood  only  coming  away  by  drops  in  the  interval. 
Being  treated  by  bleeding  and  soothing  medicines,  and  topical  astringents,  recovery  took 
place  in  four  days.     The  Cow  did  not  abort. 

9.  The  same  authority  alludes  to  the  case  of  another  Cow  which,  in  the  sixth  month  of 
pregnancy,  after  a  severe  attack  of  colic,  discharged  a  large  quantity  of  blood  from  the 
vulva,  without  any  lesion  being  detected  in  the  vagina.  The  same  treatment  was  pur- 
sued, and  the  animal  completely  recovered. 

10.  Violet  (SaintC}>r's  Traite,  p.  222)  mentions  the  case  of  a  Cat  which  had  nearly 
reached  the  time  for  parturition,  when  it  fell  from  a  height  of  about  eighteen  feet,  expir- 
ing soon  afterwards.  An  autopsy  was  made  immediately,  and  it  was  noted  that  the 
uterus  was  deeply  congested  and  full  of  dark  blood,  which  had  partially  separated  the 
placentas, 

11.  The  same  authority  alludes  to  another  Cat,  also  pregnant,  which  died  very  sud- 
denly, and  the  uterus  of  which  showed  the  same  appearances  as  in  the  above  case. 

When  there  is  no  escape  of  blood  externally,  the  diagnosis  of  this 
accident  is  most  difficult ;  but  when  the  haemorrhage  is  apparent,  then 
topical  remedies  might  be  applied  in  severe  cases,  and  if  these  are  of  no 
avail,  then  artificial  delivery  should  be  attempted  and  the'  same  treat- 
ment adopted  as  iox  post-partum  haemorrhage  (wJtich  see). 

Abnormal  Eetention  of  the  Fcetus. 

It  was  remarked,  when  speaking  of  the  normal  period  of  gestation, 
that  this  varied  within  considerable  limits,  and  that  the  foetus  might 
remain  in  the  uterus  for  a  comparatively  long  period  beyond  the 
ordinary  time,  without  any  serious  inconvenience  to  itself  or  its 
bearer. 

But  when,  from  any  special  cause,  delivery  cannot  take  place,  then 
very  grave  results  may,  and  indeed  nearly  always,  follow. 

Cases  of  abnormal  retention  of  the  foetus  were  observed  in  the  last 


ACCIDENTS  OF  PREONANCY.  199 

century  by  BoutroUe,*  Gervy,-  and  Iluzard,  senior  and  junior;  the  latter 
exhibited  to  the  Society  of  the  Facuhy  of  Medicine  of  Paris,  in  1815, 
the  uterus  of  a  Sheep  containing  a  fcetus  which  had  been  there  for 
three  years.  Since  that  period  the  Hterature  of  the  subject  has  become 
very  extensive,  more  than  forty  instances  being  recorded  in  Enghsh 
veterinary  journals  alone.  All  the  domesticated  animals  may  suffer 
from  abnormal  retention  of  the  foetus,  but  the  Cow  appears  to  be  far 
more  exposed  to  it  than  any  other  —  the  frequency  in  tins  animal 
being  as  twelve  to  one  in  the  Mare,  and  ten  to  one  in  the  Sheep.  Of 
the  forty-eight  instances  recorded  by  Saint-Cyr,  35  occurred  in  the 
Cow,  7  in  the  Ewe,  5  in  the  Mare,  and  only  1  in  the  Bitch. 

SY.MrTOMS  AND  TERMINATIONS. — The  symptoms  at  first  are,  of  course, 
those  of  pregnancy,  until  the  period  of  normal  parturition,  or  even 
during  pregnancy  when  abortion  is  about  to  take  place.  At  this  period 
there  are  nearly  all  the  signs  of  parturition  :  enlarged  mamma3,  swollen 
vulva,  pendulous  abdomen,  restlessness  and  anxiety.  Then  straining 
begins,  but  the  os  uteri  remains  closed  and  no  fcetus  appears.  This 
condition  may  persist  for  only  a  brief  period,  and  be  so  little  marked  as 
to  pass  uuobsen'ed  in  some  cases ;  in  others  it  may  continue  for  two, 
three,  or  four  days,  the  expulsive  efforts  gradually  diminishing  in  force 
and  frequency  until  they  altogether  disappear.  The  animal  then  re- 
gains its  ordinary  state,  and,  if  a  Cow,  the  secretion  of  milk  goes  on  as 
if  there  were  nothing  the  matter.  Health  may  never  be  impaired  from 
this  cause,  and  the  condition  of  the  animal  may  not  be  suspected  until, 
if  a  Cow  or  a  Sheep,  it  has  been  fattened  and  slaughtered  by  the  butcher 
for  food,  when  the  fcxtus  is  discovered.  It  has  been  observed  that  oestrum 
does  not  appear  in  such  animals,  as  a  rule.  The  exceptions  are  rare, 
though  Rossignol  mentions  a  Cow  which  retained  its  fcutus  for  twenty- 
seven  months,  yet  gave  an  abundance  of  milk,  often  exhibited  oestrum, 
went  to  the  Bull,  and  was  at  last  killed  because  it  became  too  fat ! 
More  cases  of  a  similar  kind  are  recorded. 

In  other  instances,  after  the  ordinary  period  of  gestation  has  been  ex- 
ceeded by  several  months,  signs  of  parturition  are  again  manifested, 
and  delivery  may  then  be  safely  accomplished,  either  witliout  aid,  which 
is  rare,  or  by  careful  manipulation  ;  the  young  animal  may  even  be  born 
alive  if  too  long  a  period  has  not  intervened  since  the  normal  time  of 
delivery.-'     Parturition  in  these  cases  is  generally  diflicult ;  and  the 

'  Le  Par/ait  [iouvkr,  1776.  He  writes  :  "  There  are  Cow«  which  are  not  '  open,'  that 
is  to  say,  which  have  not  sufficient  pasHage  for  the  Calf,  which  nm.iins  in  the  Cow  an<l 
becomes  dried  up  like  a  ball.  The  Cow  does  not  die  for  all  thin,  if  it  is  well  cared  for  ; 
but  many  perish  when,  instead  of  drying  up,  the  fcetus  becomes  a  mass  of  corruption.  The 
Cow  which  carries  it--*  dried  up  Calf  in  the  uterui  does  not  seek  the  Bull.  ...  It  is  neces 
sary  to  take  care  of  these  Cows  for  ten  months  or  a  year,  and  to  feed  them  well,  especially 
when  the  Calf  dries,  for  they  eat  little  and  become  extremely  emaciated  for  fifteen  days. 
In  about  ten  months  or  earlier,  if  ther«  is  any  herbajje,  these  Cows  are  put  out  t<^i  pasture, 
and  they  fatten  like  others  ;  the  butchers  find  the  calf  dried  up  in  the  Calf-bag." 

'^  Iiuilruclions  I'cUriuairf,  vol.  iv.,  p.  '25tJ. 

'  In  the  Xeicca.'^tle  Jonnial  for  January  18,  1840,  there  is  the  description  of  a  Calf 
which  wa«  bom  on  the  306th  day  (fifty  two  weeks  and  one  day).  It  waa  alive  when 
dropped,  but  died  soon  after.  It  was  of  great  size,  though  born  without  assistance  ;  it 
was  a  male. 

Strange  to  relate,  in  the  Veterinarian  for  IS.'iO  (p.  14S),  a  Mr.  Tatam,  of  Homcastle, 
records  a  caae  of  abnormal  pregnancy  in  a  Cow  in  his  locality,  in  which  not  only  was  the 
peri<xl  the  same  (fifty  two  weeks  and  a  day),  but  the  Calf  was  a  male,  as  extraordinary  in 
size,  and  excited  a  similar  degree  of  wonder,  as  the  above.  Mr.  Tatam  saw  the  Calf  ; 
had  he  seen  the  other  one  ? 


200  PA  T HO  LOG  Y  OF  PREGXA  NCY. 

favourable  termination  of  such  a  condition  is  due  to  the  membranes 
of  the  foetus  remaining  intact,  and  the  os  sufficiently  contracted  and 
close  to  exclude  the  atmosphere.  Even  under  these  circumstances, 
the  retention  of  the  foetus  may  not  have  so  fortunate  an  ending. 
Very  often,  after  fruitless  straining,  the  animal  continues  unwell ;  it 
has  little  or  no  appetite,  languishes,  becomes  feeble ;  hectic  fever 
appears ;  it  falls  into  a  state  of  marasmus,  and  dies  after  a  more  or 
less  prolonged  period  of  misery. 

"When,  at  the  usual  time  of  parturition,  the  straining  of  the  animal 
has  ruptured  the  foetal  membranes  and  the  liquor  amnii  escapes,  air  at 
the  same  time  obtaining  access  to  the  uterine  cavity,  the  case  is  in 
nearly  every  instance  very  serious.  The  foetus  soon  perishes  and  begins 
to  putrefy,  and  in  a  short  time  the  decomposing  mass  causes  inflamma- 
tion of  the  uterus  (metritis),  accompanied  by  frequent  and  exceedingly 
severe  straining ;  low  fever  supervenes  ;  a  foul-smelling  putrescent  fluid 
escapes  from  the  vagina,  and  the  creature  finally  succumbs  to  metritis 
and  putrid  infection.  In  other  instances  the  termination  is  not  so 
rapid.  The  animal  remains  unhealthy ;  the  secretion  of  milk  is  sus- 
pended ;  horribly  foetid  discharges  are  passed  jjcr  vaginam,  containing 
pus,  broken-up  decomposed  tissues,  and  even  bones  of  the  foetus ;  these 
discharges  are  increased  by  the  straining  which  sometimes  takes  place 
at  intervals.  In  the  meantime,  the  creature  loses  condition,  emaciation 
becomes  extreme,  and  death  ensues  from  debility  and  marasmus. 

With  the  Cow  we  may,  nevertheless,  have  a  vaginal  discharge, 
due  to  the  presence  of  a  putrefying  foetus,  and  for  a  long  time,  with- 
out any  such  serious  result.  Figuier  removed  from  the  uterus  of  a 
Cow  the  entire  skeleton  of  a  foetus  which  had  been  there  for  more 
than  Jive  years,  without  giving  rise  to  any  other  symptoms  than  a 
very  disgusting  intermittent  vaginal  discharge.  The  animal  quite  re- 
covered. Thierry  reports  the  abortion  of  a  Cow  at  the  fifth  month  of 
gestation,  and  the  retention  of  the  putrefied  foetus  for  more  than  three 
months  afterwards,  without  any  harm  ensuing  ;  Gervy  also  removed  the 
head  of  a  foetus  which  had  lain  in  the  uterus  of  a  Cow  for  eighteen 
months,  without  the  animal  suffering  much  inconvenience  during  that 
time.  In  the  Veterinarian  (vol.  ix.,  p.  454)  there  is  an  instance  of  a  Cow 
carrying  a  decomposing  Calf  for  two  years  with  impunity ;  and  another 
(vol.  xxix.,  p.  577)  for  ten  months. 

It  is  not  the  same  with  the  Mare,  as  death  has  been  the  usual  ter- 
mination ;  but  it  would  appear,  as  already  remarked,  that  retention  of 
the  foetus  is  very  unusual  indeed  in  this  animal,  the  best  recorded 
instances  being  one  by  Hamon,  in  which  death  took  place  after  seventeen 
months'  pregnancy ;  and  another  by  Hammond,  when  the  same  result 
followed  after  twenty-two  months. 

The  period  during  which  a  foetus  may  be  retained  in  the  uterus  varies 
from  a  few  months  to  five  years. 

We  have  mentioned  that,  in  these  cases  of  retention,  the  foetus  may 
live  for  a  certain  time,  provided  the  membranes  are  not  ruptured  when 
the  symptoms  of  parturition  first  manifest  themselves  ;  it  may  even 
continue  to  develop,  as  is  evidenced  by  its  size,  its  bony  framework, 
hoofs,  teeth,  etc.,  which  often  cause  it  to  look  like  an  animal  that  has 

I  have  some  instances  of  300  days'  pregnancy  in  Cows,  the  calves  being  born  alive. 

In  the  Mare,  prolonged  pregnancy  is  not  nearly  so  frequent,  though  it  sometimes 
occurs,  the  foetus  being  retained  a  month,  or  even  a  little  longer,  without  prejudice  to  the 
Foal's  existence. 


ACCIDENTS  OF  PREGNANCY.  201 

been  born  for  two,  four,  or  six  months.  But  in  other  cases  there  can 
scarcely  be  a  doubt  that  the  fci'tus  perishes  when  the  first  inelTectual 
expulsive  efforts  are  made  by  the  mother,  or  even  at  a  period  anterior 
to  the  ordinary  occurrence  of  parturition,  as  is  proved  by  the  absence 
of  hair,  and  the  small  size  and  weight  of  the  creature  ;  while,  again,  it 
may  live  for  some  hours  after  rupture  of  the  membranes,  provided  it 
can  breathe,  or  the  placental  connections  are  intact. 

In  all  cases,  as  a  rule,  if  the  air  does  not  obtain  access  to  the  uterine 
cavity,  putrefaction  does  not  ensue  ;  and  when  the  uterus  is  examined 
after  death,  it  is  found  to  be  closely  contracted  on  its  contents,  its 
raucous  membrane  healthy  or  slightly  ecchymosed  here  and  there,  with 
the  cotyledons  pale,  wasted,  and  separated  from  the  placentuliR.  Some- 
times between  the  inner  surface  of  the  uterus  and  the  chorion  there  is 
a  gelatinous  mass,  which  covers  the  ftt'tus  and  conceals  the  placental 
cotyledons,  these  being  decayed,  spongy,  and  sometimes  completely 
destroyed.  The  liquor  amnii  has  also  been  absorbed  ;  so  that  the 
membranes  ai-e  in  close  contact  with  the  foetus,  and  may  even  have 
become  adherent  to  it  in  places.  The  foetus  itself  is  desiccated  by 
absorption,  and  its  skin  is  hard  and  dry  as  if  tanned,  or  it  is  wrinkled 
and  shrivelled  ;  while  the  flesh,  if  any  remains,  is  either  perfectly  white, 
or  pale  and  faded-looking  in  colour,  and  emits  a  kind  of  rancid  odour. 
Other  organs  are  pale  and  bloodless,  and  more  or  less  undergoing  fatty 
degeneration.  When  the  retention  has  continued  for  a  long  time,  all 
the  soft  textures  may  disappear,  and  nothing  remain  but  the  bones  ;  in 
other  instances  the  fcrtus  and  its  membranes  become  the  seat  of  calca- 
reous infiltration,  and  constitute  what  has  been  termed  a  Uthop(edian. 

It  is  sometimes  extraordinary  how  perfectly  a  fcotus  is  protected  from 
decay  in  the  uterus.  For  instance,  in  the  Veterinary  Journal  (July, 
1876),  Mr.  Taylor  mentions  one  which  had  been  retained  for  seven 
months  beyond  the  normal  period  ;  and  yet  with  the  exception  of 
absorption  of  the  eyes,  it  did  not  present  indications  of  having  passed 
more  than  a  few  days  in  excess  of  the  usual  term  in  the  uterus. 

When  the  envelopes  have  been  ruptured,  however,  and  the  liquor 
amnii  has  escaped,  we  have  a  different  pathological  condition.  Then, 
through  the  partially  dilated  os  the  air  has  been  admitted,  and  if  imme- 
diately before  this  the  fcctus  was  alive,  it  may  then  die  and  rapidly 
submit  to  the  putrefactive  process,  its  soft  parts  decomposing  and 
macerating,  and  forming  a  most  foul-smelling  mass  ;  so  that  when  the 
uterus  is  opened,  we  discover  a  gi-ey  or  greyish-red  fluid  emitting  a 
most  disgusting  odour,  and  containing  portions  of  matter  resembling 
adipocere,  and  perhaps  bones  which  may  yet  be  covered  by  soft  parts 
and  held  together  by  ligaments,  or  entirely  disunited  and  decaying. 
The  uterus  itself  shows  evidence,  in  the  majority  of  cases,  of  chronic 
metritis ;  sometimes  abscesses  have  been  formed  in  its  texture,  or  it  has 
become  adherent  to  other  organs — as  the  intestine,  or  such  tissues  as 
the  abdominal  walls — with  which  it  has  established  fistulous  communi- 
cations, and  through  which  portions  or  the  whole  of  the  fcctus  may  be 
passed. 

In  the  case  of  twins,  it  sometimes  happens  that  one  of  them  dies,  and 
this  occasions  symptoms  of  abortion  ;  but  delivery  of  the  dead  foetus 
cannot  be  effected,  owing  to  the  obstruction  offered  by  the  living  one, 
which  is  born  at  the  usual  time,  the  parent  being  in  good  health.  But 
days,  weeks,  or  even  months  after,  the  remains  of  the  dead  foetus  may 
be  passed,  or  have  to  be  extracted  from  the  uterus. 


202  PATHOLOGY  OF  PREGXANCY. 

The  foetus  may  also  be  retained  in  the  vagina  long  after  being  passed 
from  the  uterus,  the  os  of  which  is  closed  ;  but  then  it  is  of  very  small 
size,  and  does  not  appear  to  cause  serious  inconvenience. 

Causes. — Various  causes  have  been  assigned  for  the  retention  of  the 
foetus,  several  of  which  are  no  doubt  quite  sufficient  to  offer  an  obstacle 
to  normal  parturition.  Among  these  causes  may  be  cited :  a  diminution 
or  loss  of  contractile  power  in  the  uterus  itself  to  expel  its  contents,  and 
the  absence  of  assistance  when  attempts  are  made ;  adhesions  of  an  un- 
usual character  between  the  uterus  and  placenta ;  malposition  of  the 
foetus  ;  displacement  of  the  uterus  ;  deformed  pelvis  ;  fibrous  induration 
or  spasmodic  contraction  of  the  cervix  uteri ;  torsion  of  the  uterus,  or 
adhesion  of  its  ligaments,  etc. 

Tbeatment. — The  treatment  of  foetal  retention  must  greatly  depend 
upon  circumstances.  When  the  owner  of  an  animal  that  has  reached 
the  termination  of  pregnancy  and  begins  to  be  in  labour  perceives  that 
the  straining  is  weak  and  irregular,  and  not  sustained,  so  that  birth 
does  not  take  place  after  twenty-four,  thirty-six,  or  forty-eight  hours, 
and  even  when  the  symptoms  of  colic  are  slight  and  the  condition  of 
the  creature  otherwise  satisfactory,  the  attendance  of  the  veterinary 
surgeon  should  not  be  delayed.  The  latter  will  inform  himself  as  to  the 
history  of  the  case,  and  also  its  present  condition  by  careful  external 
examination  and  internal  exploration.  By  the  latter  he  will  ascertain, 
in  all  probability,  the  character  of  the  obstacle  to  parturition,  and  be  in 
a  position  to  decide  whether  delay  is  necessary,  or  if  he  is  to  promote 
immediate  delivery.  In  some  instances  it  will  be  difficult  to  arrive  at 
a  decision.  Some  practitioners  of  note  recommend  abstention  from 
interference  and  the  adoption  of  expectant  treatment,  so  long  as  the  os 
is  not  sufficiently  dilated  or  the  foetal  membranes  are  not  ruptured ; 
and  they  insist  on  this  course  even  when  there  is  a  material  obstacle 
present — such  as  torsion  of  the  uterus  or  degeneration  of  the  cervix — 
which  renders  spontaneous  or  natural  delivery  impossible. 

This  treatment  is  based  on  the  relative  innocuousness  of  the  foetus  in 
the  uterus,  even  for  a  very  long  period,  so  long  as  the  liquor  amnii  has 
not  escaped  and  the  air  has  not  penetrated.  This  course  is  no  doubt 
most  judicious  in  some  cases,  and  is  followed  by  successful  results. 
All  that  has  to  be  done  is  to  keep  the  animal  very  quiet — in  a  darkened 
place  if  possible — and  to  administer  opium  or  chloral  in  full  doses,  both 
in  draught  and  enema  if  need  be. 

But  in  the  majority  of  cases,  if  not  in  all,  it  is  preferable  to  resort 
to  active  measures.  The  expectant  method  was  all  very  well  when 
art  found  itself  disarmed  in  the  face  of  certain  accidents,  such  as 
torsion  of  the  cervix,  which  rendered  spontaneous  delivery  impossible ; 
but  it  cannot  be  urgently  insisted  upon  now,  when  we  are  in  possession 
of  methods  which  enable  us  to  overcome  these  accidents.  Therefore, 
as  a  rule,  it  is  the  duty  of  the  obstetrist  to  terminate  as  soon  as  possible 
the  act  of  parturition,  when  it  has  once  commenced.  In  compliance  with 
this  advice,  the  veterinarian,  after  informing  himself  as  to  the  nature  of 
the  obstacle  opposed  to  delivery,  should  act  according  to  the  rules  appli- 
cable to  each  particular  case,  rules  which  will  be  alluded  to  hereafter. 

When  the  membranes  are  ruptured,  then  delay  may  be  out  of  the 
question,  and  intervention  might  require  to  be  prompt,  if  serious  conse- 
quences are  to  be  averted.     Attempts  to  effect  speedy  delivery  should 


ACCIDEXTS  OF  PREGXANCY.  'iQ'i 

be  resorted  to  at  once,  in  the  majority  of  cases,  if  not  in  all.  Never- 
theless, even  here  we  tind  excellent  practitioners  recommending  absten- 
tion, at  least  for  some  hours,  according  to  circumstances.  For  instance, 
Dupont,^  of  Boi-deaux,  a  good  authority,  does  not  at  all  agree  with 
the  generally  received  opinion  that  death  of  the  fujtus  nmst  neces- 
sarily immediately  follow  rupture  of  the  membranes,  as  he  has  met 
with  many  cases  in  which  it  has  lived  for  a  long  interval — twenty-four 
to  thirty-six  hours — after  the  escape  of  the  liquor  anuiii  ;  and  he  does 
not  hesitate  to  affirm  that  respiration  commences  with,  and  is  con- 
tinued after,  the  evacuation  of  this  fluid,  especially  if  the  young 
creature  is  in  a  natural  position — tiie  fore-limbs  and  nose  in  the  os. 
He  will  not  say  so  much  for  all  the  positions  of  the  foetus,  though  he 
has  effected  delivery  in  them  fifteen  to  twenty  hours  after  escape  of 
the  "  waters,"  and  the  creature  has  respired  and  lived.  He  thinks  that 
the  popular  opinion  is  due  to  the  fact,  that  the  attention  of  the  obstetrist 
is  solely  directed  to  preserving  the  life  of  the  mother,  and  that  the  fa'tus 
is  killed  through  the  violent  compression  it  sustains  in  a  narrow  pelvis, 
from  the  powerful  contractions  of  the  uterus,  without  the  intervention 
of  other  causes. 

When  some  time — days,  for  instance — has  elapsed  since  this  stage 
in  parturition  was  reached,  and  labour  has  completely  subsided,  the 
case  is  ditlicult,  and  it  will  again  depend  upon  circumstances  whether 
expectant  or  active  treatment  shall  be  adopted.  An  exploration  should 
certainly  be  made,  and  if  it  can  be  ascertained  that  the  membranes  are 
not  ruptured,  while  there  is  no  straining  and  the  condition  of  the 
animal  is  satisfactory,  then  it  will  be  advisable  to  wait  until  indications 
of  labour  are  once  more  manifested.  If  the  state  of  the  animal  is  not 
80  favourable  and  delivery  is  decided  upon,  and  should  the  os  be  imperme- 
able, or  not  sufliciently  dilated  to  allow  the  passage  of  the  foetus,  then 
it  must  be  opened  either  by  careful  manipulation,  uterine  douches,  the 
uterine  dilating  bag,  or  other  modes  which  will  be  alluded  to  when 
treating  of  dystokia. 

When  a  long  period  has  intervened,  and  the  general  and  local  dis- 
turbance in  tiie  animal  necessitate  active  interference  on  the  part  of 
the  veterinary  obstetrist,  then  of  course  the  first  and  most  urgent  indi- 
cation is  to  remove  the  cause — the  putrefying  foetus — from  the  uterus. 
When  the  os  is  not  sufficiently  open  to  admit  the  hand  and  the  with- 
drawal of  the  foetus,  then  the  case  is  one  of  difficult  labour,  complicated 
by  the  death  of  the  fa-tus  and  its  state  of  decomposition.  If  the  os 
should  chance  to  be  contracted,  it  must  either  be  dilated  by  the  means 
we  have  named,  or  if  these  do  not  succeed  (though  they  often  do),  then 
the  cer\ix  must  be  incised.  In  very  exceptional  cases,  gastro-hyster- 
otoniy  has  to  be  performed  if  the  foetus  or  its  remains  arc  to  be  got  rid 
of ;  and  in  some  instances,  owing  to  the  emphysematous  condition  of 
the  fcetus,  its  shape  or  size,  or  deformity  of  the  genital  passages  of  the 
mother,  embryotomy  is  called  for. 

When  the  uterus  is  emptied  of  all  the  matters,  solid  and  fluid,  it 
contains,  it  should  be  thoroughly  cleansed  by  repeated  injections  or 
washings  with  tepid  water,  and  finally  with  someanti-putrescent  fluid — 
weak  solutions  of  chloral,  permanganate  of  potassium  (Condy's  fluid),  or 
of  carbolic  or  salicylic  acids.  General  treatment  may  also  be  necessar}*, 
and  this  must  be  regulated  according  to  the  indications.  In  all  the 
manipulative  operations  subsequent  to  delivery,  it   will  generally  be 

*  Archive  Vcterinaire,  June,  1876. 


204  PATHOLOGY  OF  PREGNANCY. 

found  that  care  and  patience,  and,  above  all  things,  an  absence  of  undue 
haste,  are  commendable,  and  particularly  with  regard  to  the  removal  of 
the  membranes,  especially  in  primiparae.  The  danger  of  septic  infection 
may  be  largely  averted  by  intravaginal  emollient  douches,  and  serious 
consequences  may  often  be  avoided  by  abstaining  from  premature  and 
violent  interference. 

When  portions  of  the  foetus  are  expelled  through  fistulous  openings, 
even  then  surgical  interference  might  be  successfully  invoked. 

Abortion. 

"When  pregnancy  is  interrupted  by  the  expulsion  of  the  ovum,  or  of 
the  foetus  at  a  stage  when  this  has  not  attained  sufficient  development 
to  live  external  to  its  parent,  abortion  {loartus  immaturus)  is  said  to  occur. 
But  when  the  foetus  is  expelled  before  the  ordinary  period  of  parturition, 
yet  with  all  its  organs  sufficiently  perfected  to  enable  it  to  exist  for  at 
least  some  time  in  the  external  world,  this  is  designated  incmaturc  birth 
{partus  ])rcEmaturus).  In  the  first  instance,  the  young  creature  is  either 
dead  when  expelled*  from  the  uterus,  or  dies  immediately  afterwards  ; 
and  in  the  second,  it  may  be  weakly  and  immature,  and  succumb  after 
a  variable  period  ;  or  it  may  continue  to  live  and  thrive.  In  practice, 
there  is  no  accurately  defined  limit  between  abortion  and  premature 
birth,  and  especially  when  the  latter  has  been  brought  about  by  some 
of  the  causes  which  produce  the  former. 

Abortion  may  be  said  to  take  place  in  Solipeds,  when  the  foetus  is 
expelled  forty  days  before  the  normal  period ;  in  the  Bovine  species, 
thirty-five  days  ;  in  the  Sheep  and  Goat,  twenty  days ;  in  the  Pig, 
fifteen  days  ;  and  with  the  Bitch  and  Cat,  seven  days.  Saint-Cyr  says 
that  it  may  be  acknowledged  that  abortion  has  taken  place,  when  the 
foetus  is  expelled  in  the  Mare  before  the  300th  day  of  gestation,  in  the 
Cow  before  the  200th,  in  the  Ewe  before  the  140th,  and  in  the  Sow 
before  the  100th  day. 

There  is  not  the  same  tendency  or  readiness  in  all  the  domesticated 
animals  to  abort.  The  Bitch  and  Cat  rarely  do  so,  even  after  serious 
injuries  ;  and  the  Sow  retains  its  foetuses  almost  as  tenaciously  ;  but 
the  Sheep  and  Goat  are  rather  liable  to  this  accident.  The  Cow  and 
Mare,  but  more  especially  the  former,  most  frequently  lose  their  foetus. 
In  what  proportion  abortions  occur  is  not  ascertainable  from  any  docu- 
mentary evidence.  For  the  Cow,  Baumeister  and  Eueff  state  that  in 
France,  in  a  dairy  containing  Durham  Cows,  and  numbering  100  preg- 
nancies, there  were  17  abortions ;  and  at  Hohenheim,  from  a  register 
kept  for  thirty  years,  it  appears  that  one-fifth  of  the  Cows  aborted. 
Among  5,864  Sheep  of  various  breeds  at  the  same  establishment,  there 
were  only  26  abortions,  or  0-433  per  cent. 

Abortion  may  occur  at  any  period  of  gestation  within  the  limits  above 
named,  though  it  is  much  more  frequent  during  the  first  than  the 
second  half  of  pregnancy,  and  especially  with  the  Mare.  When  this 
accident  occurs  at  a  very  early  stage,  it  may  produce  no  appreciable 
disturbance  of  health  in  the  female,  and  the  developing  ovum  escapes 
intact,  and  often  unperceived.  The  accident  is  more  serious  when  it 
happens  at  a  late  period;  as  it  then  not  only  causes  the  loss  of  the  young 
animal,  but  may  compromise  the  existence  or  value  of  the  mother. 

Abortion  may  be  either  sporadic,  enzootic,  or  epizootic.  When  cases 
occur  here  and  there  on  farms  or  breeding  establishments  over  a 
wide  extent  of  country,  without  any  relationship  as  to  causation,  they 


ACCIDEXTS  OF  PREGXAXCV.  205 

are  sporadic  or  accidental  abortions  ;  and  tliougli  they  must  bo  reckoned 
as  losses,  yet  they  rarely  attract  much  attention  from  the  damage  they 
intlict,  because  of  their  isolated,  and  by  no  means  unusual,  occur- 
rence. But  when,  on  the  contrary,  the  pregnant  animals — say  Cows, 
Ewes,  or  Mares — on  a  farm,  in  a  village,  or  over  a  large  district  or 
country,  abort  in  large  numbers,  and  the  mishap  is  evidently  due  to  the 
same  cause  or  causes,  then  it  is  indeed  a  grave  misfortune,  as  it  entails 
serious  damage — present  and  prospective — to  the  interests  of  agricul- 
ture and  live  stock.  This  is  enzootic  or  epizootic  abortion — -an  occurrence, 
unfortunately,  far  from  uncommon,  and  the  etiology  of  which  has 
Utracted  the  attention  of  the  most  distinguished  European  veterinarians 
ior  many  years. 

Sporadic  Abortion. 

Causes. — The  assignable  causes  of  sporadic  abortion  are  very 
numerous,  but  the  way  in  which  many  of  them  operate  in  causing 
separation'  of  the  foetus  from  the  mother  is  either  unknown  or  little 
understood.  However,  it  is  considered  or  presumed  that  they  may  act 
either  directly  or  indirectly,  and  produce  their  effects  in  an  evident  or 
an  obscure  manner.     They  may  be  ranged  as  external  or  internal. 

1.  External  Causes. — Atmospherical  influences,  bad  weather,  or 
irregular  seasons,  have  been  cited  as  predisposing  to  or  causing  abor- 
tion. There  can  be  no  doubt  whatever  that  cold,  and  especially  when 
suddenly  applied  to  the  skin,  may  produce  this  result;  and  hence  it  is  that 
the  abrupt  setting  in  of  cold  weather  is  often  marked  by  miscarriages 
among  animals  exposed  to  it.  Many  observers  have  noted  that  the 
continued  and  severe  cold  of  winter  is  far  less  frequently  productive  of 
abortions  than  when  cold,  wet,  or  frosty  nights  in  autumn  succeed  line 
warm  days.     Cold  rain  is  sometimes  very  damaging  in  this  respect. 

With  regard  to  food  and  ingesta  in  general,  there  can  be  no  doubt 
that  here  we  often  have  an  undoubted  cause.  Food  of  bad  quality, 
indigestible,  or  containing  injurious  ingredients,  is  well  known  to  bo 
dangerous.  After  unfavourable  seasons,  when  forage  has  not  been  well 
dried  and  made,  abortions  are  far  from  uncommon.  Indigestible  food, 
or  that  which  has  a  tendency  to  collect  or  ferment  in  the  stomach,  may, 
by  exerting  pressure  on  the  uterus,  produce  this  accident.'  On  the 
other  hand,  too  great  an  abundance  of  easily-digested  and  stimulating 
food,  by  inducing  plethora,  and  consequent  congestion  of  the  uterus 
and  loosening  of  the  placentas,  has  been  set  down  as  another  cause. 
Frozen  food  or  water,  when  taken  in  immoderate  quantity,  and  espe- 
cially if  the  digestive  organs  are  nearly  empty,  as  well  as  forage  or 
herbage  covered  with  snow  or  fi-ost,  are  also  injurious  in  this  i-espect 
to  all  the  larger  animals  when  pregnant,  and  abortion  often  follows 

'  Delwart  has  given  a  good  illustration  of  this.  "  For  twenty  years  all  the  Cowa  in  a 
herd  of  thirty  aborted  each  year,  and  if  by  chance  one  Calf  nached  it.s  term,  it  was  so 
puny  and  deformed  that  it  died  in  a  few  days  after  birth.  The  cauHe  of  these  alxirtions 
appeared  to  me  to  lie  in  the  too  lirge  >|uantity  of  ^jrains  and  balU  of  cereals  with  which 
the  animals  were  fed  ;  the  nimen  and  Hecond  compartment  of  the  Htomacli  formed  a 
compact  mass  which  weighed  on  the  fa>tus,  prevented  its  development,  ami  ended  by 
killing  it.  These  Cows  were  put  under  our  care,  and  submitted  to  a  different  kind  of 
alimentation  ;  roots  replaced  the  innutritions  fixxl  previously  given,  and  which  gave  rise 
to  permanent  indigestion.  This  regime  was  seconded  by  the  administration  of  a  decocti<  n 
'•f  linseed,  five  or  !«i.\  bucketfuls  in  the  day,  and  a  draught  of  a  pound  of  sodium  sulphate 
to  each  Cow.  .  .  .  Success  was  complete  ;  the  desttuctive  scourge  entirely  disappeared, 
and  twenty- eight  healthy  Calves  were  born  at  the  proper  time." 


206  PATHOLOGY  OF  PREGNANCY 

immediately.^  Filthy  putrid  water  has  also  very  frequently  a  perni- 
cious influence  on  gestation.  Some  plants — such  as  the  horse-tails 
(Equisctacece),  sedges  (Gyperacece),  etc. — and  the  leaves  of  beetroot, 
readily  induce  abortion,  according  to  several  authorities.  Eue,  savin, 
ergot  of  rye,  and  other  ecbolics  will,  of  course,  have  a  tendency  to  cause 
expulsion  of  the  foetus  more  or  less  readily ;  and  toxical  substances, 
such  as  cantharides,  which  act  upon  the  uterus,  will  do  the  same. 
Purgatives,  especially  those  of  a  drastic  kind,  are  a  fertile  cause  ;  and 
opium,  digitalis,  and  some  other  drugs  have  to  be  administered  with 
caution.  Food  or  herbage  altered  by  the  presence  of  cryptogamic 
vegetation,  especially  when  damp,  has  long  been  known  to  cause  abor- 
tions. Ergotised  grasses  and  grains  have  often  produced  wide-spread 
losses  from  this  accident. ^ 

Excessive  muscular  exertion  and  unusual  travelling,  and  especially  if 
there  is  a  predisposition  to  abortion,  is  very  likely  to  produce  it ;  if  the 
exertion  is  sudden  and  severe,  or  even  moderate,  but  coming  after  a 
long  period  of  rest,  it  is  all  the  more  certain.  Contusions  to  the 
abdomen  by  kicks  or  falls,  or  squeezing  through  a  narrow  doorway  or 
passage,  railway  or  steam-boat  travelling,  blows  and  shocks,  keeping 
the  animals  in  stalls  with  very  inclined  floors,  are  all  so  many  causes. 
A  case  came  under  my  observation  recently,  of  a  little  Bitch,  extremely 
fat,  which  aborted  at  a  late  period  of  gestation,  through  frequently 
ascending  and  descending  a  steep  staircase. 

Access  of  the  male  not  unfrequently  produces  a  miscarriage ;  and 
exploration  per  ■vaginam  by  the  expert  has  also  been  blamed,  as  well 
as  surgical  operations  performed  on  pregnant  animals — bleeding,  for 
instance,  or  throwing  an  animal  down  to  be  operated  upon.^ 

^  Saint-Cyr  mentions  that  Gelle  has  witnessed  nearly  one-fifth  of  a  flock  of  Sheep 
abort  immediately  after  drinking  from  a  pond,  the  ice  on  which  had  to  be  broken  to 
water  them.  Audoy  reports  an  exactly  similar  occurrence  ;  and  Delorme,  who  haw  also 
observed  analogous  accidents,  adds  that  they  are  most  likely  to  happen  when  the  Sheep 
have  been  deprived  of  water  for  several  days.  Huvellier  mentions  a  rich  grazier  of 
Merlerault  who  owned  ten  brood  Mareg,  one  half  of  which  aborted  every  year,  because 
they  were  sent  three  times  a  da}'  to  drink  cold  water.  Often,  after  quenching  their 
thirst,  they  trembled,  were  seized  with  colic,  and  aborted.  The  regime  was  changed  ; 
the  ISIares  received  water  at  morning  and  mid-day  in  the  stable,  a  handfid  of  bran  being 
put  in  the  water  ;  and  only  in  the  evening  were  they  allowed  to  be  watered  outside, 
after  the  stable-doors  had  been  opened  for  an  hour.  The  abortions  ceased.  Flandrin 
relates  similar  accidents  occux-ring  to  the  Mares  belonging  to  the  Prince  of  Conde,  and 
from  the  same  cause. 

*  The  Veterinary  Journal  (vol.  i.,  p.  422)  alludes  to  an  occurrence  of  this  kind  in 
New  Zealand  in  1875.  It  appears  that  this  accident  was  comparatively  rare  in  that 
colony  until  the  introduction  of  rye-grass  on  the  pastures,  after  which  it  was  common, 
and  a  cause  of  great  loss  when  the  rye  became  ergotised.  The  same  journal  (vol.  ii. , 
p.  51)  contains  an  account  of  serious  abortions  among  Mares  in  Germany,  due  to  rust 
{Trkhobasis  rubigo)  on  the  straw  on  which  they  were  fed.  In  Animal  Playiies  (London, 
1871)  many  interesting  notices  are  given  of  similar  occurrences. 

Haselbach  reports  that  in  a  cow-shed  where  maize  infested  with  its  parasitic  fungus 
(Utitila(/o  mh'idi!>)  was  given  to  the  cattle,  eleven  aborted  within  eight  days.  The  food 
was  changed  at  once,  and  the  other  Cows  escaped  the  accident.  A  certain  quantity  was 
administered  to  two  pregnant  Bitches,  and  they  both  expelled  their  young. 

With  regard  to  the  ergot  of  rye,  its  action  as  an  ecbolic  does  not  appear  to  be  so 
certain  in  Herbivorous  as  in  Carnivorous  animals,  large  quantities  of  it  having  been 
given  to  pregnant  Cows  without  abortion  resulting. 

^  Professor  Bonley  performed  the  operation  of  castration  on  three  pregnant  Cows  ; 
they  aborted  in  two  days  after,  and  one  died.  Nevertheless,  Chanel  has  seen  a  cas- 
trator  operate  on  a  Sow  about  two  months  pregnant.  Three  fcetuses,  the  size  of  the 
middle  fing-er,  were  removed,  along  with  the  portion  of  cortiu  in  which  they  were  con- 
tained. The  poor  beast  lost  much  blood,  and  was  very  ill  for  six  or  seven  days  ;  yet  in 
more  than  two  months  afterwards  it  brought   forth   five  young  Pigs,  which  it  suckled. 


ALVIJJEiXTS  OF  PMEUXAXCY.  207 

Carrying  a  rider,  in  the  case  of  the  Marc,  and  especially  if  spurs  are 
used,  is  attended  with  much  risk. 

Excitement,  fear,^  sudden  surprise,  or  anger,  are  also  causes.  Heavy 
thunder  has  sometimes  been  serious  in  this  way  ;  and  the  fear  produced 
hy  Dogs  leads  sometimes  to  heavy  losses  among  Sheep — foxhounds 
running  near  or  among  pregnant  Cattle  or  Sheep  often  cause  consider- 
able damage,  especially  among  nervous  animals. 

Certain  odours  are  said  to  cause  abortion. 

2.  IntcrnalCauscs. — Badly-fed  and  neglected  animals  sometimes  abort, 
but  not  nearly  so  frequently,  perhaps,  as  those  in  the  opposite  condition 
and  extremely  fat.  It  is  generally  admitted  that  with  some  animals 
there  is  a  special  predisposition  to  abort,  and  that  a  very  trifling  cause 
— especially  previous  abortions — and  sometimes  no  apprecial)le  cause 
at  all,  will  induce  this  accident  ;  while  other  animals  never  lose  their 
fa?tus,  though  exposed  to  the  influence  of  apparently  most  powerful 
causes.  This  predisposition  is  not  manifest  externally,  and  sometimes 
it  disappears  as  age  advances. 

A  more  constant  and  potent  cause,  however,  is  to  be  found  in  the 
presence  of  grave  diseases,  and  especially  those  which  affect  the  system 
generally,  producing  more  or  less  derangement  of  all  the  functions. 
The  various  serious  epizot'Jtic  maladies,  enteritis,  and  all  those  abdo- 
minal disorders  which  give  rise  to  restlessness,  tympanitis,  cough,  as 
well  as  those  diseases  which  induce  cough — as  bronchitis,  pneumonia, 
asthma,  etc. — pleurisy  and  other  affections  and  injuiues  accompanied 
by  great  pain  ;  as  well  as  nervous  or  convulsive  derangements — such  as 
tetanus,  epilepsy,  vertigo,  etc.,  are  all  set  down  as  causes. 

In  acute  febrile  diseases  of  the  mother,  the  foetus  may  perish  from 
the  abnormal  accumulation  of  heat ;  or  chronic  or  acute  anaemia  in  the 
female  may  prove  fatal  to  the  foetus,  by  causing  asphyxia  in  it. 

Certain  virulent  disorders  affecting  the  female  may  likewise  cause  the 
death  and  expulsion  of  the  young  creature  ?»  utcro — for  example,  foot- 
and-mouth  disease  and  tuberculosis.  The  foetus  of  a  Cow  affected  with 
contagious  pleuro-pneumonia,  has  been  found  with  its  lungs  affected  in 
a  similar  manner  ;-'  and  to  prove  that  the  transmission  of  these  diseases 
can  be  effected  in  this  way,  Sheep  which  were  in  the  uterus  when  their 
dam  was  affected  with  variola  (sheep-pox)  were  found  to  resist  inocula- 
tion with  the  virus  of  that  very  malignant  malady.' 

Violet  baa  even  rt-moved  t>ne  of  the  ovaries  from  a  Cow  two  months  prr^natit  without 
abortion  taking  place  or  the  animal  suffHrini,'  in  health,  and  it  would  prolKibly  have  gone 
the  full  time  and  reared  its  Calf  if  it  had  not  been  killed  for  food. 

'  The  Cat  rarely  aborts,  and  instances  are  on  record  in  which  they  have  fallen  from  a 
considerable  height  without  this  accident  occurring.  Nevertheless,  they  are  liable  to 
miscarry,  and  a  friend  who  lives  near  Chatham  had  a  favourite  Cat  heavyin  Kitten,  that 
aborted  immedi-itely  afU-r  being  pursued  by  a  strange  Dog,  which,  however,  did  not 
•eise  it.     The  accident  in  this  case  was  evidently  due  to  fear. 

'  Barrier  descril)es  an  abortion  epizoilty  among  Cows,  in  which  nearly  nil  the  Calvea 
were  exjielled  »live  at  the  fifth  tt>  the  seventh  month,  but  died  within  eight  days  after- 
wards. The  principal  symptoms  were  a  more  or  less  loud  r;lle,  the  discharge  of  ruHty- 
coloured  mucus  from  the  nostrils,  .and  constant  loud  bellowings.  At  the  autoi)sies  the 
"lungs  were  tumefied,  red,  and  fleshy,  and  the  bron^;hi  filled  with  the  saffron-tinted  fluid 
that  fl.iwed  from  the  nostrils." 

'  In  I  he  human  feniale,  Klautsth  remarks  th.at  pregnancy  m.ay  in  such  cases  l)e  brought 
to  an  end  either  by  the  death  of  the  fa>tus,  or  less  frequently  by  premature  uterine  contrac- 
tions. The  foetus  mny  die  owing  to  (1)  deficiency  of  oxygen  ;  (2)  alteration  in  temperature  ; 
or  (3)  direct  transmission  of  the  infection.  These  conditions  may  he  combined.  The 
inconstancy  of  the  transmission  of  the  ii.fection  the  author  would  explain  by  the  circum- 
stance that  it  can  only  occur  when  the  normal  connection  between  the  maternal  and 


208  PATHOLOGY  OF  PREGNANCY. 

Hydrocephalus,  ascitis,  anasarca,  and  chlorosis,  may  also  lead  to  the 
death  of  the  foetus,  which  in  nearly  every  case  is  not  only  the  most 
frequent  predisposing  cause  of  abortion,  but  is  almost  a  certain  deter- 
mining cause  of  its  expulsion,  Hydramnios,  and  other  morbid  condi- 
tions of  the  foetal  membranes,  or  faulty  formation  or  relations  between 
the  placentae,  are  other  causes ;  and  congenital  malformations  of  the 
foetus,  malposition,  or  exaggerated  volume  are  also  mentioned.  The 
presence  of  several  foetuses  often  leads  to  abortion  in  uniparous  animals. 

Disease  of  the  uterus  will,  of  course,  be  very  likely  to  lead  to  the  pre- 
mature expulsion  of  the  ovum  or  foetus.  Metritis,  abnormal  conditions 
of  the  mucous  membrane,  as  well  as  new  formations — such  as  fibroid 
and  carcinoma,  and  other  alterations  by  which  the  enlargement  of  the 
organ  is  hindered — as  enormous  tumours  in  the  abdomen,  ovarian 
dropsy,  etc. — will  predispose  to  or  excite  abortion,  as  will  also  every 
condition  which  leads  to  hyperaemia  of  this  viscus. 

Abortion  has  not  unfrequently  been  ascribed  to  some  defects  or  other 
influences  in  the  male,  though  in  what  these  consist  has  not  been 
explicitly  stated ;  unless  they  are  to  be  found  in  the  debility  arising 
from  too  frequent  usage,  or  other  causes  related  to  the  animal's  state 
of  health.  There  is  strong  and  abundant  evidence  that  a  male  en- 
feebled by  too  much  use,  is  very  likely  to  be  a  cause  of  abortion  in  the 
females  to  which  he  is  put.  This  accident  has  also  been  said  to 
occur  frequently  when  the  male  was  larger  and  more  powerful  than 
the  female. 

Various  injuries  to,  and  diseases  of  the  foetus  or  its  envelopes,  may 
lead  to  the  same  result.  External  violence  may  not  only  injure  the 
uterus  itself,  so  as  to  produce  abortion,  but  the  foetus  even  may  sustain 
damage.  Cauvet  has  remarked  in  a  case  of  abortion  in  a  Mare  brought 
about  by  kicks  on  the  abdomen,  that  the  foetal  membranes  exhibited 
at  the  corresponding  point  an  enormous  ecchymosis,  and  behind 
the  shoulder  of  the  foetus,  which  was  in  relation  to  this  extravasation, 
was  a  large  brown-coloured  exudation.  Another  observer  has  witnessed 
an  adhesion  between  the  skin  on  the  cranium  of  a  foetus  and  the  foetal 
membranes,  as  well  as  depression  of  the  cranial  bones — all  evidently 
due  to  external  violence. 

The  foetus  may  be  poisoned  by  food  or  medicines  which  do  not  pro- 
duce any  appreciable  effect  on  the  parent. 

fcEtal  circulation  is  disturbed.  Premature  pains  may  be  caused  by  (1)  increased  body 
temperature  ;  (2)  altered  blood  ;  (3)  changes  in  the  uterine  mucous  membrane,  as  in 
endometritis  exanthematica  ;  or  (4)  toxins  present  in  the  blood.  If  the  deficiency  in 
oxygen  occurs  rapidly,  the  foetus  dies  ;  if  more  gradually,  pains  are  induced.  In  typhoid 
fever  abortion  occurs  in  more  than  half  the  cases,  and  the  foetus  is  generally  born  dead, 
the  death  being  most  often  due  to  the  transmitted  infection.  Cholera  is  not  trans- 
mitted to  the  fix'tus,  the  death  beinij  here  dvie  to  the  altered  blood,  to  an  endometriti.=, 
to  a  diseased  fcetal  })lacenta,  and  to  temperature  variations.  In  measles  the  fretus  rarely 
dies.  In  severe  malaria  ihe  ftjetus  is  more  often  born  alive,  but  soon  dies  of  malarial 
cachexia.  In  pneumonia  the  death  of  the  foetus  is  not  uncommon,  and  is  due  to 
asphyxia.  Variola  frequently  kills  the  fcetus,  yet  many  are  born  alive.  As  regards  the 
pains,  the  fcetus  may  be  expelled  in  variola  even  during  the  suppurative  stage ;  in 
malaria  after  the  paroxysm  ;  in  erysipelas  most  often  when  the  eruption  appears  ;  in 
cholera  during  the  transition  stage  ;  in  influenza  soon  after  the  onset  of  the  febrile 
symptoms,  and  in  pneumonia  on  the  third  or  fourth  day.  In  typhoid  fever  the  abortion 
may  be  accompanied  by  much  hiemorrhage,  or  strong  contractions  and  little  hismorrhage. 
In  cholera  the  htemorrhage  is  profuse,  and  the  contractions  violent.  The  foetus  is  mostly 
much  more  threatened  by  the  altered  temperature,  disturbed  circulation,  and  patho- 
logical changes  in  the  endometrium,  than  by  the  transmission  of  the  infection. — 
Munchener  Med.   Wochenschrijt,  December  26,  1894. 


ACCIDENTS  OF  PREGNAiWV  209 

Symptoms. — The  symptomatology  of  abortion  is  extremely  varied, 
being  in  some  cases  so  trifling  that,  as  already  said,  the  accident  may 
be  unperceived,  so  far  as  the  female  is  concerned  ;  while  in  others  the 
symptoms  indicate  a  very  serious  condition.  This  usually  depends  on 
the  period  of  pregnancy  at  which  the  accident  occurs. 

Generally,  abortion  takes  place  without  any  premonitory  indications, 
and  the  animal  may  be  as  well  and  lively  as  usual  up  to  the  moment 
when  the  foetus  is  expelled;  and' the  expulsion  itself  is  so  sudden,  so 
prompt,  and  accomplished  with  so  little  visible  effort  or  disturbance, 
that  the  accident  in  most  cases  receives  very  little,  if  any  notice.  It 
frequently  occurs  during  the  night,  and  wonder  is  often  expressed  at 
finding  in  the  morning  the  aborted  fietus — generally  contained  in  its 
intact  envelopes — lying  behind  an  animal  which,  on  the  previous  even- 
ing, looked  perfectly  well,  and  even  now  is  so  cheerful  and  unaltered, 
and  its  functions  so  unimpaired,  that  it  can  scarcely  be  believed  that 
it  has  been  the  subject  of  such  a  mishap.  Even  the  sentiment  of 
maternity,  which  is  so  strongly  developed  in  animals,  as  Saint-Cyr 
justly  remarks,  is  not  awakened  in  favour  of  the  expelled  fcctus,  and  the 
mother  shows  the  utmost  indifference  to  it,  even  treading  on  it  as  if  it 
were  in  no  way  related  to  her. 

When  this  simple  abortion  has  taken  place  during  the  day,  it  has 
been  noted  that  the  flanks  fall  in  a  little,  the  abdomen  descends,  the 
vulva  and  vagina  slightly  dilate,  and  there  escapes  from  them  a  gluti- 
nous, sometimes  sanguinolent,  fluid,  with  which  the  ftctus  is  passed 
almost  without  effort.  We  have  said  that  the  ovum  or  foetus  is 
generally  expelled  in  its  intact  membranes ;  this  more  frequently 
happens  at  an  early  stage  of  pregnancy.  Sometimes,  however,  the 
amnion  ruptures  at  the  commencement  of  abortion,  and  the  embryo  or 
ftftus  escapes  with  a  small  quantity  of  liquor  amnii,  the  envelopes  being 
rejected  soon  after  ;  or  in  some  instances  they  may  be  retained  in  the 
utei-us,  and  thus  constitute  a  source  of  danger,  the  animal  not  making 
any  effort  to  get  rid  of  them.  This  complicated  abortion  occurs  more 
frequently  at  the  later  stages  of  pregnancy,  and  more  resembles  normal 
birth  than  simple  abortion,  which  is  most  frequently  witnessed  in  the 
first  half  of  pregnancy.  Nevertheless,  we  have  the  latter  happen  so 
late  sometimes  as  the  seventh  or  eighth  month  in  the  larger  animals. 
It  is  observed  more  particularly  in  those  which  are  debilitated  from  any 
cause  ;  but,  at  the  same  time,  animals  which  apjjear  in  the  very  best 
health  are  often  the  subjects  of  simple  abortion. 

So  little  disturbance  does  this  kind  of  abortion  cause,  that  the  animal 
can  be  treated  in  eveiy  way  as  if  nothing  had  happened  ;  though  it  is 
more  judicious  to  give  it  a  little  extra  care  for  some  hours  at  least. 

In  what  has  been  termed  laborious,  difficult,  or  complicated  abortion, 
which  is  often  due  to  external  causes,  such  as  injuries,  the  precursory 
symptoms  are  generally  well  marked,  and  vary  somewhat,  according  as 
the  fnetus  may  be  dead  or  alive.  The  animal  suddenly  appears  dull  and 
peculiarly  dejected  ;  or  it  is  restless,  uneasy,  and  continually  moving 
about ;  if  pregnancy  is  advanced  and  the  fa-tus  is  alive  and  strong,  its 
movements  are,  on  watching  the  abdomen  attentively,  perceived  to  be 
frequent,  violent,  and  disordered,  but  they  soon  become  feeble  and 
infrequent,  and  cease  altogether  when  the  foetus  has  succumbed.  The 
appetite  is  lost,  a  plaintive  neigh  in  the  Mare,  moan  in  the  Cow,  or 
bleat  in  the  Sheep,  is  emitted  every  now  and  again  ;  the  pulse  is  quick, 
small,  and  hard  as  in  haemorrhage  ;  progression  isdiflBcult  and  unsteady; 

14 


210  PATHOLOGY  OF  I'EEGXAXCY. 

the  physiognomy  is  anxious,  and  respiration  hurried.  When  the  foetus 
is  ahve  there  is  perhaps  less  prostration,  and — more  particularly  with 
the  Mare — there  appears  to  be  much  abdominal  pain.  The  animal  often 
looks  anxiously  to%Yards  the  flanks,  paws  with  its  fore  feet  and  stamps 
with  its  hind  ones,  moves  from  side  to  side,  perspires  at  the  flank, 
breast,  and  elsewhere,  lies  down  and  gets  up  again,  whisks  the  tail 
incessantly,  and  exhibits  every  indication  of  increasing  restlessness.  At 
the  same  time  the  abdomen  loses  its  round  shape,  and  drops ;  if  the 
animal  is  in  milk,  the  mammtB  become  soft  and  diminish  in  size  more 
or  less  rapidly,  while  the  secretion  diminishes  ;  but  if  it  is  not  yielding 
milk,  then,  on  the  contrary,  they  enlarge  and  become  turgid  ;  the  vulva 
is  tumefied,  and  from  it  escapes  a  tenacious  mucus,  serous,  or  sero-san- 
guinolent,  and — if  the  fcetus  is  dead — more  or  less  foetid  fluid,  according 
to  circumstances.  Then  follow  symptoms  analogous  to  those  which 
characterise  normal  parturition — the  uterus  begins  to  contract,  and  the 
expiratory  muscles  act  simultaneously  with  it ;  the  expulsive  efforts,  or 
"  labour  pains,"  acting  more  or  less  energetically  and  continuously, 
according  to  the  suddenness  of  the  abortion  and  the  strength  and 
health  of  the  animal.  The  first  result  of  this  straining  is  the  evacua- 
tion of  the  bladder  and  rectum  ;  the  next  is  the  dilatation  of  the  os 
uteri  and  protrusion  of  the  membranes  into  the  vagina,  then  through 
the  vulva,  where  they  appear  externally  as  the  "  water-bag";  this  may 
rupture  and  the  liquor  amnii  escape,  and  the  pains  becoming  more 
powerful,  the  foetus  is  at  last  expelled  either  nude  or  covered  by  the 
membranes.  This  act  occupies  a  variable  period — from  a  few  to  many 
hours,  according  to  the  strength  of  the  animal ;  and  it  may  even  require 
humah  intervention  to  bring  it  to  a  successful  termination.  In  other 
instances,  however,  the  foetus  is  not  expelled  immediately  after  it  is 
dead,  but- after  many  of  the  premonitory  symptoms  just  described  have 
been  manifested ;  with  the  cessation  of  the  movements  in  the  foetus  the 
animal  regains  its  ordinary  tranquillity,  appetite,  and  liveliness,  and  all 
the  symptoms  disappear  for  one  or  more  days,  when  they  again  set  in, 
and  the  foetus  may  be  rejected  without  any  apparent  effort,  or  after 
much  straining. 

In  the  case  of  two  or  several  foetuses,  it  may  happen  that  the  one  or 
two  nearest  the  os  are  dead,  and  are  expelled,  the  others  being  alive  are 
retained  until  pregnancy  is  complete  ;  or  the  contrary  may  occur,  the 
living  foetuses  being  in  proximity  to  the  os,  prevent  ihe  escape  of  the 
dead  ones,  and  these  being  kept  in  the  uterus  until  delivery  of  the 
others  takes  place,  become  mummified. 

And  in  some  cases  of  what  might  be  termed  "  violent  "  or  "  acute 
abortion,"  when  it  suddenly  sets  in,  and  nothing  is  prepared  for  its 
being  carried  to  a  successful  termination,  either  on  the  part  of  the 
foetus  or  of  the  mother,  the  latter  is  exhausted  by  ineffectual  efforts, 
and  soon  passes  into  a  critical  condition. 

Abortion  differs  from  normal  parturition  chiefly  in  the  state  of  the 
cervix  uteri.  Towards  the  termination  of  pregnancy,  this  part  of  the 
uterus  becomes  gradually  shorteneol  anol  softer  ;  but  in  abortion  we  do 
not  have  these  progressive  changes  which  are  so  favourable  to  the 
passage  of  the  foetus  from  the  uterine  cavity  outwards.  The  cervix  is 
long  and  rigid  as  in  the  non-pregnant  condition,  and  its  dilatation  is 
therefore  slower,  more  diflicult,  and  more  incomplete  than  when  gesta- 
tion has  reached  its  termination  ;  and  especially  as  the  muscular  fibres 
of  the  uterus  have  not  acquired  either  their  full  development  or  contrac- 


ACCIDENTS  OF  rHKHXAXt'Y'.  211 

tile  force.  To  counterbalance  this,  there  is  the  small  size  of  the  foetus, 
which  does  not  require  so  much  space  for  its  passa^'e  as  if  it  were  full 
grown  ;  so  tliat  the  dilViculty  in  removing'  it  is  less  on  this  account, 
though  the  other  dilliculties  the  obstetrist  has  so  often  to  encounter  in 
parturition  may  all  be  present. 

Results. — Abortion  is  always  a  serious  accident,  if  only  from  the 
loss  of  the  fcEtus.  It  is  frequently  complicated  by  haimorrhage,  which 
may  primarily  have  been  the  cause  of  uterine  action  ;  it  may  also  result 
in  rupture  of  the  organ,  from  the  efforts  the  animal  makes  to  overcome 
the  resistance  oflered  by  the  cervix  ;  indeed,  we  may  have  the  usual 
complications  that  attend  parturition.  But  in  many  cases  the  com- 
plications are  few  and  trilling,  the  animals  scarcely  experiencing  any 
inconvenience,  and  retaining  all  their  useful  qualities  unimpaired. 
When  the  accident  occurs  in  the  Cow  at  an  early  period — before  the 
fifth  month — the  secretion  of  milk  is  generally  interrupted,  often  for  a 
year,  as  the  mamnuu  have  not  had  time  to  experience  the  reilex  or  sym- 
pathetic influence  which  stimulates  them  into  activity ;  when,  how- 
ever, it  takes  place  in  the  last  half  of  pregnancy  the  seci'etion  may  be 
established,  though  the  yield  is  usually  diminished,  and  the  glands  do 
not  furnish  tiieir  ordinary  quantity  until  the  next  pregnancy. 

Abortion  may  produce  prolapsus  of  the  uterus  and  vagina,  and  some- 
times even  of  the  rectum. 

At  an  early  period  of  pregnancy,  as  we  have  mentioned,  when  the 
foetal  and  uterine  attachments  are  not  very  close,  the  ovum  or  foetus 
may  be  expelled  with  the  w^iole  of  the  membranes  ;  but  as  the  process 
has  advanced  this  result  is  less  probable,  and  particularly  with  the 
Cow.  The  membranes  are  frequently  retained,  wholly  or  partially, 
when  the  fcctus  comes  away  ;  and  owing  to  the  condition  of  the  cervix 
and  its  rapid  contraction,  they  are  included  in  the  uterine  cavity  and 
constitute  wliat  is  termed  "  retention  of  the  placenta'' — often  a  serious 
complication  of  abortion  in  the  Cow  after  the  first  third  of  pregnancy, 
the  membranes  decomposing  and  giving  rise  to  putrid  infection  and  other 
alarming  pathological  conditions. 

In  the  simplest  cases,  oestrum  appears  in  the  C'ow  in  from  one  to  two 
weeks  after  the  miscarriage,  as  after  parturition,  and  conception  may 
occur  then  ;  but  not  infrequently  impregnation  does  not  take  place  until 
after  several  returns  of  this  condition,  and  often  a  whole  year  elapses. 
In  other  instances,  oestrum  does  not  appear  until  the  full  interval  of 
regular  pregnancv  has  elapsed,  and  then  the  animal  conceives  almost  as 
readilv  as  before  the  niishap.  Another  very  common  result  is  a  more 
marked  disturbance  in  the  generative  functions,  in  which  there  is  a 
tendency  to  abortion  after  every  conception  ;  and  with  other  animals 
there  remains  an  excitability  of  the  generative  organs,  which  is  mani- 
fested by  an  almost  persistent  state  of  oestrum,  giving  rise  to  nympho- 
mania, accompanied  by  sterility. 

Pathologic.\l  Anatomy. — The  lesions  occasioned  by  abortion  are 
varied,  according  to  circumstances.  In  the  majority  of  cases,  and 
especially  when  pregnancy  has  been  well  advanced,  the  maternal  organs 
are  in  a  similar  condition  to  that  observed  after  normal  parturition. 
The  OS  is  dilated  or  closed,  but  in  general  the  cervix  is  a  little  softer 
than  in  the  unimpregnated  state.  The  uterus  is  more  or  less  contracted 
on  itself  and  looks  congested,  its  vessels  being  voluminous    varicose. 


212  PATHOLOGY  OF  PREGNANCY. 

and  filled  with  blood ;  its  cavity  contains  a  certain  quantity  of  blood- 
coloured  mucus,  and  often  all  the  characteristic  indications  of  placental 
retention  and  decomposition  ;  its  mucous  membrane  is  red  and  thick- 
ened, and  there  may  be  traces  of  inflammation  in  it  and  the  cotyledons, 
as  well  as  evidence  of  the  cause  which  produced  the  accident,  if  due  to 
injury. 

The  appearance  of  the  foetus  varies  also,  according  to  the  period 
at  which  it  is  expelled,  the  cause  or  causes  which  led  to  its  expulsion 
or  death,  as  well  as  the  period  of  its  decease.  At  p.  116  we  have 
enumerated  everything  known  that  is  likely  to  lead  to  a  knowledge  of 
its  age.  Whether  it  is  expelled,  or  is  found  in  the  uterus  on  examining 
the  carcase  of  an  animal  that  has  died  or  been  destroyed,  the  body  of 
the  foetus  may  be  in  a  more  or  less  perfect  state  of  preservation.  If  it 
has  perished  recently,  it  is  little  if  at  all  altered  ;  its  skin  is  firm,  white, 
elastic,  and  even  ;  the  mucous  membranes  are  pale  ;  and  its  flesh  white, 
rather  soft  or  firm,  and  odourless.  But  when  death  has  taken  place 
some  days  previously,  and  the  air  has  had  access  to  the  uterine  cavity, 
then  there  are  indications  of  putrefaction — all  the  more  marked  as  the 
interval  is  prolonged  since  death  occurred.  The  foetus  is  swollen, 
infiltrated,  and  emphysematous,  and  exhales  a  putrescent  odour,  while 
the  hairs,  and  even  the  hoofs,  are  easily  removed.  "When  the  air  has 
not  entered  the  uterus,  the  foetus  may  present  a  withered,  wrinkled  and 
mummified  appearance.  If  abortion  has  been  due  to  hydramnois,  then 
the  foetus  is  sodden  and  wasted. 

The  foetal  envelopes  have  been  found,  in  some  instances,  intensely 
congested,  and  the  fluids  reddish  tinted;  in  others  the  latter  were  turbid, 
whitish,  and  not  so  fluid  as  usual ;  while  in  others,  again,  the  envelopes 
were  softened,  fragile,  and  colourless. 

Saint-Cyr  draws  attention  to  a  fact  which  we  have  referred  to  on 
several  occasions,  but  which  is  worth  alluding  to  again.  It  is  that,  as 
a  general  rule,  the  death  of  a  foetus  brings  about  its  expulsion  in  a  short 
time  ;  and  not  its  own  expulsion  alone,  but  also,  in  multiparous  animals, 
that  of  all  the  uterus  may  contain.  This  rule,  however,  is  far  from 
being  absolute.  We  have  already  seen  that  a  dead  foetus  may  be 
retained  for  a  very  long  time  ;  and  at  the  autopsy  of  such  multiparous 
creatures  as  the  Bitch,  Cat,  and  Sow,  which  have  died  or  been  killed 
while  pregnant,  it  is  not  rare  to  find,  between  two  perfectly  healthy  and 
well-developed  foetuses,  one  which  has  been  arrested  in  its  growth,  and 
has  evidently  been  dead  for  a  long  time,  and  yet  its  presence  has  occa- 
sioned no  disturbance.  Besides,  Bitches  and  Sows,  and  even  the 
uniparous  Mare  and  Cow,  at  the  usual  period  of  parturition  will  bring 
forth,  along  with  well-developed  and  living  young,  one  or  more  dead 
foetuses  whose  general  appearance  testifies  that  they  had  ceased  to  live 
for  a  long  time.  These  facts  prove  that  the  diseased  condition,  or  even 
the  death,  of  one  or  more  of  the  foetuses  in  an  animal  does  not  always 
prevent  gestation  from  following  its  regular  course. 

Diagnosis. — The  diagnosis  of  abortion,  easy  in  some  cases,  is  in 
others  difficult  and  complicated  ;  and  as  an  error  in  distinguishing  this 
accident  may  result  in  serious  consequences  to  the  veterinary  obstetrist, 
no  less  than  to  the  animals  confided  to  his  care,  as  Saint-Cyr  properly 
remarks,  it  is  well  that  it  should  receive  attention.  This  excellent 
authority  judiciously  presents  the  problem  in  three  difi'erent  aspects  : 
1,  Prognosticate  a  possible,  but  not  yet  imminent  abortion  ;  2.  Distin- 


ACCIDENTS  OF  PliEGNANCY.  213 

guish  an  abortion  takiuf;  place  from  other  accidents  or  diseases  with  which 
it  might  be  confounded  ;  3.  Keoognise  tliat  an  abortion  has  taken  place. 

1.  Prognosticate  an  Abortion. — Suppose  the  owner  of  a  pregnant 
animal  asks  such  a  question  as,  "  Will  this  creature  carry  its  young  the 
full  time?"  this  must  be  answered  by  another  question,  "  What  loads 
you  to  think  it  will  not  ?"  For  there  can  be  no  doubt  that,  as  has  been 
already  asserted,  there  is  a  special  predisposition  in  certain  animals  to 
abort  from  the  most  trifling  cause,  and  indeed  without  any  evident 
cause  at  all  ;  and  yet  they  offer  no  visible  indication  of  this  tendency. 
In  this  aspect  of  the  question,  it  is  always  judicious  to  remember  certain 
maxims,  the  most  important  of  which  is  that  relating  to  several 
previous  miscarriages,  before  giving  an  opinion  as  to  the  probability  of 
such  an  accident ;  and  this  opinion  should  be  based  on  exact  knowledge 
of  the  causes  capable  of  compromising  the  issue  of  pregnancy  to  which 
the  animal  has  been  or  is  then  exposed.  The  inquiry  should  be  as  com- 
plete as  possible,  and  then  an  opinion  ought  to  be  carefully  given  ;  as 
many  of  the  causes  of  abortion  are  so  very  imperfectly  known,  and  so 
many  circumstances  may  modify  the  predicted  result,  that  in  the 
majority  of  cases  it  is  only  permissible  to  hazard  presumptions  which, 
after  all,  are  more  or  less  uncertain. 

2.  Jiccotjnise  an  Actual  Abortion. — Here  we  have  to  distinguish  an 
abortion  in  process  of  accomplishment ;  and  at  first  sight  nothing 
would  appear  more  easy,  and,  in  fact,  nothing  is  so  easy  if  time  be 
allowed  until  all  the  characteristic  symptoms  attending  the  expulsion 
of  the  foetus  are  plainly  developed.  But  when  the  obstetrist  is  con- 
sulted at  the  commencement — during  the  premonitory  period,  it  may 
be  very  embarrassing  to  give  a  decided  opinion.  In  many  cases,  in- 
deed, impending  abortion  is  only  announced — even  for  some  days — by 
such  vague  signs  as  an  indefinable  malaise,  a  peculiar  dulness,  inappe- 
tence,  laziness,  perhaps  a  little  fever,  with  pawing  now  and  again, 
agitation  of  the  tail,  and  symptoms  which  might  be  taken  for  those  of 
slight  colic.  Saint-Cyr  has  known  many  good  practitioners  deceived 
by  these  signs,  and  who  have  diagnosed  either  indigestion,  gastro- 
enteritis, or  some  other  malady  which  disappeared — after  the  expulsion 
of  the  fcL'tus  !  Such  a  mistake  is  unfortunate  for  the  reputation  of  the 
veterinarian,  as  well  as  for  the  owner  of  the  animal,  whose  interests 
suffer  ;  as  if  a  miscarriage  had  been  diagnosed  in  proper  time  it  might 
have  been  prevented,  and  pregnancy  allowed  to  run  its  normal  course. 

To  prevent  such  an  error,  it  is  well  to  know  that  a  mistake  is  possible  ; 
80  that  if  called  in  to  attend  an  animal  offering  some  of  the  above- 
enumerated  symptoms,  the  first  inquiry  should  be  as  to  whether  it  is 
pregnant  ;  then  the  external  organs  of  generation — the  vulva  and 
mammic — ought  to  be  examined  with  the  greatest  care,  and  the  actual 
symptoms  thoughtfully  analysed.  This  being  done,  it  will  often  be 
found  that  this  is  a  case  of  threatened  abortion  ;  and  tliat,  when  taken 
in  time,  the  accident  can  be  averted  by  rational  treatment. 

3.  Recognise  that  an  Abortion  has  taken  place. — It  may  happen  that 
information  is  required  as  to  whether  abortion  has  occurred  in  an 
animal  ;  though  this  information  is  far  less  likely  to  be  sought  from  the 
veterinarian  than  from  the  human  obstetrist.  In  the  absence  of  the 
foetus  or  its  envelopes,  such  a  question  is  not  easily  answered  with 
regard  to  animals  ;  and  the  difficulty  is  increased  if  the  foetus  is  un- 
developed, and  a  long  interval  has  elapsed  since  the  presumed  date  of 
the  suspected  abortion.     Saint-Cyr  is  of  opinion  that,  as  a  rule,  it  is 


214  PATHOLOGY  OF  PREGNANCY. 

impossible  after  fifteen  days  to  assert  with  absolute  certainty  that  such 
an  accident  has  occurred,  the  generative  organs  having  at  that  date 
resumed  their  ordinary  physiological  condition.  For  it  is  only  by  an 
early  inspection  of  these  that  v^'e  can  enlighten  ourselves  as  to  what 
may  have  taken  place.  In  this  inspection  is  included  that  of  the 
mammce,  which  are  always  a  little  tumid,  hard,  and  painful,  and  often 
yield  a  small  quantity  of  milk  after  a  recent  abortion ;  the  tail,  the 
hair  of  which  is  soiled  and  matted  by  blood,  mucus,  and  the  liquor 
amnii ;  the  vulva,  which  is  swollen  and  dilated,  and  its  mucous  mem- 
brane often  presents,  in  addition  to  its  uniform  and  more  or  less  deep- 
red  colour,  ecchymoses  due  to  the  rubbing  or  bruising  it  experiences 
during  the  passage  of  the  foetus.  On  careful  vaginal  exploration,  if  the 
cervix  is  found  to  be  softer  than  usual  and  the  os  partially  open,  and, 
better  still,  if  the  hand  can  be  introduced  without  much  difficulty  into 
the  uterine  cavity,  and  a  quantity  of  sanguinolent  or  sanious  fluid,  or 
remains  of  membranes,  is  discovered  in  it,  it  may  be  concluded  that  a 
foetus  has  been  recently  expelled. 

Treatment. — The  treatment  is  preventive  and  remedial.  With  regard 
to  preventive  treatment,  this  must  mainly  depend  upon  a  knowledge  of 
the  causes  which  produce  abortion— which  we  have  seen  are  numerous, 
and  care  in  avoiding  or  modifying  these.  This  pei'tains  to  the  chapter 
on  the  hygiene  of  pregnancy  (p.  166).  With  regard  to  animals  which 
have  a  predisposition  to  abortion,  they  should  not,  if  possible,  be  bred 
from.  Should  it  be  desired  to  breed  from  them,  if  they  are  Bovines, 
they  must  not  be  put  frequently  to  the  male,  and  certainly  not  before 
eighteen  months  or  two  years  have  elapsed  since  the  last  abortion.  If 
the  accident  has  been  due  to  in-itation  of  the  generative  organs,  then 
these  should  receive  appropriate  treatment.  When  pregnancy  has 
again  occurred,  every  precaution  should  be  observed  to  continue  it  to  a 
successful  termination,  by  avoiding  or  removing  those  causes  which 
previously  induced  the  accident,  and  attending  to  the  general  health — 
combating  plethora  on  the  one  hand,  or  anaemia  on  the  other ;  guarding 
against  constipation  by  giving  proper  food  and  administering  mild 
laxatives,  and  against  irritation,  whether  general  or  uterine,  by  doses 
of  chloral  or  opium  given  by  mouth  or  by  rectum  ;  and  allowing  only 
gentle  exercise  towards  the  end  of  gestation. 

When  abortion  appears  to  be  imminent,  active  intervention  generally 
becomes  necessary  in  order  to  avert  it ;  and  therefore  it  must  be  ac- 
curately diagnosed.  We  have  already  alluded  to  the  symptoms  and 
means  by  which  this  accident  may  be  distinguished.  If  the  veterinarian 
is  fortunately  called  upon  in  good  time,  and  he  is  able  to  assure  himself 
that  the  fa3tus  is  still  alive,  that  the  membranes  are  not  ruptured,  and 
labour  pains  have  been  few  and  not  severe,  the  accident  may  be  checked 
or  prevented  by  the  administration  of  narcotics,  and  keeping  the  animal 
in  the  most  perfect  quiet  possible — alone  in  a  darkened  place,  with 
doors  and  windows  closed,  if  convenient.  The  narcotic  may  be  opium 
(in  the  form  of  tincture  if  desirable),  chloral  hydrate,  or  chloroform. 
Baint-Cyr  recommends  laudanum  (one  to  two  and  a  half  drachms  for 
large  animals)  administered  every  half-hour  or  hour,  in  very  small 
enemata  (not  more  than  a  wine-glassful  at  once),  which  he  thinks  pre- 
ferable to  draughts,  but  which  may,  nevertheless,  be  emploj^ed  concur- 
rently. Zundel  prefers  chloroform,  which,  he  asserts,  has  yielded 
extraordinary  results  in  his  hands  in  these  cases,  by  suddenly  arresting 


ACCIDENTS   OF  J'RJ-JaXAXCV.  215 

the  straining.  Ho  gives  it  in  doses  of  about  three  drachms  to  the  Cow, 
in  the  form  of  draught  in  oil  or  mucilage,  repeating  them  every  hour. 
Carsten  Harms  recommends  camphor,  or  camphor  and  opium,  and 
Euefif  assafci'tida. 

Enemas  are  objectionable,  as  they  have  a  tendency  to  increase  the 
straining. 

The  abdomen  should  be  gently  rubbed  for  some  time,  and  the  stall 
well  littered  ;  and  if  the  animal  will  eat  and  drink,  easily-digested  food 
in  small  quantity,  and  gruel,  may  be  given  until  all  danger  has  passed 
— generally  for  one  or  two  days— when  it  may  be  gradually  put  upon 
ordinary  diet,  and  allowed  to  resume  its  usual  occupation. 

When  abortion  is  inevitable — indicated  by  rupture  of  the  membranes 
and  escape  of  the  "waters" — and  there  are  no  means  of  preventing  the 
expulsion  of  the  fcctus,  the  object  nmst  then  be  to  favour  the  latter  in 
some  cases  as  speedily  as  possible,  and  remove  the  envelopes,  should 
there  be  any  likelihood  of  their  being  retained  in  the  uterus.  In  the 
majority  of  cases,  active  intervention  is  of  little  value  here,  and  is  only 
to  be  recommended  when  the  labour  is  tedious,  and  the  animal  is  be- 
coming exhausted  by  fruitless  straining,  or  when  labour  is  altogether 
suspended  after  rupture  of  the  membranes.  Then,  having  emptied  the 
rectum,  the  oiled  hand  is  to  be  cautiously  introduced  into  the  vagina, 
and  if  the  os  is  contracted  or  not  sufficiently  open,  it  must  be  gently 
dilated  by  the  index  and  other  fingers,  until  the  interior  of  the  uterus 
can  be  reached,  when  the  fatus  is  to  be  seized  and  removed  in  the 
usual  way ;  should  it  be  in  a  wrong  position,  or  should  there  be  any 
obstacle  to  its  egress,  then  we  must  proceed  according  to  the  directions 
given  for  overcoming  such  obstacles  when  they  occur  at  the  normal 
period  of  parturition.  In  abortion  or  premature  labour,  however,  the 
fcetus  being  smaller,  the  difficulties  are  less. 

If  it  should  happen  that  the  cervix  is  contracted,  and  shows  no  sign 
of  yielding  to  gentle  manipulation,  then  after  a  sufficient  time  has  been 
allowed  measures  should  be  adopted  to  relax  it.  Belladonna  ointment 
(one  part  to  four  of  lard),  introduced  into  the  vagina  and  applied  around 
the  cervix  by  the  hand  or  any  suitable  instrument,  may  be  used  with 
advantage.  Mr.  Cox  also  recommends  rugs  dipped  in  hot  water  and 
applied  over  the  pelvic  region.  Injections  of  mucilaginous  fluids  or 
glycerine  into  the  vagina  may  be  resorted  to  if  the  passage  has  become 
dry  after  the  escape  of  the  amniotic  fluid  ;  and,  internally,  extract  of 
belladonna,  chloral,  or  ether  or  alcoliol  draughts  should  be  administered, 
particularly  if  the  animal  is  exhausted.  Gruel,  beef-tea,  milk,  or  otlier 
strengthening  fluids  may  likewise  be  required.  The  ergot  of  rye  is  of 
little  value  in  cases  occurring  in  the  larger  animals,  and  its  use  is  rarely 
to  be  prescribed. 

If  the  membranes  come  away  with  the  fcetus,  there  is  little  more  to 
be  done ;  though  in  the  contrary  case,  which  is  by  no  means  infrequent 
in  abortion  or  premature  birth,  the  membranes  are  strongly  .adherent  to 
the  uterine  placentie,  and  their  retention,  particularly  in  Cattle,  is  often 
troublesome.  Some  practitioners  in  these  instances  prefer  to  remove 
them  immediately  and  mechanically  by  the  hand,  carefully  separating 
the  placentulai  one  after  another  ;  and  though  this  is  easily  enough 
accomplished  so  long  as  the  os  is  dilated — whic  :  it  usually  is  for  three 
days  after  delivery — yet  others  are  content  with  some  simple  precautions, 
and  prefer  to  wait.  When  they  find  the  membranes  firmly  adherent, 
and  their  separation  from  the  uterus  likely  to  be  attended  with  incon- 


216  PATHOLOGY  OF  PREGNANCY. 

venience,  they  only  partially  detach  them,  then  collect  and  twist  them 
into  a  rope-like  form,  and  leave  this  mass  in  the  vagina ;  so  that  should 
the  cervix  contract,  it  may  not  be  imprisoned  in  the  uterus.  Others  tie 
them  together  with  a  piece  of  tape,  which  is  allowed  to  hang  out  of  the 
vagina.  In  a  short  time  the  placenta  becomes  loosened,  and  can  then 
be  wholly  removed.  A  few  experienced  obstetrists  rely  on  internal 
medication  for  the  separation  of  the  foetal  placenta.  Zundel,  for 
instance,  has  long  and  successfully  administered  powdered  laurel  berries 
in  an  infusion  of  fennel,  giving  1|  ounces  three  times  a  day,  with  an 
ounce  of  sodium  bicarbonate  in  half  a  pint  of  fennel  infusion.  The 
membranes  always  come  away  on  the  second  or  third  day,  particularly 
if  plenty  of  mucilaginous  fluid  has  been  given  in  the  interval.  Bychner 
employs  a  decoction  of  the  meal  of  linseed-cake  in  doses  of  about  twelve 
pints  a  day,  when  this  result  ensues  about  the  ninth  day. 

An  animal  which  has  aborted  requires  attention  after  the  delivery  of 
the  foetus.  It  should  be  kept  clean,  fed  on  gruel  and  easily-digested 
food,  though  not  in  excess,  kept  from  draughts  of  air,  particularly  in 
cold  weather,  and  otherwise  nursed  for  some  days.  The  complications 
which  sometimes  accompany  this  accident  will  be  alluded  to  hereafter, 
as  they  are  usually  those  of  ordinary  parturition.  The  animal  should 
not  be  allowed  to  become  impregnated  at  the  next  oestrum,  nor  yet 
perhaps  at  the  succeeding  period. 

Eelaxation  of  the  genital  passages  in  the  Bitch  generally  follows 
immersion  in  a  warm  bath  (112°  to  114°  Fahr.)  for  a  few  minutes;  it 
must  not  be  prolonged  after  the  respiration  becomes  hurried  or  the 
animal  looks  distressed ;  and  the  creature  should  be  well  dried  and 
kept  comfortable. 

Epizootic,  Enzootic,  or  Infectious  Abortion. 

"What  has  been  named  epizootic  or  enzootic  abortion,  but  which  we 
have  designated  "  infectious,"  differs  in  its  etiology  and  some  other 
features  from  abortion  occurring  in  isolated  or  sporadic  cases,  but  more 
particularly  from  its  attacking  all,  or  nearly  all,  the  pregnant  Cattle  (for 
it  is  more  particularly  observed  in  Cows,  seldom  in  Sheep,  and  more 
rarely  among  Mares)  on  a  farm  or  pasture,  in  a  village,  over  a  wide 
district,  or  even  throughout  an  entire  country,  for  perhaps  a  succession 
of  years — thus  constituting  itself  a  veritable  scourge  to  agriculture  ;  and 
more  especially  as  it  only  too  frequently  appears  to  defy  all  precautions 
to  prevent  its  occurrence,  and  eludes  the  most  careful  search  for  its 
exciting  cause. 

Epizootics  of  abortion  have  been  recorded  from  the  earliest  times  ;^ 
but  it  was  only  towards  the  end  of  the  last  century,  when  Flandrin, 
Barrier,  Pele,  and  other  French  veterinary  authorities  undertook  their 
investigation,  that  we  discover  the  damage  they  inflicted.  The  observers 
in  this  century  are  very  numerous,  but  space  forbids  our  alluding  to 
them ;  it  may  be  sufficient  to  state  that  Continental  authorities  are 
agreed  as  to  the  destructiveness  of  this  accident  or  disease,  and,  until 
recently,  as  to  the  obscurity  which  attends  its  development.  For 
instance,  Heuze  mentions  that  in  the  Nievre  (France)  in  1869,  the  loss  to 
certain  agriculturists  amounted  to  30,000,  40,000.  and  even  50,000  francs ; 

^  Those  occurring  up  to  A.D.  800  are  described  in  my  work  on  Animal  Plagues.  We 
need  only  allude  in  this  place  to  the  human  "abortus  epidemicus  "  of  B.C.  278  ;  to  that 
observed  in  Germany  in  1777,  in  which  Cows  and  Pigs  were  involved  ;  and  that  at 
Chalons  in  1784,  in  which  nearly  all  the  Cows  and  Mares  aborted. 


ACCIDENTS  OF  P/iK'/XAXCV.  217 

in  South  Germany,  in  18ol-52,  according  to  RuetT,  it  was  very  serious ; 
Zundel  mentions  that  it  is  frequent  in  North  Germany  ;  and,  according 
to  Harms,  it  is  very  prevalent  in  Hanover. 

Indeed,  there  is  scarcely  a  country  in  which  there  are  competent 
observers,  that  has  not  been  reported  as  suiifering  from  visitations  of 
infectious  or  epizootic  abortion.  Some  of  these  outbreaks  have  been 
most  destructive.  In  the  United  States  of  America,  for  example,  it  has 
proved  a  veritable  scourge  in  some  of  the  horse-producing  regions,  where 
it  seems  to  have  made  its  appearance  in  recent  years.  It  is  only  since 
186G  that  it  has  attracted  attention  in  the  Mississippi  Valley,  and 
gradually  increasing  in  severity,  in  1889  and  1890  it  caused  great  havoc 
— the  losses  through  Mares  aborting  amounting  to  as  many  as  75  per 
cent,  in  some  regions ;  in  others,  one-half  of  the  Mares  aborted.  The 
Horse-breeding  areas  in  Illinois  and  adjoining  States  suffered  most. 
In  Kentucky  in  1892,  it  was  reported  that  75  per  cent,  of  the  brood 
Mares — trotting  and  thoroughbred — were  either  barren  or  had  lost  their 
Foals  that  spring.  Bourbon  County  sustained  a  loss  equal  to  £10,000 
by  Mares  slipping  their  Foals.  Fayette  County  suffered  an  even  greater 
loss  ;  while  Madison  and  other  counties  experienced  the  same  misfor- 
tune. In  Montana  it  inflicted  much  damage  in  the  Horse  ranches  in 
1892,  when  it  first  appeared  there.  In  1891  the  disease  was  observed 
in  South  America — in  the  State  of  Buenos  Ayres,  Argentine  Eepublic 
— where  the  outbreak  was  described  as  the  most  extensive  of  any  that 
had  hitherto  been  observed  in  any  part  of  the  world,  and  the  epizooty 
as  entirely  a  novelty  in  that  region.  The  losses  were  very  great.  In 
Australia  an  outbreak  of  epizootic  abortion  in  Cows  was  reported  from 
Warrnanibool,  Victoria,  in  1892.  In  1889,  Labat  reports  an  outbreak 
among  Ewes  in  France.' 

C.A.USES. — If  we  attempt  to  study  the  causes  which  have  been  alleged 
as  operating  in  the  production  of  epi/.outic  abortion,  we  are  ballled 
by  conflicting  statements  and  opinions.  Many  authorities  have  adduced 
those  causes  which  have  been  already  enumerated  as  producing  sporadic 
or  accidental  abortion  ;  while  others  have  taken  into  consideration  other 
influences  which  may  give  rise  to  the  accident,  as  well  as  those  which 
may  propagate  the  disorder.  Among  the  latter  is  Zundel,  who  has  made 
a  conscientious  study  of  this  important  subject,  and  throws  consider- 
able light  upon  it. 

With  regard  to  general  causes,  it  is  remarked  that  the  disease  is  most 
frequent — enzootic — in  wet  years,  as  it  was  in  South  Germany  in  1852, 
when  inundations  were  common  (Rueff),and  in  Haute-Saone  frequently 
(Trelut),  and  in  other  countries  ;  then  it  is  probably  due  to  anaemia,  as 
well  as  to  forage  damaged  by  moisture,  ergotized,  or  otherwise  altered. 
This  adynamic  condition  of  animals,  brought  about  by  the  weather  and 
food,  is,  in  the  opinion  of  Zundel,  particularly  favourable  for  the  multi- 
phcation  ot  microphytes,  micrococci,  and  bacteria  in  the  genito-urinary 
mucous  membrane,  and  these  have  been  spoken  of  as  the  principal  local 
cause  of  this  kind  of  abortion.  He  also  adds  that  it  is  possible  that, 
among  the  fungus  or  parasitic  elements  which  infest  forage  in  wet 
seasons,  there  may  be  some  which  act,  hke  the  ergot  of  rye,  directly  on 
the  uterus.     But  in  addition  to  the  influence  of  seasons,  there  has  also 

*  For  particulars  of  these  outbreaks  in  North  and  South  America,  _Australia,  and 
France,  see  the  Veteriiianj  Journal,  voU.  xxviii.,  p.  402  ;  xxxiv.,  pp.  275,  337  ;  xxxv., 
p.  332  ;  xxxvi.,  p.  16. 


218  PATHOLOGY  OF  PREGNANCY. 

been  a  supposed  influence  of  locality — the  disease  fixing  itself  in  par- 
ticular places  and  sparing  others.  For  instance,  Heuze  remarks  that 
in  the  department  of  the  Nievre,  France,  abortions  are  very  few  in 
the  arrondissement  of  Clamecy,  while  in  other  arrondissements  there  is 
scarcely  a  calf. 

With  regard  to  local  conditions  or  causes,  it  is  certain  that  the  regime 
to  which  animals  are  subjected  cannot  be  adduced  as  in  operation  ; 
for  the  abortions  occur  under  every  kind  of  management,  and  as  fre- 
quently, perhaps,  with  poor  as  with  fat  stock,  and  irrespective  of  age, 
breed,  or  constitution. 

Malarial  poisoning  is  a  cause  of  abortion  in  domestic  animals  as 
well  as  in  the  human  species ;  and  in  the  malarial  districts  in  Africa, 
Florida,  and  India,  Weatherly  asserts  that  the  natives  of  these  parts 
are  so  well  aware  of  this,  that  they  send  their  Cattle  and  Sheep  inland 
to  breed,  only  bringing  them  back  to  fatten. ^ 

The  influence  of  inclement  seasons  may,  as  has  been  remarked, 
operate  in  inducing  wide-spread  abortion,  but  this  cannot  always  be 
adduced ;  as  the  malady — speaking  of  it  as  we  would  do  of  a  disease — 
occurs  at  all  seasons  and  in  all  kinds  of  weather,  and  perhaps  much 
more  frequently  among  animals  which  are  housed  than  among  those 
living  in  the  open  air  without  shelter  of  any  kind. 

Neither  can  the  influence  of  food  be  adduced  as  an  exciting  cause 
in  many  outbreaks,  for  animals  fed  with  the  greatest  care  both  as  to 
quality  and  quantity  do  not  escape ;  and  as  for  ergotised  grasses  or 
seeds,  admitting  that  these  may  induce  abortion — though  it  has  never 
been  possible  to  produce  this  effect  on  Mares  or  Cows  experimentally,  no 
matter  what  dose  of  the  ergot  of  rye  was  administered,  nor  how  it  was 
given  —  yet  the  most  serious  visitations  have  appeared  where  the 
herbage  was  free  from  this  condition,  and  where  the  animals  were 
stabled. 

Strebel,  for  instance,  informs  us  that  in  1878  and  1879-80,  from 
20  to  60  per  cent,  of  the  pregnant  Cows  in  the  Canton  of  Freiburg 
aborted,  though  they  were  in  very  good  cowsheds ;  and  Bruin 
mentions  that  in  November  and  December,  1884,  and  January,  1885, 
60  per  cent,  of  the  pregnant  Mares  in  his  locality  aborted,  the 
majority  of  the  foetuses  being  in  their  envelopes,  or  these  were  ex- 
pelled in  from  two  to  eight  hours  after  birth,  though  in  some  instances 
they  were  retained  from  one  to  four  days. 

All  the  causes  that  have  been  adduced  as  operating  in  the  production 
of  sporadic  abortion,  and  even  extensive  outbreaks,  will  not  account 
for  every  mishap  of  this  kind ;  consequently,  there  has  always  been 
something  mysterious,  something  inscrutable  and  baffling,  to  the 
pathologist  who  sought  to  account  for  their  appearance  and  extension. 

So  long  ago  as  the  end  of  the  last  century,  contagion  or  infection 
was  believed  to  play  the  principal,  if  not  the  sole  part  in  many  out- 
breaks ;  for  it  was  observed  that  when  a  Cow  aborted  in  a  place  where 
other  pregnant  Cows  were  kept,  these  would  abort  in  succession  until 
all,  or  nearly  all,  had  miscarried.  Not  only  this,  but  it  has  often 
happened  that  a  newly-purchased  Cow-in-calf  has  been  introduced 
into  a  farm  where  the  Cows  had  always  calved  favourably  at  the 
proper  time ;  and  when  the  stranger  has  aborted,  first  one,  theaj 
another,  then  a  third,  and  so  on,  of  the  others  have  experienced  the' 
same  misfortune,  and  the  malady  has  persisted  in  the  place  for  con- 
1  BrltLsh  Medical  Journal,  February  2,  1S95,  p.  278. 


ACCIDEXTS  OF  PREGNANCY.  210 

secutive  years.  It  is  not  always  the  pregnant  Cows  next  to  the  one 
which  has  aborted  that  are  first  seized,  but  rather  animals  some 
distance  from  it. 

Again,  when  pregnant  Cows  which  were  living  in  a  place  where  the 
disease  had  not  existed,  have  been  introduced  into  a  stable  where  it 
prevails,  those  that  are  at  the  end  of  gestation  calve  regularly  and 
normally  soon  after  arrival ;  but  if  they  are  a  certain  time  in  the 
infected  stable  before  this  period  is  reached,  they  abort  like  the  others. 

So  that  the  presence  of  an  infecting  element,  if  not  absolutely  proved, 
is  at  least  admissible,  after  the  very  numerous  observations  of  the  most 
competent  veterinarians — especially  of  Uarreau.  Cruzcl,  Felizct,  Bouley, 
Lafosse,  Nocard,  and  others,  in  France;  and  Rueff,  Haubner,  Franck, 
Rolotf,  and  many  more,  in  Germany.  The  insalubrity  and  bad  hygiene 
of  cowsheds  and  stables  appear  to  have  no  influence  in  the  patho- 
genesis of  the  accident,  as  it  appears  quite  as  severely  and  readily  in 
those  which  are  well  ventilated  and  cleansed  as  in  those  in  the  opposite 
conditions ;  in  fact,  nothing  can  so  well  explain  the  occurrence  of  par- 
ticular outbreaks  of  epizootic  or  enzootic  abortion  as  the  presence  of 
a  contagium  or  a  miasmatic  iufcctioii. 

The  existence  of  a  contagium  would  appear  to  have  been  proved  by  the 
result  of  an  experiment  performed  by  Franck,  of  the  ^lunich  Veterinary 
School,  some  years  ago.  It  had  been  established  by  microscopical  investi- 
gation, that  on  the  lining  membrane  of  the  vagina  and  vulva,  there  is 
constantly  found  —  as  on  the  buccal  mucous  membrane  —  a  minute 
fungus  mixed  with  the  mucus,  in  every  respect  similar  to  the  Lcptothrix 
biiccalis,  which,  according  to  Hallier,  is  only  an  allotropic  condition 
of  the  ordinary  moulds — such  as  the  Penicillium  (jlaucum  or  Aspergillus 
— being,  in  fact,  a  kind  of  bacillus.  Towards  the  period  of  parturition 
these  bodies  become  extraordinarily  abundant,  and  they  appear  to 
concur  in  the  decomposition  of  the  fwtal  membranes  and  their  expul- 
sion ;  when  the  membranes  are  retained  and  putrefy  in  the  uterus, 
they  are  extremely  numerous,  as  are  the  micrococci.  Franck  showed 
that,  by  smearing  the  vaginal  canal  of  a  pregnant  animal  to  a  certain 
depth  with  the  matter  from  the  expelled  membranes  of  one  which  had 
been  delivered,  abortion  can  be  induced. 

So  that,  as  Zundel  asserted,  it  is  sufiicicnt  to  introduce  into  the 
vagina  micrococci  or  bacteria,  which  will  multiply  there,  and,  penetrat- 
ing to  the  uterus,  commence  their  work  of  decomposition,  to  produce 
abortion. 

Roloff  had  also  ascertained  that  abortion  is  due  to  something  which 
finds  admission  to  the  uterus  by  the  vagina ;  that  a  certain  amount 
of  redness  and  tumefaction  of  the  lining  membrane  of  the  latter  always 
precedes  this  accident ;  and  that  this  virulifcrous  or  miasmatic  matter 
is  found  on  the  articles  soiled  by  the  delivery  of  a  Cow  which  has 
aborted,  as  well  as  in  the  drains  of  the  stable,  on  the  litter,  etc. 

Brauer  inoculated  Cows  which  were  pregnant  from  five  to  seven 
months  with  this  infective  material,  and  in  twelve,  fourteen,  fifteen, 
and  twenty-one  days  after  the  operation  they  aborted. 

It  must  be  remarked,  however,  that  such  views  were  not  accepted 
for  a  considerable  time  by  a  large  portion  of  the  veterinary  profession, 
who  endeavoured  to  explain  the  occurrence  of  this  kind  of  abortion 
by  asserting  that  when  one  animal  got  rid  of  its  fcctus  prematurely 
others  did  so  through  sympathy  or  imitation — a  very  old  notion  indeed, 
and  one  which  will  not  bear  examination.     Cows  do  not  abort  when 


220  PATHOLOGY  OF  PREGNANCY. 

others  calve  beside  them,  and  why  should  they  do  so  when  abortion 
takes  place  ?  Sympathy  should  be  shown  as  much,  if  not  more,  in 
the  first  instance  as  in  the  second. 

Then,  again,  others  attributed  this  kind  of  abortion  to  the  fact  of 
pregnant  Cows  being  brought  into  contact  with  putrescent  materials  or 
odours,  no  matter  what  they  were  derived  from  ;  this  was  another  old 
notion,  and  so  firmly  was  it  believed  in  by  farmers,  that,  in  order  to 
ensure  their  pregnant  Cow  against  this  accident,  they  were  accustomed 
to  smear  the  animals'  noses  with  tar  when  any  bad  smells  were  evident. 
But  for  this  belief  also  there  is  no  better  foundation  than  for  the 
supposed  sympathy ;  as  it  frequently  happens  that  Cows  go  their  full 
time  amid  foul  odours,  and  it  even  happens  that  in  a  shed  a  Cow  will 
calve,  and  the  placenta  will  be  retained  until  it  evolves  an  almost  in- 
supportable stench  of  putrescence,  and  yet  other  pregnant  Cows  will 
remain  unaffected  ;  while  not  unfrequently  abortions  occur  in  a  large 
cowshed  in  which  cleanliness  is  well  attended  to,  and  no  bad  smell  can 
be  perceived. 

The  evidence  in  favour  of  the  presence  of  an  infecting  agent  in  these 
outbreaks  of  abortion  which  cannot  otherwise  be  explained,  is  strong 
from  a  clinical  point  of  view,  and  still  stronger  from  an  experimental 
one  ;  for  in  addition  to  the  investigations  of  the  authorities  already 
named,  we  have  those  of  Nocard,  carried  out  ten  years  ago,  which 
should  definitely  settle  the  question,  as  they  were  almost  exhaustive 
on  every  point,  while  his  experiments  were  conducted  with  that 
scrupulous  care  which  marks  all  his  pathological  inquiries.  He  ascer- 
tained that  there  was  nothing  in  the  living  animal  to  indicate  that 
this  abortion  was  a  general  disease  of  the  Cow ;  as  all  the  functions 
are  normally  performed,  the  temperature  does  not  rise  above  the 
tenth  of  a  degree ;  the  urine  contains  neither  sugar  nor  albumin,  aud 
the  blood,  milk,  and  various  tissues  are  unaltered.  The  histological 
examination  and  cultivations  of  solids  and  fluids  did  not  reveal  the 
presence  of  pathogenic  organisms.  He  examined  the  bodies  of  Cows 
which  had  just  aborted,  of  those  about  to  abort — especially  primiparae, 
and  of  those  which  had  aborted  the  previous  year  and  were  afterwards 
sterile.  In  Cows  which  had  aborted  but  still  retained  the  foetal 
envelopes,  he  removed,  with  all  due  precautions,  fibrinous  muco- 
purulent flakes  of  a  bright  yellow  colour  he  found  in  the  latter ; 
difficulty  was  experienced  in  separating  the  maternal  and  foetal  placentae, 
and  the  placental  villi  were  of  a  dirty  white  colour,  looking  as  if  in- 
filtrated with  pus  or  macerated ;  around  the  base  of  the  cotyledons 
there  was  a  great  quantity  of  the  same  yellow  flakes,  similar  to  those 
frequently  recorded  as  passing  from  the  vulva  after  abortion.  The 
cotyledons,  after  their  placental  covering  was  removed,  were  firm, 
rosy,  and  penetrated  by  deep  wide  follicles ;  pressure  caused  the 
exudation  of  some  drops  of  purulent-looking  matter,  softer  than  the 
flakes.  Scraping  of  the  cut  surface  gave  a  milky  juice,  white  and 
homogeneous,  analogous  to  cancer  juice.  He  also  obtained  a  quantity 
of  cotyledonary  pulp,  and  this,  with  the  other  matters,  he  sowed  in 
broths  and  in  peptone-gelatine  tubes.  When  stained  and  examined 
microscopically,  the  puriform  matter  was  found  to  consist  of  a  mass 
of  epithelial  cells  and  leucocytes  mixed  up  in  a  mucus  and  fibrinous 
network,  together  with  a  number  of  micrococci — isolated,  double,  and 
in  short  chains — consisting  of  three,  four,  and  five  cocci ;  here  and  there 
were  also  a  few  short  thick  bacilli,  isolated  or  associated  two  by  two. 


ACCIDENTS  OF  mKCXAXCV.  221 

Til  the  cotyledonary  juice  these  bacilli  were  found  almost  to  the  entire 
exclusion  of  the  niicrococci,  and  in  the  juice  scraped  from  the  mucous 
surface  these  organisms  existed  in  about  equal  numbers.  After  forty- 
eight  hours  the  sown  tubes  exliibited  an  abundant  cultivation.  Those 
sown  with  the  cotyledonary  juice,  cultivated  in  a  state  of  purity, 
showed  the  short,  thick  geminated  bacillus  just  referred  to  ;  while  those 
sown  with  purulent  matter  had,  on  the  contrary,  a  mixed  culture  of 
micrococci  and  bacilli,  the  former  being  most  abundant.  Tlie  tubes 
sown  with  blood  and  milk  preserved  their  limpidity. 

Similar  results  were  obtained  in  all  the  experiments  ;  but  in  a  Cow 
which  had  aborted  the  previous  year,  and  was  afterwards  "sterile,  a 
mixed  variety  of  organisms  was  found,  while  the  matter  obtained  by 
scraping  the  uterine  mucous  membrane  gave  a  slightly  acid  reaction  that 
was  probably  the  cause  of  the  animal  being  incapable  of  impregnation  ; 
as  spermatozoa  cannot  retain  their  vitality  in  other  than  an  alkaline 
medium. 

It  was  observed  that  Cows — primiparoe  and  pluripane  —  from  a 
district  where  this  abortion  did  not  exist,  had  no  micro-organisms 
between  the  uterine  mucous  membrane  and  the  foetal  envelopes. 

In  his  obsen'ations  on  the  Calves,  Nocard  found  that  neither  the 
blood,  bile,  pulp  of  the  spleen,  liver,  kidneys,  nor  mesenteric  glands,  nor 
yet  the  serum  from  the  pericai'dium,  pleura,  or  peritoneum,  yielded 
cultivations  ;  but  from  the  fluid  in  the  stomach  and  the  intestines,  as 
well  as  the  medulla  oblongata,  he  obtained  cultures  of  the  same  micro- 
coccus that  he  had  found  in  the  liquor  amnii  and  flaky  muco-purulent 
matter. 

It  was,  of  course,  necessary  in  these  investigations  to  select  foetuses 
which  had  been  aborted  dead,  and  had  therefore  never  breathed  ;  for  as 
soon  as  respiration  begins,  micro-organisms  are  always  found  in  the 
alimentary  canal  of  all  animals. 

From  his  inquiries,  Nocard  was  of  opinion  that  the  peculiar  bellow 
of  the  Calf,  like  the  altered  voice  of  the  rabid  Dog,  is  due  to  cerebral 
derangement,  caused  by  the  presence  of  these  micrococci.  He  also 
believed  that  many  cases  of  death  from  diarrhea  in  newly-born  Calves 
are  due  to  this  cause  ;  he  has  examined  the  medulla  oblongata  of  those 
which  succumbed,  and  found  a  microbe  in  all  respects  identical ;  so 
that  he  questions  whether  it  is  not  one  and  the  same  disease,  develop- 
ing at  different  periods  in  the  life  of  the  young  animal.  The  existence 
of  micro-organisms  in  the  alimentary  canal  of  aborted  foetuses,  previous 
to  expulsion  from  the  uterus  (though  none  are  in  the  healthy  fcetus 
during  intra-uterine  life),  was  also  demonstrated;  thus  showing  the 
microbic  nature  of  this  infectious  abortion. 

In  the  outbreak  of  infectious  abortion  among  Mares  in  Montana, 
United  States,  inoculation  experiments  were  made  with  cultures  from 
the  membranes  and  blood  of  an  aborted  foetus,  and  these  were  successful 
not  only  in  inducing  abortion,  but  the  Foal  of  one  which  lived  for  a 
short  time  had  disease  of  the  knee  and  hock  joints. 

It  has  not  yet  been  absolutely  demonstrated  how  the  infection  is 
conveyed  to  the  uterus,  but  as  the  Cow  is  individually  seldom  affected, 
it  is  extremely  probable  that  the  vaginal  discharges,  as  well  as  the 
foetus  and  its  envelopes,  contain  the  organisms  which  occasion  the 
accident,  and  that  putrefaction  does  not  destroy  their  vitality.  It  has 
been  remarked  that,  in  general,  the  foetal  membranes  are  liable  to  be 
retained  in  Cows  which  abort,  and  that  when  not  removed  artificially 


222  PATHOLOGY  OF  PREGNANCY. 

they  only  come  away  when  decomposition  sets  in.  The  influence  of 
these  putrefying  membranes  has  been  noted  by  several  veterinarians — 
Pele,  Barrier,  Cruzel,  Bouley,  Eychner,  Haubner,  and  others — who 
imagined  that  the  putrescent  emanations  infected  the  economy  of  the 
animals  breathing  them ;  but  Zundel  thinks  it  more  probable  that 
direct  infection  takes  place  by  the  genital  mucous  membrane.  In 
support  of  this  opinion,  he  quotes  the  observations  of  Eoloff,  who  asserts 
that  he  always  saw  the  disease  or  accident  developed  in  stables  or  sheds 
where  the  distance  between  the  mangers  and  drains  was  small,  or  where 
the  drains  did  not  have  suflicient  fall,  whereby  the  hind  quarters  of  the 
animals  were  readily  soiled  by  the  excreta  in  them. 

The  micro-organism  may  obtain  introduction  to  the  genital  passage 
of  pregnant  Cows  through  actual  contact  with  these  matters,  or  the  air 
may  carry  it  to  them  when  the  discharges  have  become  dried. 

There  is  evidence,  then,  which  leads  to  the  belief  that,  beside  the 
other  causes  which  have  been  cited  as  giving  rise  to  abortion,  there  is  a 
specific  germ  that,  when  transmitted  from  an  animal  that  has  aborted, 
or  from  the  aborted  foetus  or  its  envelopes,  to  another  pregnant  animal 
of  these  same  species,  will  cause  it  to  abort.  Clinical,  experimental, 
and  hygienic  observation  are  in  favour  of  this  opinion,  which  if  it  cannot 
be  accepted  as  absolutely  confirmed  in  every  respect,  yet  affords  at  any 
rate  a  good  working  hypothesis  that  satisfies  the  exigencies  of  everyday 
practice. 

Whether  the  abortion  germ  is  identical  in  every  species  of  animal  is  a 
question  still  to  be  solved — though  it  probably  is  not,  as  Mares  have 
aborted  among  pregnant  Cows,  Ewes  have  done  the  same,  and  rzcc  versa, 
without  abortion  going  beyond  the  one  species. 

Symptoms. — It  is  rare  that  this  kind  of  abortion  occurs  before  the 
third  or  fourth  month  of  gestation  ;  more  frequently  it  is  at  the  fifth, 
sixth,  or  seventh  month,  or  even  later.  There  are  no  premonitory 
symptoms,  except  perhaps  a  trifling  uneasiness  for  a  few  hours  pre- 
viously, with  sinking  of  the  flanks  and  descent  of  the  abdomen  ;  the 
animal  generally  looks  well  and  hearty,  and  yields  its  supply  of  milk  as 
usual;  and  soon  after  the  foetus  is  expelled,  apparently  without  any 
effort  or  inconvenience,  and  along  with  its  membranes,  if  these  are  not 
ruptured,  with  or  without  them  when  they  are.  It  is  rare,  however, 
that  the  ruptured  membranes  are  rejected  immediately  after  the  foetus  ; 
as  a  rule  they  are  nearly  always  retained,  particularly  when  pregnancy 
is  advanced  ;  and  they  putrefy  in  the  uterus,  being  got  rid  of  only  in 
shreds  at  intervals.  ^A'hen  attempts  are  made  to  remove  them  by  hand, 
this  is  found  much  more  difficult  than  after  ordinary  parturition  ;  owing 
to  the  membranes  being  very  adherent,  the  cotyledons  have  to  be 
enucleated  separately,  and  even  then  the  membranes  come  away  in 
fragments.  Then  the  animal  generally  loses  its  appetite  and  condition, 
goes  off  its  milk,  and  sometimes  perishes,  probably  as  a  consequence  of 
this  placental  retention.  If  it  recovers,  oestrum  appears  unnaturally 
frequent,  though  conception  is  infrequent  and  sterility  common  ;  and  on 
the  other  hand,  there  are  some  animals  which  expel  the  membranes 
quickly,  conceive  soon  after,  but  again  abort  as  readily — perhaps  three 
times  in  the  course  of  a  year. 

The  foetus  is  usually  dead,  though  when  it  is  expelled  (in  the  Cow) 
after  the  fifth  month  it  may  be  alive ;  but  it  is  weakly  and  soon  dies, 
even  when  born  near  the  termination  of  pregnancy.     These  Calves  make 


ACCIDENTS  OF  PllEGNAXCV.  223 

a  rattling  noise  when  breathing,  accompanied  by  the  discharge  of  a 
rusty-coloured  mucilaginous  lluid  from  the  nostrils  ;  they  are  attacked 
by  diarrhaa  ;  they  bellow  continually,  and  are  always  emaciated  and 
flabby,  the  gums  and  palate  being  pale,  and  the  umbilical  vessels  livid 
and  withered-looking.  The  dyspna^a  and  great  weakness  evinced  by 
them  shows  that  they  are  not  properly  organised.  Nocard  believes  that 
such  Calves  die  from  the  same  cause  as  those  which  are  aborted  dead. 
Those  which  are  dead  when  expelled  exhibit  indications  of  having  ceased 
to  live  a  short  time  previously. 

As  has  been  stated,  all  the  animals  on  a  pasture  or  in  a  shed  where 
the  disease  prevails,  do  not  abort  at  the  same  time,  but  at  intervals. 
\Vhen  one  aborts,  another — its  neighbour  perhaps — appears  to  prepare 
for  the  event,  which  may  occur  in  about  eight  days ;  then  some  days 
after  this  it  is  the  turn  of  another,  and  so  on  until  two-thirds,  or  perhaps 
even  all,  of  the  pregnant  Cows  beyond  three  months'  gestation  have 
aborted. 

It  has  also  been  mentioned  that  it  is  only  after  being  some  time  in 
sheds  in  which  the  disease  is  present,  that  newly  purchased  pregnant 
Cows  are  attacked  ;  those  which  have  passed  their  eighth  month  and 
are  near  calving  escape  abortion. 

Darreau  alludes  to  instances  in  wliich  a  pregnant  Cow,  leaving  a 
shed  in  which  abortions  prevailed,  and  transferred  to  another  where  the 
accident  had  not  been  seen,  would  remain  all  right  for  some  time,  then 
suddenly  miscarry,  and  in  the  course  of  about  fifteen  days  other  abor- 
tions would  occur  in  this  shed — testifying  to  the  danger  of  keeping 
pregnant  Cows  in  contact  with  or  in  proximity  to  those  which  have 
miscarried  in  this  way.  It  has  also  been  stated  that  an  animal  which 
aborts  either  remains  sterile,  or  has  always  a  tendency  to  abort  again. 
But  it  has  been  obser\'ed  that  if  Cows  are  well  fed,  the  period  that 
elapses  after  each  abortion  is  often  longer  ;  so  that  if  a  Cow  aborts  the 
first  time  at  six  months,  it  will  do  so  again  at  the  seventh  month,  and 
the  third  time  a  little  before  the  ninth  month,  reaching  its  full  period  in 
three  pregnancies. 

The  symptoms  of  infectious  abortion  in  the  Mare  do  not  differ  much 
from  those  observed  in  the  Cow.  Very  often  nothing  at  all  is  noticed, 
the  animal  appearing  in  as  good  health  as  usual ;  in  other  instances 
there  is  uneasiness,  which  might  pass  without  attracting  much  atten- 
tion. In  the  American  outbreaks,  very  often  the  first  indication 
observ'ed  was  the  return  of  oestrum  in  Mares  supposed  to  be  some 
months  pregnant  ;  and  the  animals  being  at  pasture,  the  expelled 
foetuses  escaped  detection,  until  in  some  of  the  Mares  pregnancy  had 
considerably  advanced,  when  the  size  of  the  abortions  led  to  the  dis- 
covery that  the  disease  was  rife.  The  Foals  that  lived  for  a  short  time 
had  inflammation  of  the  joints,  which  often  ran  on  to  suppuration,  and 
this  was  ascribed  to  the  same  organism  which  had  caused  the  abortion. 

Pathological  An.\tomy. — The  appearances  observed  in  the  uterus 
and  its  contents  in  infectious  abortion  have  already  been  briefly 
alluded  to  when  describing  Nocard's  investigations,  and  there  is  not 
much  to  be  added.  The  foetal  envelopes  are  generally  nmch  altered  in 
Bovines — looking  as  if  macerated,  and  covered  with  pus  or  lymph-like 
flakes  ;  while  the  liquor  amnii  is  turbid,  and  sometimes  flocculent.  The 
mucous  membrane  of  the  uterus  it  often  very  congested.  In  America, 
in  the  case  of  the  Mares,  the  foetal  membranes  in  one  outbreak  were 


224  PATHOLOGY  OF  PREGNANCY. 

always  found  abnormal  in  appearance.  In  one  instance  the  portion  of 
the  envelopes  in  the  cornua  was  undergoing  decomposition,  having  a 
deep-red,  congested  appearance,  followed  later  by  a  leaden-gray  hue, 
and  exhaling  a  very  foetid  odour.  Patches  of  the  membranes  were 
destroyed,  and  small  quantities  of  a  muco-purulent  matter  were  found. 

Treatment. — If  the  malady  is  suspected  to  be  due  to  any  one 
particular  cause,  or  if  there  exist  predisposing  causes,  then  the  indica- 
tions for  the  prevention  or  cure  of  this  accident  are  obvious.  The 
atonic  state  which  seems  to  favour  the  occurrence  of  infectious  abortion 
in  or  after  certain  rainy  seasons,  should  be  remedied  by  good  food  and 
tonics — and  especially  preparations  of  iron.  Tonics  have  been  par- 
ticularly serviceable  when  abortion  was  supposed  to  be  due  to  ergotised 
food  ;  though  Zundel  recommends  the  internal  administration  of 
carbolic  acid.  In  cattle-sheds  where  Cows  aborted  year  after  year, 
Brauer  has  employed  carbolic  acid  with  the  most  marked  success.  He 
gave  it  to  Cows  which  were  from  five  to  seven  months  pregnant,  by 
subcutaneous  injection  in  the  neighbourhood  of  the  flank,  the  dose 
being  two  Pravaz  syringefuls  of  a  two  per  cent,  solution.^ 

If,  however,  we  admit  the  most  common  and  efficient  cause  to  be  in- 
fection or  contagion — that  abortion  is  due  to  the  presence  of  a  micro- 
organism transmissible  from  an  affected  animal,  or  from  something 
which  has  belonged  to  it,  to  another  in  healtla — then  the  first  and 
fundamental  indication  is  to  remove  or  isolate  the  source  of  the 
mischief. 

When,  therefore,  abortion  occurs,  and  there  is  reason  to  believe  that 
this  accident  is  in  its  nature  infectious,  the  foetus  and  all  pertaining  to 
it  should  be  removed  as  promptly  and  completely  as  possible  from 
the  shed  or  place  in  which  the  animal  is  located.  The  Cow  itself 
should  also  be  removed — or,  better  still,  the  other  pregnant  animals 
in  the  same  shed  should  be  moved  away  to  another  building  —  and 
either  kept  altogether  isolated,  or  at  least  away  from  all  other  pregnant 
cattle,  with  a  special  attendant  employed  to  look  after  it ;  this  at- 
tendant should  not  go  near  the  unaffected  pregnant  cattle,  and  the 
excreta  from  the  Cow  should  also  be  carefully  kept  out  of  their  Avay. 

The  shed  in  which  the  accident  has  occurred,  and  especially  if  it 
contain  more  pregnant  cattle,  ought  to  be  immediately  cleared  of 
all  manure  and  other  matters  of  an  objectionable  kind,  the  drains 
and  the  floor — particularly  that  of  the  stall  which  has  been  occupied 
by  the  Cow — being  thoroughly  swilled  with  water,  and  sprinkled  with 
some  good  disinfectant ;  the  walls  should  also  be  lime-washed ;  a 
good  layer  of  straw  may  then  be  laid  down,  and  the  cattle  replaced. 

The  shed  should  be  kept  clean  and  well  ventilated  for  a  number  of 
days,  and  the  drains  well  flushed  and  disinfected. 

The  animal  which  has  aborted  must  also  be  at  once  attended  to.     If 

1  Wochensrhri/t  fiir  71iierheilhmde  und  Viehznchf,  1884,  p.  429.  The  adminis- 
tration of  this  medicament  has  quite  recently  been  brought  forward  again,  and  its 
successful  employment  is  reported  in  the  North  British  Agriculturist  for  January  19  of 
the  present  year.  In  this  case  a  valuable  herd  was  so  haunted  with  the  abortion  plague 
that  it  was  about  to  be  destroyed.  Crude  carbolic  acid,  in  quarter-ounce  doses,  was 
dissolved  in  sufficient  warm  water  to  make  a  mash,  then  the  bran  was  added.  The  dose 
was  increased  gradually  to  half  an  ounce.     The  mashes  were  given  three  tiines  a  week. 

It  has  also  been  recommended  to  give  the  acid  (Calvert's  No.  4)  in  quarter-ounce 
doses,  as  above,  carefully  dissolved  in  one  quart  of  warm,  sweetened  water,  or  in  a  bran 
mash  once  or  twice  a  week. 

This  medication  might  be  combined  with  Nocard's  external  treatment,  mentioned  above. 


ACCIDENTS  OF  rREdXASCV.  TlTt 

the  membranes  have  not  been  discharged — which  is  most  frequently 
the  case — they  sliould  be  removed  as  early  as  possible,  and  not  allowed 
to  putrefy  ;  their  removal  should  be  effected  by  the  hand,  and  a  weak 
solution  of  carbolic  acid,  corrosive  sublimate,  perman^'anati;  of  potas- 
sium, or  salicylic  acid  ought  to  be  injected  into  the  vagina  and  uterus,  a 
o  per  cent,  solution  of  carbolic  acid  being  employed  to  sponge  about  the 
vulva,  over  the  tail  and  down  the  back  part  of  the  thighs.  The  mem- 
branes themselves  must  bo  destroyed  or  buried,  and  the  Cow  should 
not  be  allowed  to  go  near  others  whicli  are  pregnant  so  long  as  there  is 
any  discharge  jD(;r  vu'.vavi:  for  safety,  the  period  of  isolation  should 
extend  at  least  to  from  eight  to  fifteen  days.  The  animal  may  require 
good  nursing  in  the  meantime  ;  and  it  should  not  be  put  to  the  male 
until  every  trace  of  irritation  in  the  generative  organs  has  disappeared. 

If  Cows  show  any  symptoms  of  impending  abortion,  they  ought  to  be 
promptly  removed  from  the  vicinity  of  others  which  are  in  calf. 

When  this  accident  continues  in  a  stable  or  shed,  Saint-Cyr  thinks  it 
necessary  to  recommend  disposal  of  all  the  Cows  therein ;  and  before 
introducing  others  into  it,  to  thoroughly  cleanse  and  disinfect  it  by 
removing  all  excreta;  renewing  the  soil  or  flooring,  washing  and  scraping 
the  mangers,  racks,  and  walls  and  woodwork,  making  more  air-aper- 
tures if  necessary,  and  leaving  it  empty,  with  the  doors  and  windows 
open,  for  a  month  or  six  weeks. 

In  sheds  where  abortion  among  Cows  is  frequent,  Nocard  recom- 
mends the  following  preventive  measures  :  1.  Once  a  week  the  cow- 
sheds are  to  be  well  cleansed,  particularly  behind  the  Cows,  and  then 
sprinkled  with  a  strong  solution  of  sulphate  of  copper,  or  of  carbolic  acid 
— one  part  to  fifty  of  water.  i2.  The  tail,  anus,  vulva,  and  thence  down- 
wards to  the  hoofs  of  the  hind  limbs  of  every  Cow  inhabiting  these 
infected  sheds,  to  be  sponged  daily  with  the  following  preparation — 

Distilled  or  rain  water  -  -  2  gallons. 
Hydrochloric  acid  -  -  -  ~h  ounces. 
Corrosive  sublimate  -         -     2i  drachms. 

These  ingredients  to  be  thoroughly  mixed ;  and  as  the  preparation  is 
poisonous  to  man  and  beast,  care  must  be  taken. 

This  precautionary  treatment,  wherever  adopted,  has  been  found 
successful — another  proof  of  the  infectious  nature  of  this  kind  of  abor- 
tion ;  though,  as  Nocard  remarks,  in  some  instances  the  accident  does 
not  wholly  cease  during  the  first  calving  seasou,  but  it  always  does  so 
in  the  second  season. 

With  regard  to  infectious  abortion  in  the  Mare,  similar  measures  to 
those  recommended  for  this  accident  in  the  Bovine  species  should  bo 
enforced.  In  Montana,  U.S.A.,  those  prescribed  wei'e  as  follows : 
1.  If  the  Mare  aborted  in  an  open  paddock  or  pasture,  the  f(ctus  and 
ftrtal  membranes  were  to  be  burned,  and  the  animal  taken  to  a  stable 
or  small  lot,  where  she  could  be  easily  treated.  2.  If  she  was  removed 
to  a  stable,  this  had  to  be  apart  from  any  other  stable  containing 
pregnant  animals,  and  not  on  high  gi-ound  from  which  the  urine  would 
run  on  to  other  parts  frequented  by  pregnant  Mares  ;  if  removed  to  a 
small  lot,  this  had  to  be  low,  or  situated  so  that  the  drainage  from  it 
might  not  be  a  source  of  danger.  3.  When  Mares  have  aborted  and 
are  not  doing  well,  their  external  genitals  should  be  thoroughly  cleansed 
with  a  solution  of  corrosive  sublimate  (1  to  1,000  of  water) ;  the  tail 
itself  was  to  be  thoroughly  washed  with  the  same,  and,  if  in  fly-time, 

15 


226  PATHOLOGY  OF  PREUNAXCY. 

a  solution  of  carbolic  acid  (1  to  100  of  water)  was  to  be  added.  The 
vagina  and  uterus  were  also  to  be  cleansed  by  injections  of  clean  tepid 
water,  and  the  solution  just  mentioned  injected.  These  injections 
were  to  be  made  once  a  day  for  two  or  three  days.  4.  The  attendant 
on  these  Mares  w^as  to  thoroughly  disinfect  his  hands,  and,  if  possible, 
change  his  clothing  before  he  went  near  other  pregnant  Mares. 
5.  After  two  or  three  weeks  of  treatment,  the  Mares  might  be  allowed 
to  be  put  to  the  Stallions.  6.  Foals  affected  with  joint-disease  (this 
being  considered  of  the  same  nature  as  that  which  led  to  abortion,  and 
capable  of  producing  that  accident)  were  to  be  destroyed  and  their 
bodies  burnt.  7.  If,  however,  the  foal  were  suffered  to  live,  it  was  to 
be  separated  from  pregnant  Mares  before  the  swellings  had  suppurated 
or  become  sores.  8.  All  Mares  dams  of  Foals  with  affected  joints,  were 
to  undergo  the  same  antiseptic  treatment  as  if  they  had  aborted,  if  not 
doing  well.  9.  Mares  that  had  aborted  and  done  well,  were  not  to  be 
allowed  to  the  Stallion  earlier  than  two  or  three  weeks  after  the  accident. 

With  regard  to  Ewes,  similar  curative  and  preventive  measures  are 
to  be  adopted.  Those  recommended  by  Labat  at  the  outbreak  of  abor- 
tion among  these  animals  in  France  in  1888,  were  perfectly  successful. 
There  had  never  been  such  an  occurrence  among  the  flock  until  this 
one,  when  a  large  number  aborted  without  any  assignable  cause.  The 
following  precautions  were  recommended  by  him  :  1.  Evacuate  the 
sheepfold.  2.  Separate  the  pregnant  Ewes  from  those  which  have 
aborted.  3.  Place  the  pregnant  Ewes  in  a  clean,  well-ventilated  place. 
4.  Every  week  remove  the  dung,  clean  the  floor,  walls,  and  racks 
with  boiling  potash-water.  5.  Every  Ewe  which  aborts  is  to  be  imme- 
diately removed  from  the  healthy  to  the  second  group  (those  which  had 
already  aborted),  and  complete  delivery  if  it  is  incomplete  ;  replace 
soiled  litter,  the  foetus  and  membranes  to  be  covered  with  lime  and 
then  buried  in  an  out-of-the-way  place.  6.  Every  morning  sponge  the 
vulva,  anus,  perinaeum,  and  tail  of  the  Ewes  with  a  solution  of  corro- 
sive sublimate  (1  gramme  to  100  grammes  of  alcohol  and  2  litres  of 
water).     7.  Feed  on  good  food  and  avoid  chills. 

Vaginal  injections  were  not  recommended  for  the  pregnant  Ewes,  for 
fear  of  causing  abortion  if  badly  given.  Only  four  abortions  occurred 
within  four  days  after  these  measures  were  adopted.  The  treatment 
was  continued  for  eighteen  days,  and  the  pregnant  Ewes  subsequently 
gave  birth  to  their  Lambs  at  the  usual  time.  The  expense  of  the 
measures  was  trifling,  and  carrying  them  out  caused  little  trouble,  two 
men  only  having  been  employed  for  an  hour  every  morning. 

Should  abortion  be  traced  to  the  food — ergotised  or  otherwise 
damaged  fodder,  or  water,  of  course  the  use  of  this  must,  if  possible, 
be  prohibited,  and  a  change  resorted  to.  If  the  pasture  grasses  are 
ergotised,  then  the  pregnant  animals,  as  a  matter  of  precaution,  should 
be  removed  from  them,  and  placed  in  more  favourable  conditions  with 
regard  to  food.  It  may  be  remarked  that  ergotised  or  mouldy  dry 
forage  may  be  rendered  safe  for  consumption  by  scalding  it  with  boiling 
water  or  steam,  or  pickling  it  in  salt. 

It  should  not  be  forgotten  that,  whether  abortion  be  due  to  casual 
causes  or  to  a  virulent  micro-organism,  and  whenever  or  wherever  the 
accident  occurs — whether  at  pasture,  in  strawyard,  or  in  shed—  the 
greatest  possible  care  should  be  taken  to  isolate  the  animal,  if  it  is  with 
pregnant  creatures  of  the  same  species,  and  to  bury  everything — foetus, 
membranes,  etc  ,  as  well  as  to  destroy  all  traces  of  discharges. 


I'HYsiuLouy  OF  I'.urrrjuTiox.  227 

BOOlv    IV. 

XUKMAl.  PAKTUKITIUN. 

Xoii.MAL,  natural,  physiological,  or  spontaneous  parturition  or  birth,  is 
the  expulsion  of  the  fcctus  from  the  uterus  through  the  maternal 
passages,  by  natural  forces,  when  it  is  suf!iciently  developed  to  live 
external  to  its  parent.  This  act  is  designated  "  foaling,"  when  occurring 
in  the  Mare,  "  calving  "  in  the  Cow,  "  lambing  "  in  the  Sheep,  "  pup- 
ping "  in  the  Bitch,  etc.  It  receives  the  designation  of  "normal," 
"  natural,"  etc.,  when  it  is  accomplished  in  a  manner  favourable  to  the 
parent  and  offspring  without  extraneous  assistance,  and  by  natural 
forces  alone  ;  and  "  abnormal,"  "  pathological,"  or  "  dillicult,"  when  it 
cannot  be  so  accomplished,  and  when  the  aid  of  man  is  required  to 
relieve  ilie  parent  and  release  the  progeny.  Though  eminently  a 
physiological  act,  it  is  nevertheless  one  of  the  most  difficult ;  the 
inter\'al  between  normal  and  pathological  parturition  is  sometimes 
extremely  brief,  the  one  being  often  transformed  into  the  other  in  a 
remarkably  short  time.  It  is  also  said  to  be  "  premature  "  when  it 
occurs  before  the  usual  period,  and  the  young  creature  is  bcrn  in  a 
viable  condition;  while  it  is  "prolonged"  birth  when  pregnancy 
extends  beyond  the  ordinary  term.  We  have  already  spoken  of  these 
terms,  and  alluded  to  their  diversity  ;  and  we  have  only  now  to  note 
that  these  variations  do  not  appear  to  have  any  influence  on  the  physio- 
logical act  of  parturition. 


CHAPTER  I. 
Physiology  of  Parturition. 

The  act  of  parturition,  notwithstanding  its  special  object,  is  dis- 
tinguished from  all  other  physiological  acts  or  functions  by  certain 
peculiarities  ;  for  while  the  latter  are  normally  accompHshed  without 
disturbing  in  any  way  the  well-being  of  the  individual,  parturiticm,  on 
the  contrary,  even  when  natural,  is  accompanied  by  pain,  general  dis- 
turbance and  uneasiness,  and  violent  efforts.  And  during  birth  nature 
does  not  appear  to  obey  those  in)nmtable  laws  so  strictly  as  in  the 
accomplishment  of  other  physiological  acts,  but  makes  frequent  and 
wide  deviations  ;  though  these  do  not  often  compromise  the  final  result. 
We  never  find  two  births  exactly  alike,  but  each  otTers  something  pecu- 
liar when  attentively  observed.  We  need  only  refer  to  the  duration  of 
the  act  as  a  whole,  as  well  as  to  each  of  its  periods  or  stages.  Some- 
times it  only  occupies  a  few  minutes,  in  other  instances  days  are 
required  to  complete  it ;  in  some  cases  the  first  stage  is  long  and  the 
second  short,  and  in  others  it  is  the  reverse.  The  "  labour  pains,"  or 
utero-abdominal  contractions,  present  as  notable  differences  with  regard 
to  intensity,  duration,  and  frequency,  as  well  as  in  the  pain  they  cause 
and  the  influence  they  exercise  on  the  other  parts  of  tlie  body  ;  while 
the  amount  of  allantoid  or  amniotic  fluid  is  as  variable,  though  no  ill 
effects  may  result  from  this.  And,  finally,  the  foetus  may  present  itself 
for  expulsion  in  a  variety  of  positions,  which,  though  they  may  not 
impede  birth,  yet  prove  that  parturition  is  an  extremely  variable  act, 
while  its  phenomena  are  highly  complex. 


228  NORMAL  PARTURITION. 

SECTION  I.— CAUSES  OF  PARTURITION. 

Though  parturition  only  occurs  at  the  end  of  pregnancy,  nevertheless 
this  act  is  being  prepared  for  from  an  early  period  in  the  development 
of  the  ovum,  as  we  have  shown  when  speaking  of  the  anatomy  and 
physiology  of  the  generative  organs.  During  the  evolution  and  deve- 
lopment of  the  ovum,  the  uterus  increases  in  a  corresponding  manner,  and 
its  muscular  structure  is  proportionately  augmented.  When,  towards 
the  termination  of  gestation,  the  ovum  has  reached  maturity,  and  the 
organs  necessary  for  the  independent  existence  of  the  foetus  are  com- 
pletely developed,  certain  alterations  occur,  both  in  the  uterus  and  the 
foetal  connections  with  it,  which  bring  about  the  expulsion  of  the  young 
creature. 

These  alterations  would  appear  to  consist  in  a  gradually  increasing 
fatty  degeneration  of  the  decidua,  by  which  the  organic  connection  that 
had  existed  between  the  peripheral  portions  of  the  ovum  and  the 
uterus  is  gradually  destroyed,  by  a  regressive  process  in  the  cells  lying 
between  them  ;  while  the  blood  which  was  sent  to  the  organ  is  now 
diverted  towards  the  mammae,  for  the  secretion  of  milk.  The  exchange 
of  materials  between  the  uterus  and  foetus  is  lessened,  and  the  latter — 
always  more  or  less  of  a  parasite — becomes  like  a  foreign  body  in  the 
cavity  of  the  former,  its  greatly  augmented  weight  and  volume  also 
aiding  in  the  change.  At  all  the  places  where  the  cell  degeneration  has 
reached  a  certain  stage,  the  terminations  of  the  nerves  are  irritated. 
But  to  obtain  a  reflex  action,  and  consequent  contraction  of  the  uterine 
muscles,  as  Schroeder  observes,  a  certain  amount  of  continuous  irrita- 
tion is  necessary.  This  sum  once  obtained,  a  reflex  action  takes  place 
in  the  form  of  a  contraction,  which,  however,  is  slight  at  the  beginning. 
Then  a  pause  follows,  until  the  sum  of  the  irritation  is  again  sufficient 
to  cause  a  contraction.  By  the  increase  in  intensity  of  the  contrac- 
tions the  uterine  wall  is  removed  from  the  envelopes,  and  this  separa- 
tion becomes  a  new  source  of  irritation  to  the  uterine  nerve-fibres.  The 
reflex  action,  in  the  form  of  labour-pains,  becomes  more  and  more 
powerful,  until  these  follow  at  last  in  rapid  succession  and  complete  the 
expulsion  of  the  ovum.  This  irritability  of  the  uterine  nerves  progres- 
sively increases  with  the  advance  of  pregnancy,  and  explains  the  regular 
setting  in  of  labour,  as  well  as  the  not  infrequent  retardation  of  the 
pains  in  cases  where  the  separation  of  the  membranes  has  been  pre- 
mature. 

The  sympathetic  nerve  is  in  all  probability  that  which  is  most  con- 
cerned in  the  uterine  contractions,  as  it  is  the  motor  nerve  of  the  organ  ; 
and  its  influence  is  called  forth  by  the  irritation  just  mentioned  as 
being  produced  on  the  terminations  of  the  nerves  on  the  inner  surface 
of  the  uterus  by  reflex  action,  the  irritation  being  transformed  into 
involuntary  motor  activity.  It  is  surmised  that  the  sacral  nerves  are 
merely  inhibitory. 

SECTION  I  [.—THE  EXPELLING  POWERS. 

The  expulsive  force  by  which  parturition  is  effected  resides  in  the 
unstriped  muscular  fibres  of  the  uterus  ;  these  cause  the  organ  to  con- 
tract in  a  rhythmical  and  somewhat  peristaltic  manner,  the  contrac- 
tions of  the  abdominal  muscles  and  diaphragm  being  merely  auxiliary. 
The   contractions  of   the   uterus  may  take  place  although  the  organ 


THE  EXI'ELLIXH  I'OU'Kns  IX  I'AirrmiTlnX.  229 

does  not  contain  a  foetus,  and  have  been  noted  in  extra-uterine 
pregnancy,  when  they  probably  occur  through  sympathy.  They  have 
been  observed  in  the  false  gestation  of  the  Bitch  which  has  not  really 
conceived,  but  whose  manimic  enlarge,  and  which  makes  its  bed  and 
exhibits  other  indications  of  approaching  labour  ;  as  well  as  in  preg 
nancies  prolonged  beyond  their  ordinary  limit. 

As  the  uterine  contractions  which  lead  to  expulsion  are  usually 
accompanied  by  a  painful  sensation  (due  to  the  pressure  exercised  on 
the  terminations  of  the  nerves  within  the  muscular  fibres),  they  are  in 
common  parlance  designated  "labour  pains"  {dolores  ad  j^arttun)  ; 
while  the  resistance  they  have  to  overcome  is  centred  in  the  foetus  and 
its  envelopes,  as  well  as  in  the  passages  these  have  to  traverse  in  order 
to  reach  the  external  world. 

Expulsion  is  not  effected  by  one  contraction,  but  by  a  series  of  con- 
tractions ;  between  each  of  these  there  is  an  interval  of  apparent  repose, 
during  which  the  organ  seems  to  be  gathering  strength  for  a  new  effort. 
As  in  almost  all  unstriped  muscular  fibres,  the  reflex  action  following 
upon  an  irritation  is  slow  and  gradual,  and,  according  to  the  degree 
of  irritation,  of  varying  intensity  and  duration.  At  the  commence- 
ment, corresponding  to  the  slight  irritation,  the  contraction  is  feeble 
and  short,  and  the  time  required  to  obtain  the  necessary  sum  of  the  per- 
sistent irritation  for  a  new  reflex  action  is  comparatively  long  ;  though 
the  uterine  walls  are  not  relaxed  on  their  contents,  but  are  maintained 
in  a  certain  state  of  contraction  by  the  tonicity  of  their  muscles. 

When  the  pains  are  regular,  there  is  also  a  certain  gradation  in  each 
individual  contraction.  Feeble  at  its  commencement,  it  gradually 
increases,  the  uterus  becoming  harder  until  the  maximum  of  contraction 
has  been  reached  ;  this  persists  for  some  time,  and  then  as  gradually 
subsides. 

As  parturition  progresses,  and  the  separation  between  tlie  uterus  and 
ftt'tus  increases,  the  irritation  becomes  stronger,  and  the  intervals 
between  the  contractions  shorter,  while  these  latter  augment  progres- 
sively in  intensity  and  duration.  The  necessity  for  these  intermissions, 
particularly  in  the  early  stage  of  parturition,  is  obvious.  They  allow 
the  animal  time  to  recover,  to  some  extent,  from  the  exhaustion  they 
occasion,  and  permit  the  genital  passages  to  become  gradually  prepared 
for  the  exit  of  the  foetus  through  them  ;  while  the  latter  can  also 
recover  from  the  inconvenience  it  may  suffer  from  the  interruption 
between  it  and  the  uterus  during  the  pain,  and  especially  towards  the 
termination  of  the  act. 

During  each  regular  pain  the  whole  of  the  uterus  contracts,  though 
the  fundus  does  so  most  energetically  ;  and  the  longitudinal  fibres  of  the 
organ  are  more  particularly  brought  into  play  at  the  initial  and  middle 
stage  of  parturition.  The  cornua  likewise  contract ;  they  are  twisted 
on  themselves  anteriorly,  are  shortened  through  the  action  of  the  longi- 
tudinal fibres,  and  are  brought  nearer  the  body  of  the  uterus,  which  is 
also  shortened  ;  and  as  this  shortening  is  always  taking  place  in  the 
direction  of  the  cervix,  it  is  here  that  the  sum  total  of  the  expelling 
force  is  centred  ;  and  it  is  this  force,  commencing  to  operate  at  the 
fundus  of  the  organ,  and  exerted  on  the  incompressible  liquor  amnii, 
which  gradually  opens  the  os  for  the  extrusion  of  the  foetus.  The 
latter,  with  its  envelopes,  first  acts  as  a  stimulus  to  the  uterus,  but  they 
soon  begin  to  play  quite  a  mechanical  part  in  the  dilatation  of  the 
already  greatly  shortened  cer\-ix.     The  latter  becomes  thinner  as  the 


230  NORMAL  PARTmiTIOX. 

contractions  force  the  bag  of  waters  against  it ;  so  that  the  os  is  gradu- 
ally widened,  and  the  cervix  really  becomes  a  part  of  the  uterine  cavity. 
As  soon  as  the  os  is  slightly  opened,  the  bag  of  waters  enters  it  and  acts 
as  a  mechanical  dilator ;  then  the  lower  parts  of  the  fore  limbs, 
succeeded  by  the  head  of  the  foetus,  are  introduced,  and  from  their 
combined  shape  act  like  a  wedge,  until,  by  the  eccentric  pressure,  the 
chest  is  passed  in,  and  the  cervix  being  drawn  over  the  presenting  parts, 
the  OS  is  of  the  same  diameter  as  the  vagina,  which  then,  with  the 
uterus,  constitutes  one  common  cavity.  Every  part  of  the  cervix  being 
acted  on  by  the  longitudinal  fibres,  the  aperture  of  the  os  is  perfectly 
circular  at  this  stage — as  is  observed  in  the  Cow  and  Goat  wheh  the 
uterus  is  pushed  back,  and  its  orifice  is  visible  at  the  vulva.  Irregu- 
larity in  the  contractions,  however,  and  particularly  when  they  are 
rendered  so  from  a  transverse  position  of  the  fcetus,  delays  the  dilata- 
tion, which  is  otherwise  rapid  according  to  their  force  and  frequency. 
At  first  the  dilatation  occurs  very  slowly,  especially  in  primiparai ;  and 
when  the  foetus  presents  by  the  croup,  or  when  the  body  of  the  uterus 
inclines  too  much  downwards,  causing  the  cervix  to  bend  up  towards 
the  sacrum,  it  is  also  very  tardy.  As  soon,  however,  as  the  mechanical 
action  of  the  water-bag  and  foetus  comes  into  operation,  it  makes  rapid 
progress  in  natural  parturition. 

If  the  uterus  of  animals  usually  uniparous  contain  two  foetuses,  the 
two  cornua  are  about  the  same  size,  each  having  a  foetus  in  the  same 
position  as  if  there  were  only  one  in  the  uterine  cavity.  In  general,  the 
two  foetuses  present  anteriorly,  although  it  sometimes  happens  that 
the  second,  or  the  first,  or  even  both,  present  posteriorly ;  not  infre- 
quently the  second  makes  a  mal-presentation.  When  there  are  twins, 
parturition  is  more  difficult  and  slower  than  when  there  is  only  one  : 
possibly  because  the  great  distention  of  the  uterus  diminishes  its  con- 
tractile power.  Another  feature  in  twin  pregnancies  is  that  parturition 
often  occurs  before  the  ordinary  time ;  and  even  when  this  has  been 
reached,  one  or  both  foetuses  are  smaller  and  weaker  than  when  there  is 
only  a  single  foetus. 

When  twin  parturition  sets  in,  the  uterine  contractions  commence 
almost  simultaneously  in  both  cornua,  which  are  much  less  apart  than 
in  the  non-pregnant  state ;  but  as  the  two  foetuses  cannot  be  born 
together,  that  which  is  most  advanced  is  delivered  first,  the  other,  which 
is  behind  it,  mechanically  aiding  in  its  expulsion.  In  the  Mare,  the 
interval  between  the  birth  of  twins  is  rarely  more  than  ten  minutes  ; 
with  the  Cow  it  may  be  one  or  two  hours  ;  and  with  the  Ewe  half  an 
hour.  When  the  position  of  the  second  foetus  is  favourable,  it  is  usually 
expelled  more  rapidly  and  easily  than  the  first ;  and  when  they  are  of 
a  different  size,  the  largest  is  ordinarily  born  before  the  other.  When 
the  number  of  foetuses  is  greater,  they  are  also  expelled  successively  at 
intervals  of  Pome  hours. 

In  cases  of  superfoetation,  if  such  an  occurrence  can  take  place  in 
animals  other  than  in  those  the  cornua  of  whose  uterus  open  into  the 
vagina,  the  uterine  contractions  must  be  limited  to  the  cornu  contain- 
ing the  foetus  whose  period  for  birth  has  arrived  ;  otherwise,  the  other 
foetus  would  be  expelled  at  the  same  time,  and  there  would  then  be  a 
birth  and  an  abortion. 

With  the  small  multiparous  animals,  in  which  the  foetuses  are 
expelled  one  after  the  other,  it  may  be  admitted  that  each  fraction  of 
the  uterus  corresponding  to  a  foetus  contracts  in  its  turn — at  first  the 


77/ /v   HXl'i:LLISn  POWERS  IX  I'lnTlTRITIOX.  Ti\ 

seKiiiont  of  one  of  the  cornua  nearest  the  cervix,  then  the  next  segment, 
and  so  on  until  tlie  one  in  proximity  to  tlie  ovary  is  reached,  so  as  to 
j^'et  rid  of  all  successively — one  cornu  expelling  a  fcetus  alternately  with 
the  other  ;  the  uterine  contractions,  although  general,  being  most  ener- 
getic at  the  portions  intermediate  to  the  fcetuses. 

The  uterine  contractions  are  very  powerful,  as  anyone  can  testify 
who  has  had  occasion  to  introduce  his  hand  into  the  uterus  of  one  of  the 
larger  animals  during  parturition  ;  and  their  force  is  not  always  related 
to  the  general  physical  power  of  the  animal — though  they  are  always 
m:  ire  energetic  in  the  Mare  than  the  Cow,  as  well  as  more  continuous. 
.\  )t  iufrecjuently  they  are  more  powerful  in  weak-looking  animals  than 
in  those  wliich  are  robust  and  vigorous  ;  and  their  energy  depends 
evidently  upon  the  development  of  the  muscular  structure  of  the  uterus, 
and  the  potency  of  the  sympathetic  ganglia  which  stimulate  it.  Their 
energy  and  frequency  also  often  depend  upon  the  duration  of  the 
pains,  and  the  existence  of  mechanical  obstacles  to  the  birth  of  the 
fu'tus. 

After  the  complete  dilatation  of  the  os,  the  third  stage  of  delivery 
begins,  and  the  manner  in  which  the  uterus  contracts  is  modified. 
The  resistance  is  no  longer  at  the  cei'vix,  but  in  the  uterus  itself,  being 
due  to  the  presence  of  the  fcetus ;  and  now  the  circular  as  well  as  the 
longitudinal  fibres  come  into  action  simultaneously,  in  order  to  diminish 
the  uterine  cavity  and  quite  expel  its  contents.  In  this  they  are 
greatly  aided  by  the  abdominal  muscles  and  the  diaphragm,  which 
until  now  could  assist  but  little  ;  though  the  participation  of  these 
does  not  appear  to  be  absolutely  indispensable,  for  birth  may  take 
place  without  it.  Nevertheless,  it  is  a  fact  that,  in  diminishing  the 
abdominal  cavity  and  pressing  on  its  contents,  these  muscles  concur 
in  pushing  the  fcetus  in  the  direction  in  which  least  resistance  is 
offered  —  towards  the  pelvic  cavity ;  and  as  their  contractions  are 
effective,  so  do  those  of  the  uterus,  which  are  coincident  with  them, 
become  increased  in  power  and  frequency.  The  animal  '*  strains,"  as 
in  defecation  or  micturition,  but  with  all  its  force  ;  and  these  throes, 
which  are  involuntary  to  a  great  extent,  and  in  which  nearly  all  the 
muscles  of  the  trunk  share,  soon  bring  tlie  act  to  a  termination. 

The  fcetus  itself  has  been  sometimes  regarded  as  the  chief  agent  in 
parturition,  from  the  fact  that  this  act  is  longer  and  more  dilVicult 
when  the  creature  is  dead,  and  that  it  has  been  expelled  after  the 
mother  has  ceased  to  live.  But  it  must  be  remembered  that  the  move- 
ments of  the  fcL'tus  are  very  trifling,  and  of  little  importance  when  com- 
pared with  the  resistance  to  be  overcome  at  birth  ;  so  that  the  young 
creature  must  remain  almost,  if  not  quite,  passive  during  the  act.  And 
if  this  act  is  tardily  accomplished  when  the  fcetus  is  dead,  the  delay 
may  be  due  to  the  absence  of  stimulation  or  irritation  in  the  organ,  to 
the  uterus  not  having  a  fixed  point  to  act  upon,  or  perhaps  even  to  a 
local  septosis  or  paralysis  from  the  decomposition  of  the  foetus. 

With  regard  to  expulsion  of  the  futus  after  the  death  of  the  mother, 
it  must  also  be  remembered  that  all  the  organs  do  not  cease  to  live  at 
once,  and  that  many  continue  to  contract  for  some  time  after  the 
mother's  heart  has  ceased  to  pulsate.  Leroux  has  felt  this  organ  con- 
tracting a  quarter  of  an  hour  after  death,  and  after  gastro-hysterotomy 
on  the  dead  human  body  it  has  been  seen  to  contract  as  in  the  living 
woman  ;  Haller  has  witnessed  the  contraction  of  the  cornua  of  the 
Cat's  uterus,  even  when  the  organ  was  detached  from  the  body  ;  and 


232  NORMAL  PARTUEITIOX. 

Colin  states  that  he  has  observed  the  uterus  of  Sheep  to  contract  for 
forty  and  fifty  minutes  after  death. 

As  we  have  said,  the  resistance  which  the  expelling  forces  have  to 
overcome  is  constituted  by  the  foetus  and  its  membranes,  and  the 
genital  passages — the  os  uteri,  vagina,  vulva,  as  well  as  the  pelvis  and 
soft  parts  covering  and  lining  it.  The  fcetus  participates  in  the  resist- 
ance by  its  volume,  its  form,  its  manner  of  presentation,  its  position, 
the  conformation  and  texture  of  the  tissues  which  unite  it  to  the 
mother,  etc. ;  while  the  genital  passages  offer  resistance  from  their 
form,  width,  extensibility,  and  rigidity  or  softness.  The  faeces  ac- 
cumulated in  the  rectum,  or  urine  in  the  bladder,  sometimes  increase 
the  resistance  to  be  overcome. 

In  order  that  birth  may  be  possible,  the  expelling  force  must  be 
greater  than  the  resistance,  and  it  is  upon  the  relation  between  these 
that  the  manner  in  which  the  fcetus  is  expelled  will  more  particularly 
depend,  as  well  as  the  difficulty  attending  its  expulsion  and  the  time 
required  for  the  act  of  parturition. 

We  have  only  now  to  allude  to  the  influence  of  the  expelling  force 
on  the  foetal  membranes.  We  have  seen  that  these,  which  we  may 
now,  with  their  contents,  designate  the  "  water  bag,"  assist  in  dilating 
the  OS,  and  that  the  uterine  contractions  propel  them  further  into  the 
vagina  in  the  form  of  an  elongated  bladder  partly  filled  with  fluid. 
This  soon  appears  between  the  labia  of  the  vulva  as  a  round  distended 
tumour  at  the  moment  a  pain  occurs,  but  flaccid  in  the  interval;  and 
not  long  afterwards  as  a  somewhat  voluminous  pediculated  tumour,  to 
which  each  pain  adds  a  little  more  fluid,  until  at  last  the  membranes 
cannot  resist  the  strain,  and  rupture  ;  when  the  allantoic,  and  then  the 
amniotic  fluids  escape  from  them,  leaving  a  variable  quantity  in  the 
uterus  ;  some  of  this  is  discharged  into  the  vagina  at  the  termination 
of  each  pain,  and  assists  in  lubrifying  the  mucous  membrane  and 
aiding  in  the  passage  of  the  foetus. 

It  may  be  remarked  that  numerous  causes  influence  the  period  when 
this  rupture  occurs.  In  the  Mare  the  membranes  are  thicker,  more 
resisting,  and  much  less  adherent  to  the  uterus  than  in  the  Cow  ;  so 
that  rupture  is  later  in  taking  place,  and  it  not  unfrequently  happens 
that  the  Foal  is  born  in  them  ;  though  the  Calf,  I  believe,  never  is. 
But  thei'e  are  individual  differences  in  this  respect  even,  and  in  some 
instances  it  will  be  found  that  rupture  takes  place  at  the  commence- 
ment of  parturition,  in  others  towards  the  end ;  though  when  this 
takes  place  late  it  is  more  favourable  than  when  it  occurs  early,  as  the 
amniotic  fluid  preserves  the  foetus  from  undue  compression  by  the 
uterus,  while  it  powerfully  aids  in  the  progressive  and  regular  dilata- 
tion of  the  OS  and  vulva,  and  lubrifies  the  passages,  thus  diminishing 
friction  and  protecting  the  maternal  organs  fri'in  injury.  When  rupture 
occurs  too  eai'ly,  and  before  the  foetus  has  been  sufficiently  expelled, 
the  parts  become  dry,  and  labour  is  always  longer  and  more  painful 
and  difficult  for  the  mother,  while  it  is  often  fatal  to  the  foetus. 

SECTION  III.— SIGNS  AND  COURSE  OF  PARTURITION. 

The  physiological  phenomena  just  alluded  to,  and  by  which  the 
foetus  is  born,  are  collectively  designated  as  "labour."  The  entire 
period  of  labour  is,  for  facility  of  description  and  study,  divided  into  a 
certain  number  of  stages  or  periods — usually  three  or  four.     These  are  : 


SIGXS  AND  COURSE  OF  PAnTClUTION.  23$ 

1.  Preliminari/  staijc  ;  2.  Dilatation  of  tlic  os  uteri;  3.  Exptdsion  of 
thefntus;  4.  Expulsion  of  tlic  membranes. 

1.  Preliiniiiarif  Stage. — Various  precursory  signs  announce  the 
approaching  termination  of  pregnancy  and  the  advent  of  labour. 
These  may  be  observed  some  hours,  sometimes  even  for  days,  before 
that  event  occurs. 

One  of  the  most  important  signs  is  the  enlargement  and  increased 
sensibiUty  of  the  mamma;,  to  which  the  excess  of  blood  no  longer 
required  in  the  uterus  is  directed.  These  glands  become  voluminous, 
hard  and  tender  ;  and  this  phenomenon  is  more  particularly  remarkable 
in  those  animals  whose  milk  is  not  utilised  after  the  young  have  been 
weaned.  The  mammary  glands  then  become  soft,  Haccid,  and  small, 
and  cease  to  secrete.  In  sucli  animals  as  the  Mare  and  VlwG,  these 
glands,  ordinarily  small  and  scarcely  perceptible,  before  parturition 
become  so  remarkably  developed  as  to  cause  alarm  in  people  who  do 
not  understand  the  cause.  With  the  Mare  especially,  the  develop- 
ment of  the  mammoD  is  sometimes  so  considerable,  that  the  engorge- 
ment extends  along  the  inferior  surface  of  the  abdomen  and  simulates 
oedema  ;  or  it  ascends  between  the  thighs  as  high  as  the  vulva  as  a 
prominent  ridge,  while  the  skin  in  this  region,  if  white,  looks  reddened. 
At  a  later  period,  the  teat  yields  a  serous  fluid  on  pressure,  or  this 
constitutes  a  crust  around  it ;  the  fluid  afterwards  becomes  somewhat 
lactescent,  and  finally  appears  as  the  "  colostrum  "  or  first  milk. 

Another  premonitory  sign  is  the  tumefaction  of  the  vulva,  increase  of 
the  space  between  the  labia,  which  become  soft  and  flabby,  while  their 
lining  membrane  is  reddened,  and  a  viscid  glairy  mucus  covers  it.  This 
mucus,  derived  from  the  va^'inal  lining  membrane,  soon  becomes  so 
abundant  that  it  is  discharged  in  long  filamentous  streams,  particularly 
in  the  Cow,  and  soils  the  tail  and  hocks  ;  it  is  destined  to  lubricate 
the  genital  passages,  and  faciUtate  the  extrusion  of  tlie  foetus. 

With  these  changes  the  al)domen  falls,  or  rather  becomes  more 
pendent ;  the  croup  looks  hollow,  as  do  the  flanks,  due  to  the  relaxa- 
tion of  the  broad  ligaments.  The  spine,  particularly  in  the  lumbar 
region,  becomes  more  horizontal  and  rather  inclines  downwards,  as  if 
yielding  to  tlie  weight  of  the  abdomen.  The  haunches  appear  to  be 
wider  apart,  and  the  gluteal  muscles  to  subside,  owing  to  the  falling  in 
or  modification  of  the  sacro-sciatic,  as  well  as  the  sub-sciatic,  ligaments, 
from  serous  infiltration. 

The  animal  walks  sluggishly  and  unwillingly,  and  if  grazing  witli 
others  does  not  appear  to  care  about  following  tliem.  Sometimes,  as 
has  been  mentioned,  there  is  swelling  of  tlie  limbs,  particularly  the  hind 
ones. 

If  very  careful  vaginal  exploration  be  made  at  this  time,  it  will  bo 
found  that  the  cei-vix  uteri  has  become  a  part  of  the  uterine  cavity  and 
is  almost  completely  effaced,  being  reduced  to  merely  a  thin  circular 
ring ;  its  tissue  is  soft,  and  the  os  is  slightly  open  in  those  animals 
which  have  previously  had  young. 

As  parturition  draws  nearer,  these  phenomena  are  more  marked. 
The  animal  also  begins  to  be  restless,  and  continually  agitated ;  if  feed- 
ing, it  stops  for  some  moments,  as  if  listening  to  some  sound  only 
audible  to  itself,  or  as  if  experiencing  some  strange  internal  sensation 
for  the  first  time,  and  which  may  certainly  be  the  preparatory  or  com- 
mencing contractions  of  the  uterus.  Not  unfrequently  the  animal  lies 
down  and  gets  up  again,  as  if  suffering  from  colic.     Some  are  quite 


234  NORMAL  PAllTURITION. 

mute,  though  anxious  and  uneasy ;  while  others,  in  addition  to  exliibit- 
ing  restlessness  and  distress,  utter  a  half-stifled  cry  of  pain.  The  Mare 
whisks  its  tail,  the  Cow  bellows,  the  Ewe  bleats,  the  Bitch  often  whines, 
and  the  Cat  emits  a  low  cry  as  if  in  suiifering.  If  the  animal  is  at  liberty, 
it  seeks  a  remote  quiet  place  in  which  to  bring  forth  its  young ;  while 
some — such  as  the  Bitch,  Cat,  Sow,  and  Kabbit — prepare  a  special  nest. 

2.  Dilatation  of  the  Os  Uteri. — The  limit  between  this  stage  and  the 
former  is  not  so  well  marked  as  our  division  would  indicate.  Neverthe- 
less, it  is  meant  to  imply  that  the  stage  of  dilatation  of  the  os  termi- 
nates pregnancy  and  ends  with  complete  extension  in  width  of  that 
uterine  passage.  It  is  marked  by  increasing  uneasiness  of  the  animal  : 
pawing,  lying  down  and  rising  frequently  in  a  kind  of  aimless  fashion, 
while  the  expression  of  the  physiognomy  betrays  suffering.  When  the 
uterine  contractions  really  commence,  the  creature  suddenly  stops,  as  if 
surprised  by  the  pain  ;  its  eye  looks  animated  and  expresses  anguish  ; 
the  skin  is  hot,  pulse  quickened,  visible  mucous  membranes  injected  ; 
the  abdominal  walls  are  rigid  and  contracted,  the  flank  is  tense,  and 
very  frequently  faeces  or  urine  are  voided.  During  this  pain,  if  the 
cervix  uteri  is  explored,  it  will  be  found  that  its  attenuated  border  has  a 
tendency  to  become  hard  and  prominent.  When  the  pain  has  passed, 
calm  succeeds  ;  the  cervix  becomes  thick  and  elastic,  and  the  os  is 
markedly  enlarged.  Bach  pain  lasts  for  some  seconds  to  two  or  three 
minutes,  the  interval  of  quiet  continuing  to  about  fifteen  minutes  at 
first ;  though  it  diminishes  when  the  contractions  become  more  frequent, 
more  energetic,  and  more  prolonged,  and  dilatation  of  the  os  progresses. 
Then  the  fcetal  membranes  begin  to  be  detached  from  the  inner  surface 
of  the  uterus  and  enter  the  os,  whence  they  pass  into  the  vagina  and 
between  the  labia  of  the  vulva,  where  they  appear  externally  as  the 
*'  water-bag."  In  the  meantime,  the  fore  limbs  and  the  nose  and  head 
of  the  foetus  enter  the  os,  and  dilate  it  to  its  fullest  extent,  when  the 
cavity  of  the  uterus  forms  a  canal  continuous  with  the  vagina. 

3.  Expulsion  of  tlie  Foetus. — The  pains  become  more  severe,  frequent, 
and  sustained,  and  to  the  uterine  contractions  are  added  those  of  the 
diaphragm,  and  abdominal  and  other  muscles.  If  the  animal  is  stand- 
ing, it  brings  all  its  limbs  under  the  body,  arches  the  back,  elevates  the 
tail,  slightly  flexes  the  hocks,  makes  a  deep  inspiration,  closes  the  glottis 
to  imprison  the  air  in  the  chest,  and  by  a  powerful  contraction  of  all  the 
muscles  of  the  trunk,  it  brings  such  an  amount  of  pressure  to  bear  on 
the  foetus  as  to  propel  it  into  the  pelvic  cavity  and  rupture  the  chorion. 
At  each  contraction  the  "water-bag" — formed  by  the  allantois  and 
amnion — protruded  beyond  the  vulva,  increases  in  volume.  It  varies 
in  different  animals  ;  being  in  the  Cow  about  as  large  as  the  bladder  of 
a  Pig,  and  in  the  Bitch  the  size  of  the  carp's  swimming  bladder.  When 
it  is  very  large  in  advanced  parturition,  it  is  reckoned  a  good  sign  ; 
though  it  may  not  indicate  a  good  presentation  of  the  foetus,  nor  yet  an 
easy  birth. 

The  water-bag  soon  ruptures,  and  its  contents  partly  escape — that 
behind  the  thorax  of  the  foetus  being  i-etained,  and  voided  only  in  small 
quantity  as  the  uterus  contracts.  When  the  membranes  are  thinner 
and  weaker  than  usual,  they  may  rupture  before  the  os  is  completely 
dilated,  and  then  the  fluid  escapes  in  a  small  quantity  at  a  time ;  this 
frequently  happens  with  primiparae,  though  it  is  sometimes  observed  in 
protracted  labour,  which  is  the  most  painful.  In  general,  however,  no 
harm  results  from  this  premature  rupture  if  parturition  is  not  too  long 


siGXS  Axn  corns E  of  r.i/rrrniT/o.v.  235 

delayed  ;  indeed,  in  some  cases  it  may  be  useful,  as  when  the  uterus  is 
over-distended  with  fluid — in  hydramnios,  for  example — wlien  its  dis- 
charj^e  allows  the  or^an  to  contract  more  freely.  In  other  instances  the 
membranes  are  remarkably  strong  and  resisting',  and  withstand  the  con- 
tractions for  a  long  time  after  they  have  been  extruded  beyond  the  vulva  ; 
their  artificial  rupture  may  even  be  required.  Sometimes  they  do  not 
rupture  at  all,  and  the  fcttus  is  born  in  them,  or  even  after  them,  as  has 
occurred  in  the  Cow.  The  rupture  usually  occurs  at  the  most  dependent 
part  of  the  bag — at  the  uterine  orifice,  towards  the  os,  or  in  front  of  it. 
Then  succeeds  a  brief  interval  of  (juiet— the  foetus  being  meanwhile 
retained  in  the  uterus — during  which  the  organ  is  closely  applied  to  the 
body  of  the  fii-tus.  and  is  preparing  itself  for  a  final  effort,  which  is  soon 
made.  The  contractions  are  most  energetic  and  rapid,  and  every  time 
they  are  made  the  waters  flow  in  small  quantity,  moistening  and  relax- 
ing the  parts  ;  the  fcrtus  passes  on  until  the  fore  feet  and  muzzle,  form- 
ing a  kind  of  cone,  appear  at  the  vulva,  the  orifice  of  which  is  opened 
by  them.  When  the  head  has  cleared  the  vulva,  there  is  usually  a 
short  pause,  as  if  to  allow  the  tissues  of  this  region  to  become  accus- 
tomed to  the  distention,  and  to  prepare  them  for  the  still  greater  strain 
which  is  yet  to  be  imposed  on  them.  The  thorax  and  shoulders  of  the 
fietus  have  now  arrived  at  the  inlet  of  the  pelvis,  and  as  they  form  the 
deepest  and  most  diflicult  part  of  the  young  creature's  body,  the  con- 
tractions which  ensue  for  its  complete  expulsion,  though  most  powerful 
and  continuous,  only  impel  it  slowly  towards  the  outlet,  on  arriving  at 
which  a  more  energetic  and  painful  effort  than  all  the  others  pushes  it 
through.  The  act  may  now  be  said  to  have  terminated  ;  as  to  expel 
the  croup  requires  only  a  few  comparatively  weak  throes,  and  the  weight 
of  the  anterior  part  of  the  body  of  the  foetus,  hanging  beyond  the  vulva, 
greatly  aids  them.  It  is  rare  indeed  that  the  croup  offers  a  serious 
obstacle  to  expulsion. 

During  this  act  the  creature  betrays  evidence  of  pain,  especially  if  it 
be  a  primipara  :  and  this  is  particularly  marked  when  the  head  of  the 
f(rtus  passes  through  the,  as  yet,  incompletely  dilated  os,  and  still  more 
so  when  the  chest  and  shoulders  strain  the  textures  of  the  vulva  and 
perinipum  to  the  utmost.  Then  the  pulse  is  hard  and  frequent,  and  the 
skin  hot — sometimes  covered  with  perspiration — or  the  body  is  rigid. 
The  Hitch  and  Cat  often  utter  a  cry  of  pain  as  the  head  and  chest  pass 
through  the  vulva. 

After  the  young  animal  is  expelled,  the  umbilical  cord  is  torn,  and 
the  liquor  amnii  remaining  in  the  uterus  escapes,  accompanied  or 
followed  by  a  little  blood  resulting  from  the  sudden  separation  of  the 
placenta?. 

The  position  assumed  by  animals  during  parturition  is  somewhat 
variable.  The  larger  animals  which  usually  only  bring  forth  one  at  a 
birth,  such  as  the  Mare,  Cow,  and  Sheep,  ordinarily  do  so  standing ; 
and  this  position  has  the  following  advantage  :  The  vertebro- sacral 
angle  is  ettaced,  and  the  obstacle  that  its  projection  might  offer  to  the 
passage  of  the  foetus  into  the  pelvis  is  diminished  ;  the  auxiliary 
muscles — abdorninal  and  diaphragmatic — can  act  more  energetically  ; 
the  young  creature,  being  sustained  by  the  umbilical  cord  when  it  has 
cleared  the  vulva,  glides  gently  on  the  half-flexed  hocks  of  the  parent, 
and  so  reaches  the  ground  without  injury  (Fig.  (39). 

Such  an  attitude,  however,  is  far  from   being  constant  with  these 


236  NORMAL  PARTURITION. 

animals  ;  and  very  often,  especially  with  the  Cow,  they  bring  forth  in  a 
reclining  position — maintained  from  the  very  commencement  of  the  act, 
and  only  rising  when  birth  is  completed  (Fig.  70).  These  cases,  which 
are  quite  natural,  though  debility  may  be  present,  offer  nothing  par- 
ticular in  the  position  of  the  female — it  being  merely  that  assumed  on 
ordinary  occasions,  though,  of  course,  parturition  is  more  difficult. 

The  animal  rests  on  the  sternum,  the  body  inclined  to  the  right  or 
left  side,  the  fore  limbs  flexed  beneath  the  chest,  and  the  hind  ones 
beneath  the  abdomen.  In  this  attitude  labour  is  carried  on  somewhat 
as  when  standing.  The  creature,  reclining  on  the  breast  and  partially 
on  the  quarter,  arches  the  back  in  straining,  slightly  raises  itself  on  the 
hind  feet,  and  drops  again  when  the  pain  has  subsided. 

It  is  rare  indeed  that  these  animals  lie  full  length  on  one  side  of  the 
body  during  parturition,  and  when  it  does  occur  it  nearly  always  indi- 
cates a  long,  difficult,  and  exhausting  labour. 

Multiparous  animals — as  the  Bitch,  Cat,  and  Sow — always  assume 
the  recumbent  position,  and  lie  reclining  on  one  side,  with  the  body 


Fig.  69. 
Cow  IN  THE  Act  of  Parturition  :   Standing  Position. 

disposed  in  a  semicircular  fashion,  the  head  towards  the  tail.  This 
position  appears  to  be  very  favourable  to  birth,  the  sacro-vertebral  angle 
being  effaced,  and  the  young  being  spared  the  risk  of  falling ;  in 
addition,  each  foetus  as  it  issues  from  the  vulva  is  within  reach  of  the 
mother's  mouth  ;  so  that  it  can,  without  disturbing  itself,  remove  the 
membranes  from  it,  divide  the  umbilical  cord,  clean  it  with  its  tongue, 
put  it  in  a  proper  position,  and  even  direct  its  head  towards  the  teat, 
in  order  to  soothe  it  while  another  is  born.  It  may  be  remarked  that, 
with  the  Sow,  the  young  creature  is  expelled  with  such  force  from  the 
vulva  that  it  often  turns  a  somersault.  It  may  also  be  observed  that, 
with  the  small  multiparous  animals  the  "water-bag"  usually  only 
appeal's  with  the  first  of  the  litter,  the  others  being  preceded  or  followed 
by  their  ruptured  membranes. 

The  total  duration  of  parturition  is,  of  course,  extremely  variable,  not 
only  according  to  accidental  circumstances,  individual  peculiarities,  and 
species,  but  even  in  the  same  animal  at  different  births.     With   the 


1 


S/';\s  JXD  COURSE  OF  rARTunTTToy. 


•J37 


Mare  it  is  usually  brief,  and  is  ordinarily  accomplished  in  about  ten 
minutes,  sometimes  in  live — tliouj^h  it  may  extend  to  a  quarter  or  half 
an  hour,  rarely  more.  This  rapidity  appears  to  be  due  to  the  fact  tliat 
tlie  placenta  is  detached  from  the  uterus  during  the  early  pains,  and 
consequently  the  ftrtus  cannot  live  long  after  this  occurs — three  hours 
being  supposed  to  be  the  limit — unless  it  can  breathe  by  the  lungs. 
The  duration  in  the  Cow  is,  on  the  average,  one  to  two  hours ;  though 
it  may  only  be  a  few  minutes  to  half  an  hour,  or  be  extended,  without 
injury  to  the  Calf,  to  one  or  two  days.  With  Cows  at  pasture  or  which 
do  no  work,  it  is  sometimes  only  fifteen  minutes.  With  the  Sheep  the 
period  is  also  brief,  being  about  fifteen  minutes.  If  there  are  several 
Lambs,  there  is  usually  an  interval  of  fifteen  minutes  to  two  hours 
between  them — the  second  and  succeeding  births  being  always  quicker 
than  the  first. 

With  multiparous  animals — Sow,  Bitch,  and  Cat — there  is  ordinarily 
a  period  of  ten  or  fifteen  minutes,  and  sometimes  half  an  hour,  an  hour 


Fig.  70. 
M.MiK  IS  THK  Act  ok  Parturition  :  Rkcimrest  Po.sition. 


or  even  more,  between  each  birth.  Not  unfrequently  the  Sow  will 
bring  forth  ten  young  ones  within  the  course  of  an  hour. 

We  have  mentioned  that  with  those  animals  which  are  delivered  in 
a  standing  position,  the  umbilical  cord  is  ruptured  when  the  young 
creature  reaches  the  ground,  and  usually  close  to  its  abdomen.  If  the 
mother  is  recumbent  when  the  olVspring  is  born,  the  cord  is  torn  as  she 
gets  up,  which  is  usually  immediately  after  parturition.  The  circula- 
tion in  and  by  the  cord  being  incomplete  shortly  before  and  during 
labour,  its  texture  appears  to  undergo  a  kind  of  softening  that  favours 
rupture  ;  while  owing  to  the  vessels  being  reduced  in  size,  and  also  the 
way  in  which  their  rupture  occurs,  hjrmorrhage  is  trifling.  Sometimes, 
however,  the  cord  is  sutViciently  strong  and  elastic  to  resist  spontaneous 
rupture,  and  the  young  creature  is  born  with  the  membranes  attached 
to  it  by  means  of  this  bond  of  union.  The  mother  then,  by  a  remark- 
able instinct,  in  cleansing  the  young  creature  with  its  tongue,  gnaws 
through  the  cord  and  sets  free  its  progeny.  The  Mare  and  Cow  have 
been  known  to  do  this  at  times ;  otherwise  it  is  usual  with  the 
Carnivora. 

Whether  the  cord  be  ruptured  spontaneously  or  gnawn  through  by 


238  NOIIMAL  PARTURITION. 

the  parent,  there  is  nothing  to  be  feared  from  haemorrhage  from  either 
the  foetal  or  placental  end ;  for,  contrary  to  what  is  observed  in  the 
human  species,  the  blood  has  very  little  tendency  to  flow  from  the 
umbilical  vessels,  and  the  laceration  and  cold  soon  check  any  slight 
escape.  But  it  may  sometimes  happen  that  it  is  necessary  to  divide 
the  cord  at  a  short  distance  from  the  umbilicus,  and  this  is  usually 
effected  either  by  scraping,  torsion,  or  cutting  directly  through  it  by 
the  bistoury  or  scissors.  Even  then  there  is  little  to  apprehend  from 
bleeding.  Eainard,  in  thirty  years'  experience,  and  other  authorities, 
has  never  observed  any  harm  to  result ;  and  the  cases  in  which  there 
was  danger  are  certainly  very  few.  Eainard  quotes  from  Brugnone, 
that  Beranger  of  Carpi  has  seen  Horse  and  Ass  Foals  perish  from 
haemorrhage,  through  the  cord  having  been  cut  and  no  ligature  applied; 
and  Peuch  has  witnessed  a  case  of  umbilical  haemorrhage  in  a  new-born 
Calf  from  which,  notwithstanding  a  thread  tied  round  the  cord,  the 
blood  escaped  in  drops  ;  another  ligature  placed  above  the  other  did  not 
check  this  escape,  and  it  was  necessary  to  fix  a  compress,  steeped  in 
perchloride  of  iron,  along  the  course  of  the  cord  before  the  haemorrhage 
could  be  checked.  It  must  be  borne  in  mind  that  similar  accidents  are 
possible,  if  a  ligature  is  not  applied  an  inch  or  so  from  the  umbilicus. 
Whether  it  be  tied  or  not,  the  portion  remaining  attached  to  the 
umbilicus  soon  becomes  dry  and  withered,  and  falls  off  in  a  few  days 
after  birth ;  the  other  end  most  frequently  hanging  to  the  foetal  mem- 
branes, which  immediately  after  parturition  protrude  from  the  vagina. 

4.  Expulsion  of  the  Membranes. — The  expulsion  of  the  foetal  mem- 
branes, or  "  afterbirth,"  as  they  are  sometimes  designated,  may  occur 
at  birth,  immediately  after,  or  be  delayed  for  a  variable  period — this 
depending  not  only  upon  accidental  circumstances  and  individual 
peculiarities,  but  also  upon  species,  and,  consequently,  the  placental 
connections. 

Immediately  after  the  foetus  is  expelled,  the  uterus  contracts  and 
retracts  energetically  on  itself,  and  its  internal  capacity  rapidly 
diminishes  ;  consequently,  the  placental  villosities  are  detached  from 
their  alveoli,  the  uterine  and  chorionic  surfaces  become  wider  apart, 
and  the  placenta  is  ultimately  separated  from  the  uterus.  The  same 
contractions  which  loosened  them  are  also  instrumental  in  forcing  the 
membranes  through  the  gaping  flaccid  os  into  the  vagina;  and  the 
auxiliary  muscles,  being  again  stimulated  by  their  presence  here,  as 
they  were  by  the  head  of  the  foetus  in  the  same  passage,  add  their 
powerful  contractions  ;  so  that  these  new  pains,  aided  by  the  physical 
weight  of  the  extruded  portion  with  its  appended  umbilical  cord,  soon 
bring  the  whole  mass  away.  The  contractions  of  the  vagina  have 
probably  little,  if  anything,  to  do  with  this  expulsion,  which  is  rarely 
followed  by  haemorrhage  in  animals  ;  though  in  woman,  owing  to  the 
inertia  of  the  uterus,  this  accident  is  not  at  all  uncommon.  Sometimes 
the  expulsion  of  the  membranes  is  expedited  by  the  young  creature  as 
it  descends  from  the  vulva. 

With  the  Mare,  owing  to  the  disseminated  placenta  and  the  slight 
adherence  of  the  placental  villi,  the  separation  of  the  membranes  takes 
place  rapidly  ;  indeed,  the  Foal  is  not  infrequently  born  in  the  intact 
envelopes.  But  generally  only  a  few  minutes  elapse  before  the  after- 
birth is  detached.  Eetention  of  the  placenta  is  therefore  exceedingly 
rare  in  the  Mare,  though  it  is  very  dangerous  ;  as  in  attempting  to 
remove  it  there  is  great  risk  of  hajmorrhage. 


s/t.w's  .tx/)  vurnsE  uf  /•.urrrnjTiox.  2.Ji> 

With  the  Cow,  because  of  the  multiple  placentubri,  the  number  of 
which  may  be  over  a  hundred,  the  adhesion  between  the  uterus  and 
fa'tal  membranes  is  very  intimate  ;  while  the  small  volume  of  the 
cotyledons  offers  but  little  surface  for  the  uterine  contractions  to  act 
upon.  So  that  while  it  happens  that  tlie  Calf  is  never  born  in  its  intact 
envelopes,  it  is  also  the  case  that  the  afterbirth  is  only  slowly  and 
tardily  extruded — two,  four,  or  more  hours,  or  even  days,  being  required ; 
and,  indeed,  it  is  not  at  all  rare  for  retention  to  occur  in  this  animal, 
and  the  envelopes  require  to  be  removed  artificially. 

Multiparous  animals  get  rid  of  the  envelopes  as  they  expel  the 
fcjetuses,  the  birth  of  the  first  being  followed  in  a  very  brief  space  by  its 
membranes ;  after  which  comes  the  second  fcetus,  then  its  envelopes, 
and  so  on ;  so  that  only  those  of  the  last  foetus  may  be  retained — an 
accident  which  sometimes  occurs.  In  these  animals,  the  membraues 
appear  to  be  expelled  without  any  difficulty  ;  the  Bitch,  for  instance, 
runs  into  a  corner,  and  assuming  a  position  as  if  about  to  micturate, 
expels  the  secundines  of  the  last  puppy,  devours  them,  and  returns  to 
the  other  puppies. 

With  animals  usually  uniparous,  but  which  sometimes  bring  forth 
two  or  more  young,  the  envelopes  of  each  foetus  are  expelled  imme- 
diately after  it  is  born,  so  long  as  they  do  not  offer  an  obstacle  to  the 
passage  of  the  next  foetus ;  so  that  in  a  double  birth  in  the  Cow  or 
Ewe,  a  foetus  being  lodged  in  each  horn,  the  second  may  be  born 
without  the  envelopes  of  the  first  having  been  discharged. 

We  may  here  note  the  strange  instinct  which  impels  not  only  carni- 
vorous and  omnivorous,  but  also  herbivorous  animals — Bitch,  Cat,  Sow, 
Cow,  and  even  sometimes  the  Mare — to  devour  the  membranes  as 
soon  as  they  are  expelled,  if  they  are  not  quickly  removed  from  beyond 
their  reach  ;  at  times  they  even  devour  them  as  they  are  being 
extruded,  and  the  work  of  delivery  is  thus  hastened.  However  un- 
natural and  disgusting  this  propensity  may  appear,  and  though  the 
cause  for  it  is  unknown,  it  does  not  occasion  any  visible  inconvenience 
to  the  animal 

It  has  been  already  remarked,  that  when  the  young  creature  is 
expelled  in  its  intact  envelopes,  the  mother,  if  at  large,  frees  it  from 
them  by  gnawing  them  through  ;  more  rarely  does  the  progeny  release 
itself  by  its  own  efforts.  If  the  mother  should  chance  to  be  tied  up, 
as  in  a  stall,  assistance  may  be  required  to  cut  the  umbilical  cord  and 
extract  the  young  animal  from  its  imprisoning  membranes,  else  it  may 
become  asphyxiated.  This  peculiarity  is  most  frequently  observed  in 
the  Mare,  with  which  birth  is  always  rapid,  and  the  cliorion  strong 
and  easily  detached  from  the  uterus.  Rueff  states  that  it  is  not  unusual 
in  the  Sow. 


Cri.\PTER  II. 
Presentations  of  the  Foetus  and  Mechanism  of  Parturition. 

In  addition  to,  and  to  a  certain  extent  independent  of,  the  physiological 
phenomena  of  gestation  and  parturition,  there  are  in  the  latter  certain 
l)hysical  and  mechanical  acts  which  have  been,  as  Saint-Cyr  remarks, 
liitherto  very  imperfectly  studied  in  veterinary  medicine,  but  the  con- 


240 


NORMAL  PARTURITION. 


sideration  of  which  is,  nevertheless,  very  important  from  a  practical 
point  of  view. 

These  acts  are  related  to  the  manner  in  which  the  foetus  presents  at 
the  pelvic  inlet  for  passage  through  the  outlet,  and  the  way  in  which 
this  passage  is  effected  ;  they  belong,  in  fact,  to  the  presentations  and 
positions  of  the  foetus,  and  the  mechanism  of  parturition. 

The  presentations  and  positions  of  the  foetus  during  parturition,  as 
well  as  the  mechanism  of  that  act,  are  of  much  practical  importance 
to  the  veterinary  obstetrist,  and  demand  careful  consideration.  Allusion 
has  been  repeatedly  made  to  the  position  of  the  foetus  in  the  uterus 
during  gestation,  and  to  the  fact  that  this  position  is  changed  as  par- 
turition draws  near.  What  the  agency  or  influence  may  be  which 
induces  this  change,  has  not  been  ascertained  ;  but  it  has  been  surmised 
that  it  is  due  to  an  instinctive  tendency  of  the  foetus  to  assume,  towards 


Fig.  71. 
Normal  Position  of  the  ra:TDs  in  the  Make  at  Parturition  (First  Stage). 


the  termination  of  pregnancy,  the  position  most  favourable  for  its  exit 
through  the  pelvic  cavity  ;  though  it  is  indeed  very  questionable  whether 
the  instinctive  faculties  of  the  young  creature  are  already  sufficiently 
developed  to  bring  about  this  result,  which  may,  after  all,  be  due  to 
some  reflex  action.  However  this  may  be,  it  is  certain  that  the  foetus 
is  very  far  from  being  always  in  this  favourable  situation,  and  that  the 
resources  of  art  are  often  needed  to  remedy  the  false  positions  the 
young  creature  may  have  assumed  at  the  termination  of  pregnancy. 

In  studying  the  various  positions  and  attitudes  the  foetus  assumes 
at  birth,  and  the  consequent  presentations  it  offers  towards  the  anterior 
opening  of  the  pelvis,  there  are  to  be  considered:  (1)  the  region  of  its 
body  which  is  first  presented  to  the  pelvic  inlet,  and  (2)  the  relations 
of,  or  correspondence  between,  this  region  and  the  shape  and  dimen- 
sions of  the  pelvic  cavity  itself. 

The  first  has  been  designated  the  presentation,  and  the  second  the 
position  of  the  foetus  ;  and  the  inlet,  instead  of  the  outlet,  of  the  pelvis 


PRESENTATIOXS  OF  THE  FCETUS. 


'241 


is  considored  in  this  respect,  because  it  is  the  most  important  in  practice, 
unil  the  position  may  be  altered  either  spontaneously  or  artificially 
iluring  labour ;  indeed,  this  alteration  has  often  to  be  effected  by  the 
obstetrist  in  order  to  render  birth  possible. 

SECTION  I.— rilESENTATlONS. 

The  presentation  results  from  the  part  of  the  fa^tus  which  first  offers 
itself  at  the  pelvic  inlet — that  re^'ion  of  the  young  creature  which  the 
hand  of  the  obstetrist  immediately  meets  on  being  passed  into  the  os, 
and  which  is  directly  opposite  the  inlet.  In  this  sense  the  head,  fore 
feet,  hind  feet,  croup,  etc.,  are  said  to  be  presented,  according  as  one  or 
other  of  them  first  offers  itself  on  exploration. 

These  presentations  are  extremely  varied,  as  any  part  of  the  foetus 


Fig.  72. 

Normal  Position  oi-  the  Kams  i.\  tub  Make  at  rARTURiTiON  (Second  Stage). 

a.  Allantoic  ;  b.  Amnion. 

may  occupy  this  situation  ;  though  so  far  as  description  and  compre- 
hensibility  are  concerned,  their  study  can  be  greatly  simplified.  As 
Hainard  says:  "The  futus,  when  covered  by  its  envelopes,  is  oval 
shaped,  or  like  an  olive  which  it  is  desired  to  pass  down  the  neck  of 
a  bottle,  and  which  may  be  presented  to  this  in  three  ways — either  by 
one  of  its  two  ends  or  by  its  middle."  These  ends  are  the  anterior 
part  of  the  chest  in  front,  and  the  croup  behind  ;  and  it  is  these  parts 
on  which  the  classification  of  the  presentations  is  based.  This  classi- 
fication gives  two  lonfjitudinal,  or  an  anterior  and  posterior  presentation  ; 
and  as  the  foetus  may  also  offer  itself  across  the  long  axis  of  the 
uterine  cavity,  we  have  a  transverse  presentation,  which  may  again  be 
dorso-linnbar  or  sterno-ahdominal,  according  to  the  side  of  the  fcRtus 
which  presents.  These  four  fundamental  presentations  are,  therefore  : 
1.  Anterior  Presentation. — The  chest  of  the  foetus  presents  towards 

16 


242  NORMAL  PARTURITION. 

the  inlet,  and  is  preceded,  accompanied,  or  followed  by  the  head  and 
fore  limi)S  :  the  situation  and  direction  of  which  may  vary  without 
altering  the  essential  features  of  the  presentation. 

2.  Posterior  Presentation. — The  croup  or  breech  is  facing  the  inlet, 
and  the  presence  or  absence  of  the  limbs  there  only  constitutes  a  variety 
of  the  presentation. 

3.  Dorso-lwnbar  Presentation . — Any  portion  of  the  upper  part  of  the 
body  opposite  the  inlet.  Lecoq  and  Eainard  admit  presentations  of 
the  withers,  back,  loins,  shoulder  or  haunch,  as  distinct  presentations  ; 
but  I  agree  with  Saint-Cyr  in  declaring  the  distinction  to  be  practically 
useless.  On  exploring  the  pelvic  cavity,  no  matter  what  part  of  the 
back  is  first  touched,  the  hand  always  encounters  the  spine  of  the 
foetus,  either  directly  in  the  axis  of  the  pelvis,  or  obliquely  and  at  some 
distance  from  it.  All  these  varieties  may,  therefore,  be  reduced  to  the 
one  now  named,  and  which  may  be  either  direct  or  oblique,  according 
as  the  case  may  be. 

4.  Sterno-abdominal  Presentation. — The  limbs  in  this  case  are  in  reality 
first  touched,  and  we  may  have  all  four,  or  only  three  or  two  ;  these, 
however,  are  not  the  fixed  point  of  the  presentation,  which  is  the 
inferior  part  of  the  body — or  sterno-abdominal  region  —  hence  the 
designation. 

These  four  principal  presentations  have  been  divided  into  natural  or 
normal,  in  which  spontaneous  or  unaided  birth  is  possible  ;  and  into 
connatural  or  abnormal,  in  which  parturition  is  impossible  without 
human  intervention.  The  longitudinal  presentations  alone  comprise 
the  first,  although  they  are  not  always  normal ;  as  a  wrong  direction  of 
the  head  or  limbs  may  prove  an  obstacle  more  or  less  difficult  to 
overcome,  and  requires  the  aid  of  art.  In  the  anterior  presentation. 
the  head  passes  before  the  body,  but  in  the  posterior  presentation  it 
follows  the  body  ;  in  the  former  presentation  the  extended  fore  limbs 
accompany  the  head,  as  there  is  space  for  them,  for  the  diameter  of  the 
chest  being  really  greater  than  that  of  the  pelvic  inlet,  there  would  not 
be  room  for  them  to  pass  through  if  they  were  alongside  the  thorax. 
In  the  2)osterior  j^resoitation  also  the  hind  limbs  should  be  extended,  as- 
if  flexed  they  would  add  to  the  volume  of  the  trunk.  In  the  Carnivora 
the  head  is  generally  larger  than  the  chest,  so  it  does  not  matter  so 
much  if  the  fore  legs  are  thrown  back.  Taking  this  view  into  considera- 
tion, the  presentations  may  either  he  simple,  or  more  or  less  comj)! icated , 
according  to  circumstances. 

SECTION  II.— POSITIONS. 

The  presentation  being  determined  by  the  part  of  the  foetus  which 
offers  at  the  pelvic  inlet,  it  must  be  evident  that  this  part,  whichever  it 
chance  to  be,  may  vary  considerably  in  its  relations  to  the  circum- 
ference of  that  passage.  If  the  chest  of  the  foetus  first  enters  it,  the 
attitude  of  this  region  may  be  very  different  in  different  cases ;, 
in  one  the  withers  may  correspond  to  the  sacrum  of  the  mother,  and 
the  sternum  to  the  pubis,  or  the  reverse  msij  happen ;  in  another  the 
foetus  may  be  lying  on  the  right  side,  the  sternum  corresponding  to^ 
the  right  branch  of  the  mother's  ilium,  and  the  withers  to  the  left 
ilium,  or  vice  versa.  So  that  here  are  four  different  positions  in  the 
same  presentation — the  anterior;  and  it  will  readily  be  understood 
that  it  should  be  the  same,  or  nearly  the  same,  for  the  other  presenta- 
tions. 


POSITIONS  OF  THE  FOiTUS. 


243 


Tlie  position  has  accordingly  been  defined  to  be  the  relation  of  a 
determinate  point  on  the  surface  of  the  foetus,  to  an  equally  determinate 
point  of  the  pelvic  circumference.  The  poiuts,  so  far  as  tlie  mother  is 
concerned,  may  be  determined  once  for  all,  and  they  will  always  remain 
the  same  for  every  presentation  ;  they  may  be,  for  instance,  the  sacral 
region  above,  the  pubic  below,  and  tlie  two  ascending  branches  of  the 
ilium  at  the  sides.  If  with  the  fcctus  we  select  any  region — say  the 
withers — and  put  this  part  in  relation  with  any  of  these  four  points  of 
the  pelvic  circumference,  we  shall  have  four  successive  and  easily 
recognised  positions.  If,  therefore,  we  first  give  the  name  of  the  region 
in  the  ftctus,  and  next  that  of  the  pelvic  circumference  with  which  it  is 
in  relation,  we  have  a  ready  means  of  designating  the  positions — de- 


Fig.  73. 

Normal  Position  ok  the  Futis   i.v  thk   Mark  (Thiri)  Sta(;k.).     Dobso- 
SACKAL  Position. 


scribing  the  fcetus  to  be  in  a  vertebrosacral  position,  for  instance,  when 
its  vertebral  region  is  in  relation  with  the  micrum  of  the  mother.  The. 
fixed  points  may  be  invariable  in  the  latter  ;  but  they  cannot  be  so  with 
the  fcctus,  as  they  will  vary  with  each  presentation. 

With  regard  to  the  anterior  and  posterior  presentations,  Rainard  has 
selected  the  fixed  points  as  follows  in  tlie  loiujitudiual  presentations  : 
for  the  first,  he  has  taken  the  spinous  processes  of  the  dorsal  vertebra; 
in  th(!  region  of  the  withers  ;  for  the  second,  the  lumbar  vertebra\ 
For  the  positions  in  the  other  two  presentations,  he  has  not  been  so 
fortunate  in  a  designation,  in  the  opinion  of  Saint-Cyr,  who  has  very 
judiciously  proposed  others  which  are  more  explicit  and  comprehen- 
sible. The  latter  gives  the  various  positions  which  should  be  recognised 
in  each  presentation,  as  follows  :  — 

,  A.  Anterior  Position.  —  The  chest  of  the  fatus  is  at  the  pelvic 
inlet,  and  it  is  desired  to  make  known  what  relation  this  part  has  to 


244 


NOllMA  L  PA  n  TU HIT  ION. 


the  pelvic  circumference.  The  determinate  point  on  the  foetus  is  the 
vertebrae  of  the  withers  ;  and  these  may  be  in  relation  with  the  sacrum 
above,  the  pubis  below,  the  right  ascending  branch  of  the  ilium  on  the 
right  side,  and  the  left  ditto  on  the  left.  From  this  we  have  four 
positions,  named  by  Saint-Cyr  as  follows  : 

1.  Dorso-sacral  Position  (Vertehw-sacral  Position  of  Eainard,  Fig.  73). 
— This  is  the  most  favourable  and  the  most  frequent  of  all,  and  is  said 
to  be  the  only  natural  position.  The  vertebrae  of  the  foetus  correspond 
to  those  of  the  mother,  its  withers  touching  the  sacrum  of  the  latter, 
the  belly  corresponding  to  the  abdominal  parietes,  and  its  sternum  to 
the  pubis.  This  is  sometimes  named  the yirs^  anterior  j^osition,  while 
its  sterno-dorsal  diameter  corresponds  to  the  sacro-pubic  diameter  of 
the  parent  (Fig.  74  a  b). 

2.  Dorso-intbic  Position  {Vertebro-pubic  Position  of  Eainard). — This  is 
exactly  the  inverse  of  the  first :  the  foetus  lying  on  its  back,  its  withers 


Fig.  74. 

Diameters  of  the  Pelvis. 

a  b,  Superoinferior,  oi-  Sscro-pubic  Diameter  ;  c  d,  Superior  Bis-iliac  Diameter  ; 
ef.  Inferior  Biis-iliac  Diameter;  ei,J'h,  Oblique,  Ilio-sacral,  or  Sacro-iliac 
Diameters  ;  J  K,  ISIiddle  Diameter. 


towards  the  pubis,  and  the  sternum  opposed  to  the  sacrum  of  the  female. 
This  is  also  named  the  second  anterior  position. 

3.  Bight  Dorso-ilial  Position  (Bight  Vertehro-ilial  Position  of  Bainard). 
— The  foetus  lies  in  the  left  flank,  its  head  to  the  right  side  of  the 
mother,  the  neck  being  in  the  same  direction,  and  when  passing 
through  the  pelvic  cavity,  touching  the  ascending  branch  of  the  left 
ilium  ;  then  the  sterno-dorsal  diameter  of  the  foetus  corresponds  to  the 
bis-ihac  diameter  passing  through  the  centre  of  the  pelvis  (Fig.  l-i,j  k). 
tlie  extent  of  which  is  slightly  less  than  the  superior  bis-iliac  diameter. 
The  feet,  when  they  are  not  in  the  pelvis,  must,  of  course,  be  sought 
for  on  the  opposite  side,  towards  the  right  flank  of  the  mother. 

4.  Left  Dorso-ilial  Position  {Left  Vertebro-ilial  Position  of  Bainard). 
— This  is  exactly  the  reverse  of  the  last-described  position,  the  withers 
corresponding  to  the  right  ilium. 

The  two  last  are  sometimes  named  the  anterior  lateral  j^ositions. 
They  are  less  frequent,  as  primary  positions,  than  the  first  two,  and 


posiTioxs  OF  mi-:  fu-jtus. 


24  r. 


are  sometimes  met  with  as  secondary  positions  after  the  reduction  of 
a  inal-presentatiou — cliielly  the  dorsal  or  ventral. 

lu  addition  to  these  anterior  positions,  Saint-Cyr  gives  other  four 
intermediate  ones  whicli  may  be  observed  wlien  the  sterno-dorsal 
diameter  of  the  fa'tus  corresponds  to  the  oblique  diameters  of  th(! 
pelvis  (Fig.  74,  c  i,  f  h).     These  are  as  follows  : 

o.  Bight  Dorso-ilio-sacral  Position. — This  is  the  intermediate  posi- 
tion between  the  dorso-sacral  and  right  dorso-ilial,  the  withers  being 
in  relation  with  the  right  ilio-sacral  articulation. 

G.  Left  Dorso-supra'Cotyloid  Position. — This,  again,  is  intermediate 
between  the  dorso-pubic  and  left  dorso-ilial  position,  and  quite  the 
reverse  of  the  preceding ;  the  withers  are  inclined  downwards  and  to 


Fig.  75. 

LfMBO-SACRAL   Po.smON. 


the  left,  above  the  cotyloid  cavity,  while  the  sternum  lies  towards  the 
sacro-iliac  articulation. 

7.  Lc/t  Dorso-ilio-sacral  Position. — Here  the  position  is  intermediate 
between  the  dorso-sacral  and  left  dorso-ilial. 

8.  Iii(iht  Dorso-supra-cotyloid  Position. — This  is  the  reverse  of  the 
preceding. 

The  dorso-sacral  and  the  two  dorso-ilio-sacral  positions  are  quite 
natural,  as  during  parturition  the  curving  of  the  body  of  the  foetus 
corresponds  to  that  of  the  mother's  body,  while  the  superior  diameters 
of  the  tirst — the  ccrvico-biscupulo-hnmeral  and  hicoxo-frmoral — which 
are  the  greatest,  are  related  to  the  superior  bis-iliac  diameter  of  the 
pelvis.  The  two  dorso  snpra-cotyloid  positions  are,  on  the  contrary, 
reversed  and  abnormal,  like  the  dorso-piibic,  because  the  curved  con- 
dition of  the  body  of  the  foetus  is  the  reverse  of  that  of  the  body  of 
the  parent,  as  well  as  opposed  to  the  direction  of  the  axis  of  the  pelvis ; 


246 


NORMAL  PARTURITION. 


SO  that  the  foetus  experiences  much  difficulty  in  moving  along.  The 
relations  are  still  more  reversed  between  the  transverse  diameters  of 
the  foetus  and  those  of  the  pelvis  when  the  first  correspond  to  the 
inferior  bis-iliac  diameter  of  the  mother. 

Positions  in  the  Posterior  Presentation. — In  this  the  croup  or 
breech  first  presents  at  the  pelvic  inlet.  The  lumbar  region  of  the 
foetus,  which  is  the  determinate  point,  may  be  directed  towards  the 
sacrum,  the  pubis,  or  the  right  or  left  branch  of   the  ilium  of   the 


Fig.  76. 
Right  Cephalo-ilial  Position  in  the  Dorso-lumbar  Presentation. 


female  towards  the  oblique  diameters  of  the  pelvic  cavity.     Hence  we 
have  eight  positions,  as  in  the  preceding  presentation.     These  are  : 

1.  Lumbosacral  Position. — The  foetus  is  in  what  some  authorities 
have  called  a  "  natural  "  position  (Fig.  75),  but  which  is  asserted  by 
others  to  be  unnatural.  The  loins  are  towards  the  sacrum  of  the 
mother,  the  right  coxo-femoral  articulation  towards  the  right  ilium, 
and  the  left  articulation  towards  the  left  ilium.  This  is  sometimes 
named  the  first  j^osterior  position. 

2.  Luviho-jxuhic  Position.  —  Some  practitioners  designate  this  the 
posterior  reversed  position.  The  foetus  is  lying  on  its  back,  its  croup 
and  loins  corresponding  to  the  pubis  of  the  mother,  while  the  limbs 


POSITIONS  OF  THE  F(ETUS. 


247 


are  towards  the  sacrum,  aj^ainst  which  they  are  more  or  less  pressed. 
This  is  sometimes  termetl  tlio  second  posterior  j)06ilion. 

3.  liiijht  Lninho-Uial  rosition. — The  fa'tus  is  lyinj^on  the  right  fhmk. 
its  croup  and  /<)/;/,s  opposite  the  asceudinj^  branch  of  the  right  iHum  of 
the  female,  and  the  hmbs  towards  the  left  Hank  of  the  mother,  where 
they  must  be  sought  for  if  they  do  not  present  in  the  pelvis. 

4.  Left  Lumbo-ilial  Position.  —  This  is  exactly  the  reverse  of  the 
preceding  position. 

5.  liiijht  Lumho-ilio-sacral  Position. — This  is  intermediate  between 
the  lumbo-sacral  and  the  right  lumbo-ilial  positions,  the  lumbar  region 
being  towards  the  right  ilio-sacral  articulation. 

6.  Left  Liimbo-supra'Coti/loid  Position. — This  is  also  intermediate 
between  the  lumbo-pubic  and  left  lumbo-ilial  position,  being  the  reverse 
of  the  preceding,  as  the  withers  are  at  the  other  extremity  of  the  same 
obliiiue  diameter. 


Fig.  77. 
Ceph.\lo-sacr.\i.  Position  in  the  I)on.so-i.uMB.\K  Tkicskntation. 


7.  Left  Lumho-ilio-siicral  Position  is  intermediate  between  the  lumbo- 
sacral and  left  lumbo-ilial  positions. 

H.  Jiight  L  umbo -supra -cotyloid  Position  is  the  opposite  of  the 
]M-eceding. 

The  lumbo-sacral  and  lumbo-ilio-sacral  positions  are  the  same  as 
their  corresponding  anterior  positions,  and  therefore  natural ;  but  the 
lumbo-pubic  and  lumbn-supra-cotifloid  are,  on  the  contrary,  the  reverse 
of  these,  and  an-  accordingly  abnormal,  while  the  luniho-ilial,  like  the 
dorso-ilial,  hold  tln'  middle  place  with  regard  to  facilities  and  diOiculties 
in  parturition. 

Positions  in  the  Dokso-lumhau  Pkesentation. — Here  the  fcctus 
is  presented  across  or  trdn.srcrse,  and  it  may  lie  on  one  or  other  of  its 
sides,  its  head  towards  one  of  the  maternal  flanks,  and  the  body  curved 
like  that  of  a  Dog  asleep.  In  this  we  have  two  distinct  positions, 
according  as  the  fatus  lies  on  one  side  or  the  other.  But  it  may  also 
assume  a  third  and  almost  vertical  position — the  croup  on  the  floor  of 


248 


NORMA L  PJ nTUniTIOX. 


Fig.  78. 
Cephalo-sacral  Position  in  the  Dorso-lujibar  Presentation. 


Fig.  79. 
Left  Cephalo-ilial  Position  in  the  Steeno-abdominal  Presentation. 


rosiTioxs  OF  THE  FO-yri's.  219 

the  abdomen  of  the  mother,  and  the  creature  in  the  attitude  of  a  Dog 
sitting. 

Tlie  important  consideration  in  tiiese  three  positions  is  related  to 
the  situation  or  direction  of  the  liead  ;  if  this  is  known,  it  is  easy  to 
infer  that  of  the  other  parts  of  its  body,  and  thus  appreciate  the  in- 
dications for  delivery  to  bo  followed  in  this  presentation.  According 
to  the  direction  of  the  head,  the  three  following  positions  are  described  : 

1.  Right  Ct'pluilo-ilial  Position. — The  fu'tus  is  on  its  right  side,  which 
rests  more  or  less  directly  on  tlie  abdominal  walls  of  the  mother,  the 
head  in  the  right  tlank,  the  croup  towards  the  left  Hank,  the  body  more 
or  less  curved,  and  the  dorso- lumbar  region  towards  the  pelvis,  in  which 
it  presents  (Figs.  70,  77). 

2.  Left  Ccphalo-ilial  Position. — This  is  the  reverse  of  the  preceding. 

3.  Ccphalo-sacral  Position. — In  this  position  the  foetus  presents  by 
the  back,  and  in  an  almost  vertical  attitude — the  croup  resting  on  the 
floor  of  the  mother's  abdomen,  the  head  more  or  less  depressed,  and 
directed  forward  towards  the  sacro-lumbar  region  —  the  creature  being 
seated,  as  it  were,  on  the  udder  of  its  parent  (Fig.  78). 

Positions  in  the  Stkhno-ahdominal  Pkkskntation. — In  this  trans- 
verse presentation  the  foetus  otTers  the  abdomen  to  the  inlet  of  the  ))elvis, 
and  on  deep  exploration  the  hand  first  meets  this  part,  and  perhai)s  two 
or  more  of  the  limbs,  generally  a  hind  and  a  fore  one.  The  head  may 
be  found  (Fig.  79),  or  it  maybe  out  of  reach;  or  the  head  and  limbs 
may  be  doubled  back,  so  that  no  part  of  the  creature  has  entered  the 
vagina,  though  the  sternum  and  other  parts  on  the  lower  surface  of  the 
body  can  be  felt. 

In  this  presentation  there  are  three  principal  positions  : — 

1.  Left  Ccphalo-ilial  Position. — The  fa'tus  lies  on  the  right  side,  the 
head  towards  the  left  ilium  of  the  mother,  and  the  croup  to  the  right 
ilium  (Fig.  79). 

2.  liitjht  Ccphalo-ilial  Position. — This  is  the  reverse  of  the  preceding. 

3.  Cephalo-sacral  Position. — In  this  position  the  fu-tus  is  vertical,  the 
croup  being  downward ;  but  the  abdomen  and  sternum  are  towards  the 
pelvic  inlet,  all  the  limbs  being  directed  towards  tiie  os  uteri,  while  the 
withers  correspond  to  the  sacro-lumbar  region,  and  the  head  is  turned 
to  the  back  or  sides  of  the  foetus. 

All  these  transverse  positions  are  abnormal  and  dystokial. 

SaintCyr,  who  has  mainly  followed  Rainard  in  the  definition  of  these 
presentations  and  positions  of  the  fa-tus,  insists  on  the  necessity  for 
studying  them  carefully,  as  by  so  doing  those  who  commence  the  practice 
of  obstetricy  will  be  greatly  enlightened  as  to  the  diOiculties  they  may 
encounter,  and  the  readiest  and  most  scientific  way  of  overcoming 
them  ;  while  this  study  will  enable  the  skilled  practitioner  to  describe 
his  interesting  cases  with  more  clearness  and  precision.  To  render 
what  has  just  been  stated  more  convenient,  the  following  table  is  given, 
in  order  to  show  at  a  glance  the  dififerent  presentations  and  positions  : 


250  NORMAL  PARTURITION. 


/"Longitudinal 


Ph 


I'Dorso-sacral. 

I  Right  Dorso-ilio-sacral. 
/'Natural  Positions     -'  Left  Dorso-ilio-sacral. 
I  Right  Dorsoilial. 

Anterior  J  VLeft  Dorso-ilial. 

I  r Right  Dorso-supra-cotyloid. 

^Abnormal  Positions^  Left  Dorso-supra-cotyloid. 

[  Dorso  pubic. 

?Lumbo-sacral. 

I  Right  Lumbo-ilio-sacral. 
'Natural  Positions     -;  Left  Lumbo-ilio-sacral. 
Right  Lumbo-ilial. 


/'Natural  Positions     -;  J 


^PosteriorX  vLeft  Lumbo-ilial. 

I  i  Right  Lumbo-supra-cotylold. 

lAbnormal  Positions-  Left  Lumbo-supra-cotyloid. 
I  Lumbo-pubic. 
[  Right  Cephalo-ilial. 
[ Dorso-lu7nhar — Abnormal  Positions        -  Left  Cephalo-ilial. 
.Transversei  ^  Cephalo  sacral. 

I  r  Right  Cephalo-ilial. 

yStcrno-abdominal — Abnormal  Positions  -  Left  Cephalo-ilial. 

\  Cephalo-sacral. 

The  longitudinal  presentations,  with  natural  positions  of  the  trunk  of 
the  foetus,  do  not  necessarily  imply  an  easy  birth,  as,  independently 
of  disproportion  between  the  dimensions  of  the  passage  and  those  of  the 
foetus,  there  may  be  a  misdirection  of  the  head  or  Hrabs,  which  would 
constitute  dystokial  presentations. 


SECTION  III.— MECHANISM  OF  PARTURITION. 

Under  normal  conditions,  it  may  be  said  that  the  pelvis  itself  does 
not  offer  any  obstacle  to  the  passage  of  the  fa3tus,  and  that  it  is  the  soft 
parts  alone  which  oppose  its  exit. 

Of  the  different  presentations  enumerated,  the  anterior — in  which  the 
fore  feet,  head,  and  chest  present  simultaneously-^is  the  only  one  we 
may  designate  as  "  natural,"  especially  with  the  larger  animals  and 
primiparae. 

Fromage  de  Feugre  was  the  first  to  point  this  out,  though  Eainard 
was  of  opinion  that  the  posterior  presentation  should  also  be  looked 
upon  as  normal ;  while  Desplas  gave  three  natural  positions — head  and 
fore  limbs,  head  only,  and  hind  limbs  only  ;  and  Delwart  gives  four 
normal  positions.  But  experience  abundantly  proves  that  the  first  we 
have  described  is  that  which  alone  merits  the  designation,  as  it  is  the 
one  in  which  birth  can  take  place  without  artificial  aid.  It  is  true  that 
birth  is  possible  when  the  Foal  or  the  Calf  presents  posteriorly  at  the 
pelvic  inlet ;  but  this  is  a  rare  presentation,  and  under  the  most 
auspicious  circumstances  it  is  much  less  favourable,  and  more  difficult 
for  the  mother,  while  it  is  very  often  death  to  the  young  animal  (espe- 
cially in  the  Mare).  In  the  majority  of  cases,  without  assistance  ex- 
pulsion proceeds  no  further  than  the  hocks,  and  the  foetus  dies  ;  and 
even  sometimes  with  assistance  much  force  is  necessary  to  deliver. 
Whereas,  in  the  anterior  presentation,  the  cases  are  exceptional  (and 
these  chiefly  in  primiparae)  in  which  even  slight  traction  is  necessary. 

We  will  follow  Saint-Cja-  in  first  studying  the  mechanism  of  parturi- 
tion in  this  presentation,  in  which,  of  the  eight  positions  pertaining  to 
it,  the  vertebrosacral  is  by  far  the  most  frequent  and  favourable.  This 
we  will  now  notice. 


M  ECU  A  MS. M  or  I'AirrriilTKiX.  251 

Make. 
Anterior  Presentation. 

1.  Mechanism  of  Parturition  in  the  Dorso-sacrai  Positio)i. — In  this 
position  it  has  been  stated  that  the  foetus  presents  simultaneously  with 
the  head  and  fore  limbs,  the  back  directed  to  that  of  the  mother  and 
the  withers  towards  the  sacrum.  Wlien  perfectly  natural,  the  head 
and  fore  lej,'s  first  enter  the  inlet ;  the  head  is  extended,  forehead  look- 
ing upwards  to  the  sacrum,  cliin  towards  the  pul)is,  nose  forward,  the 
lower  jaw  resting  on  the  outstretched  limbs,  the  feet  of  which  extend  a 
little  beyond  the  nose.  Then  comes  the  neck,  and  after  it  the  chest 
and  shoulders,  which  arrive  at  the  inlet  when  the  nose  and  feet  show 
themselves  at  the  vulva. 

In  this  course  it  will  be  observed  that,  so  far  as  the  head  and  limbs 
are  concerned,  there  is  no  dilViculty,  as  tlie  pelvic  diameter  readily  admits 
them  when  the  soft  parts  are  sufficiently  relaxed.  With  the  chest,  how- 
ever, there  is  dilliculty,  as  its  diameter  is  greater  than  that  of  the  pelvis; 
and  the  question  is,  therefore,  how  it  is  got  through  the  canal.  In 
1870,  Saint-Cyr  saw  four  well-bred  iiarness  and  saddle  Mares  give 
birth  to  Foals  at  the  Lyons  Veterinary  School.  (Jestation  had  been 
regular,  and  parturition,  which  was  easy  and  favourable,  did  not  exceed 
tlie  ordinary  duration.  In  taking  the  diameters  of  the  maternal  pelvis 
by  the  method  already  described,  and  those  of  the  fcetus  (dorso-sternal, 
biscapulo-humcral,  and  bicoxo-femoral),  it  was  found  that  in  these  four 
instances  the  biscapulo  humeral  diameter — the  largest  in  the  chest — was 
easily  accommodated  in  the  bis-iliac  diameter  of  the  female  pelvis,  which 
was  greater  by  i'2,  45,  -48,  and  even  52  millimetres  (from  li  to  2  inches) ; 
while  the  sterno-dorsal  diameter  of  the  young  creatures  exceeded  that 
of  the  sacro-pubic  region  in  the  mothers  by  2.S,  85,  87,  88  millimetres 
(from  1  to  S\  inches).  This  part  of  the  body  of  the  foetus  had,  therefore, 
to  undergo  a  corresponding  reduction  in  a  vertical  direction  before  it 
could  clear  the  inlet ;  and  even  if  we  take  into  account  the  excess  of  the 
lateral  diameter  of  the  pelvis,  it  will  be  found  that  the  thorax  and  withers 
of  the  fu'tus  still  notably  exceed  in  size  theoj)ening  through  which  they 
must  pass.  That  they  do  pass  through  it,  and  with  ease  in  the  majority 
of  cases,  without  injury  to  the  mother  or  the  young  creature,  is  a  matter 
of  daily  experience  ;  but  the  mechanism  by  which  the  reduction  is 
effected  has  been  much  discussed. 

Lafosse  endeavoured,  in  the  last  century,  to  describe  it,  and  came  to 
the  conclusion  that  the  head  once  through  the  inlet,  the  shoulders  of 
the  Foal,  which  exceed  the  withers,  pass  by  their  upper  part  in  front  of 
the  neck,  thus  forming  a  kind  of  channel  which  glides  along  the  maternal 
sacnnn  ;  also  that  the  spinous  processes  of  the  withers,  wliieh  are  almost 
cartilaginous,  bend  back  on  eacli  other,  and  to  right  and  left  of  the  spine, 
thus  preventing  too  great  compression  of  the  chest.  Altogether,  he  con- 
cluded that  the  Foal  in  its  passage  becomes  moulded  in  such  a  manner 
that  the  chest  has  the  form  of  the  keel  of  a  ship  gliding  on  the  stocks, 
and  in  every  way  corresponds  to  the  mother's  pelvis,  the  internal  contour 
of  whicli  it  assumes. 

Rainard,  however,  takes  a  slightly  different  view  of  this  matter  ;  for 
while  admitting,  with  Lafosse,  the  inclination  backward  of  the  dorsal 
spines  as  a  tirst  cause  in  diminishing  the  vertebro-sternal  or  perpendi- 
cular diameter  of  the  thorax,  he  cannot  admit  that  the  upper  border  of 
the  scapuUr  lie  against  the  neck,  but  states  that  theshoulders,  on  arriv- 


252  NORMAL  P ART  U HIT  ION. 

ing  at  the  pelvic  entrance,  come  in  contact  with  the  ascending  branches 
of  the  ihum,  and  are  thrown  back  somewhat,  leaving  the  front  part  of 
the  chest  free,  and  thus  diminishing  its  diameter.  He  also  adds  that 
the  witliers  first  enter  beneath  the  sacrum  ;  that  the  sternum  below  is 
pushed  back  by  the  anterior  border  of  the  pubis,  and  the  chest  in  this 
way  submits  to  a  process  of  elongation  which  notably  diminishes  its 
vertical  diameter. 

Saint-Cyr  agrees  with  Eainard  in  this  interpretation  of  the  real 
mechanism  of  parturition  in  the  Mare.  The  sternum,  in  being  carried 
backwards,  also  pulls  back  the  ribs  attached  to  it,  and  this  not  only 
diminishes  the  chest  in  a  vertical,  but  also  in  a  horizontal  direction, 
as  is  witnessed  in  studying  the  mechanism  of  respiration  in  the 
living  animal,  in  which,  during  expiration,  the  chest  decreases  in 
width  and  depth.  When  the  chest  is  so  altered  during  parturi- 
tion, the  foetus  becomes,  as  it  were,  elongated  by  this  part  being 
depressed ;  an  alteration  which  occurs  all  the  more  readily,  from 
the  bones  composing  the  thorax  being  soft  and  supple,  and  the 
organs  they  enclose  (the  lungs)  not  being  so  developed  as  they  are 
immediately  afterwards  ;  so  that  a  moderate  amount  of  pressure,  pro- 
vided it  is  not  too  long  continued,  may  be  borne  with  comparative 
impunity. 

In  the  larger  animals,  the  pelvis  cannot  undergo  any  sensible  in- 
crease in  size  during  the  passage  of  the  deepest  portion  of  the  foetal 
body  through  the  inlet,  which  is,  in  the  Mare,  an  absolute  inextensible 
bony  girdle.  Lafosse  has  sawn  through  the  pubes  of  Mares  about  to 
foal,  and  he  found  that  during  parturition  there  was  only  a  space  of 
two  lines  between  the  sawn  margins.  So  that  it  is  the  body  of  the 
foetus  which  has  to  accommodate  itself  to  this  part  of  the  passage  at 
this  stage  of  delivery. 

When,  however,  it  has  passed  through  the  inlet,  extensibility  of  the 
maternal  tissues  can,  and  does,  take  place,  and  permits  an  enlargement 
of  the  canal.  The  wide  sacro-sciatic  ligaments  which  enclose  the  pelvis 
laterally,  are  softened  and  more  elastic  during  birth  ;  the  sacro-iliac 
and  sacro-lumbar  articulations  are  increased  in  mobility  ;  and  even  the 
posterior  part  of  the  ischio-pubic  symphysis  may  become  slightly 
relaxed.  So  that  when  once  approaching  the  outlet  the  progress  of 
birth  is  more  rapid,  and  this  progress  may  be  aided  if,  as  is  pointed 
out  by  Lafosse,  the  tail  of  the  mother  is  well  elevated. 

A  slight  check  to  expulsion  is  observed  when  the  croup  arrives  at  the 
inlet,  as  this  part  nearly  corresponds  in  diameter  to  this  opening,  being, 
if  anything,  slightly  less.  However,  notwithstanding  this,  in  conse- 
quence of  the  croup  being  less  susceptible  of  diminution  than  the  chest, 
and  although  the  bones  may  yield  to  some  extent,  friction  will  occur, 
more  particularly  if  the  croup  is  largely  developed,  which  is  the  case  in 
some  Foals.  One  haunch  may  pass  into  the  inlet  before  the  other,  how- 
ever, and  thus  facilitate  the  passage. 

2.  Mechanism  of  Parturition  in  the  Dorso-ilio-sacral  Positi())}s. — 
These  positions  are  two  in  number  and  symmetrical,  and  probably  are 
frequent  at  the  commencement  of  birth  in  the  anterior  presentation, 
when  the  width  of  the  pelvis  exceeds  its  depth — the  oblique  diameters 
being  then  greater  than  the  vertical — so  that  the  foetal  thorax  enters 
even  more  easily,  and  it  is  only  when  the  croup  reaches  the  inlet  that 
the  foetus  is  compelled  to  rotate  slightly  on  itself  to  assume  the  first 
position  on  its  passage  outwards  ;  when  the  depth  of   the  pelvis   is- 


MKCIIAXISM  OF  I'AUTilUTKiX.  2h',\ 

j^reater  than  its  width  this  rotation  is  effected  spontaneously  at  the 
commencement  of  birtli.  So  that  these  oblique  positions  are  as  favour- 
able as  the  dorso-sacral  position. 

3.  Mechanism  of  Parturition  in  the  Domo-Uial  Positions. — These 
lateral  positions — also  two  in  number  and  symmetrical — are,  accord- 
inf^  to  Saint-Cyr,  rarely  primary,  but,  as  Kainard  remarks,  are  some- 
times found  as  sccondar;/  j>ositions,  due  to  the  reduction  of  some 
mal-presentations.  The  latter  authority  asserts  that  spontaneous  birth 
is  impossible  in  these  positions,  because  the  chest  of  the  fa;tu8 
presents  its  greatest  diameter  to  the  smallest  diameter  of  the  pelvis 
of  the  mother.  This,  however,  is  an  exaggeration,  as  the  bis-iliac 
diameter  is  sometimes  equal,  or  even  superior,  to  the  sacro-pubic 
diameter;  so  that  it  is  not  always  absolutely  impossible  for  delivery  to 
occur  spontaneously  in  these  positions  ;  though  it  is  very  true  that  it 
is  alicays  more  dillicult,  and  sometimes  impossible,  if  the  position  is  not 
altered.  Independently  of  the  disproportion  between  the  diameters  of 
the  pelvis  and  the  corresponding  diameters  of  the  fa-tus,  here  also  we 
find  the  two  salient  parts  of  the  latter — the  sternum  and  dorsal  spines 
jamming  against  the  tw^o  resisting  parts  of  tlie  ])elvic  circumference — 
the  ascending  branch  of  each  ilium,  and  it  will  he  readily  seen  that  in 
some  cases  tliese  will  prove  an  insurmountable  obstacle.  Nevertheless, 
as  a  general  rule,  this  obstacle  may  be  easily  turned,  if  the  pelvis  is 
sutliciently  wide,  by  merely  causing  the  body  of  the  fcetus  to  rotate  in 
such  a  manner  that  its  greatest  diameter  will  be  brought  opposite  the 
oblique  diameter  of  the  inlet,  which  extends  from  the  ilio-pectineal 
ridge  to  the  sacro-iliac  articulation  on  the  opposite  side.  Then  its 
<;ntrance  into  the  pelvic  cavity,  and  complete  expulsion,  is  rendered 
possible. 

But  if  the  pelvis  is  narrow,  the  faulty  position  must  be  modified  at 
the  commencement  of  birth  so  as  to  make  it  oblique  or  dorso-sacral, 
and  if  the  ftetus  is  not  large  the  croup  will  probably  follow  without 
(lifliculty.  If,  however,  the  fa-tus  is  large,  it  should  be  placed  in  the 
<lorso-ilial  position  in  order  to  accommodate  it  to  the  larger  diameter 
of  the  pelvis. 

It  will  be  seen  that  the  dorso-ilial  positions  may  sometimes  admit  of 
spontaneous  birth,  but  that  it  will  also  happen  that  aid  will  be  neces- 
sary to  effect  delivery. 

Posterior  Presentation. 

Mechanism  of  Parturition  in  the  Lumbosacral  Position.  —  Of  the 
positions  in  which  we  may  have  a  breech  or  posterior  presentation, 
only  one  is  compatible  with  spontaneous  delivery— the  lumho-sacral  ; 
though  even  this  is  denied  by  other  authorities.  Tiie  fu'tus  is  pre- 
sented by  the  breech,  the  loins  towards  the  sacrum  of  the  mother, 
the  hind  limbs  in  complete  extension  and  entering  the  inlet,  so  as 
to  open  the  passage  for  the  body ;  and  though  this  position  may 
appear  to  be  favourable  for  the  expulsion  of  the  young  creature, 
yet  it  is  far  less  so  than  the  first  anterior  position.  The  croup  of 
the  fcetus  is  a  rounded  voluminous  mass  which  does  not  admit  of 
much  compression,  and  the  diameters  of  which  -  particularly  the  trans- 
verse—are nearly  equal  to  those  of  the  pelvis;  it  is,  therefore,  not 
well  disposed  for  passing  through  the  latter,  and,  in  addition,  its  upper 
part  presses  against  the  sacro-vertebral  angle  ;  while  the  stifles,  which 
are  salient,  press  against  the  edge  of   the  pubis,  and  the  hip-joints 


254  NORMAL  PARTURITION. 

against  the  branches  of  the  ilium.  Entrance  into  the  inlet  must  there- 
fore be  slow,  difficult,  and  painful  for  the  mother,  and  when  this 
first  obstacle  is  overcome  and  the  croup  is  in  the  pelvic  cavity,  the  chest 
has  to  follow,  and  to  submit  to  the  same  compression  at  the  inlet  as  in 
the  anterior  presentation.  But  this  part  of  the  fcetus  is  much  less 
favourably  disposed  for  such  a  reduction  of  dimensions  in  this  position  ; 
as  the  resistance  offered  by  the  walls  of  the  maternal  pelvis  has  a  ten- 
dency to  erect  the  dorsal  spines,  and  to  carry  the  ribs  and  sternum 
forward — all  this  going  to  increase  the  diameter  of  the  fcetus  in  every 
direction.  It  is  only,  then,  by  direct  compression  or  squeezing,  that 
the  necessary  diminution  in  the  diameters  of  the  young  creature  can  be 
effected,  and  not  by  a  kind  of  physiological  decrease,  as  in  the  anterior 
pi'esentation. 

There  is  also  the  obstacle  offered  by  the  hair  of  the  foetus,  the  "  set  " 
of  which  is  against  the  direction  of  movement ;  and  this  obstacle  will 
be  greatly  increased  if  the  fluids  have  escaped  for  some  time,  and  the 
parts  are  more  or  less  dry. 

Taking  all  these  considerations  into  account,  it  will  be  seen  that  in 
this  position,  even  when  birth  is  possible  with  extraneous  assistance, 
labour  must  be  long  and  exhausting,  and  that  the  young  creature 
incurs  the  greatest  danger.  Labour,  however,  is  more  likely  to  be 
successful  and  less  tedious  if  the  haunches  of  the  foetus  present  one 
after  the  other  at  the  inlet ;  so  that  a  slight  obliquity  in  the  presenta- 
tion makes  a  great  difference  ;  and  it  is  just  possible  that  when  birth 
takes  place  in  this  position  without  aid,  this  obliquity  may  have  been 
present. 

Cow. 

Anterior  Presentation. 

Mechanism  of  Partiirition  in  the  Dorso-sacral  Position. — In  the  Cow, 
the  mechanism  of  parturition  in  this  presentation  is  similar  to  that  in 
the  Mare.  Saint-Cyr  shows,  from  actual  measurements  of  Cow  and 
foetus,  that  the  head  of  the  Calf  can  easily  pass  into  the  inlet,  owing  to 
its  less  diameter,  and  that  the  principal  difficulty  is  encountered  by  the 
foetal  thorax,  which  is  slightly  larger  in  every  sense  than  the  inlet. ^ 

The  bicoxo-femoral  diameter  of  the  croup  slightly  exceeds  the  bis- 
iliac  diameter  of  the  pelvis  ;  but  it  is  possible  that  the  pelvis  of  the 
Calf,  being  more  cartilaginous  and  supple  than  that  of  the  Foal,  may 
be  submitted  to  a  slight  temporary  compression.  It  is  to  be  remarked, 
however,  that  the  progress  of  the  Calf  through  the  pelvis  must  be  more 
protracted  tban  that  of  the  Foal,  owing  to  the  greater  length  of  the 
maternal  pubic  symphysis,  and  the  more  considerable  extent  of  the 
pelvic  walls,  as  well  as  the  peculiar  curve  in  the  floor  of  the  pelvis ; 
though  these  disadvantages  are  somewhat  compensated  for  by  the  greater 
mobility  of  the  sacrum.  And,  as  we  have  seen,  such  is  really  the 
case,  the  duration  of  parturition  being  shorter  in  the  Mare  than  in 
the  Cow.-' 

The  other  positions   in  this  presentation   do  not  differ  much  from 

1  Saint-Cjr  in  these  observations  measured  the  thorax  after  the  birth  of  the  young 
creatures,  and  when  the  lungs  had  become  expanded.  He  does  not  appear  to  have  made 
any  allowance  for  this  expansion,  which  of  course  makes  a  difference  in  the  size  of  the 
thorax  after  biith. 

-  The  fact  that  parturition  is  more  quickly  pei formed  in  the  Mare  than  any  other 
quadruped  was  well  known  to  Aristotle  :  Equa,  omnium  qiiadrupedem,  J'acilllme,  parit. 


.VAVAW^JA'l'  All)  IX  Xol.M.lL   rAnTHUTloX.  25^ 

tliose  in  the  Mare  with  a  narrow  pelvis,  to  wliich  that  of  the  Cow  bears 
considerable  resemblance. 

The  same  may  he  said  of  the  positions  in  the  tostkiuok  i'uksknta- 
riON.  In  the  lumbo-sacral  })osition,  tlie  stiHes  of  the  Calf,  beinj^  more 
oblique  than  those  of  the  Foal,  are  not  so  liable  to  be  held  by  the 
anterior  border  of  the  pubis,  while  another  advanta^'e  is  to  be  found  in 
the  smaller  disproportion  between  the  lengtli  of  femurs  of  the  (!alf  and 
the  sacro-pubic  diameter  of  the  Clow  ;  so  that  tlie  Calf  is  more  fre- 
(juently  born  alive  in  this  position  than  the  Foal,  wliile  the  Cow  is  more 
rarely  subject  to  injury,  though  extraneous  aid  may  be  necessary  at 
times. 

Other  Animals. 

With  regard  to  the  smaller  female  animals,  the  same  remarks  are 
applicable  to  presentations  and  positions,  as  in  the  case  of  the  Mare 
and  Cow,  and  mors  especially  with  reference  to  tlie  Sheep  and  Goat. 
In  these  latter,  when  there  is  only  one  foetus,  birth  is  etTected  by 
the  same  mechanism,  and  when  there  are  more  than  one  it  is  no  less 
easy,  as  the  fa-tuses  are  smaller.  This  is  nearly  always  the  case,  also, 
with  the  Sow,  and  still  more  frequently  with  the  Bitch  and  Cat. 

It  may  be  noted  that  with  the  common-bred  Bitch,  which  has  a  more 
or  less  elongated  muzzle,  when  fecundated  by  a  Dog  of  the  same  con- 
formation and  size,  and  which  in  due  course  brings  forth  from  five  ti> 
eight  young,  there  is  usually  no  difliculty  in  delivery.  The  conical 
form  of  the  muzzle  of  the  puppies,  and  the  softness  of  their  tissues, 
permits  their  entering  the  inlet  in  this  presentation,  and  passing  easily 
through  it  under  the  influence  of  the  uterine  and  abdominal  contrac- 
tions. But  when  the  Bitch  is  of  small  size,  and  is  fecundated  by  a 
young,  vigorous,  and  larger  Dog,  and  especially  if  the  muzzle  of  either 
or  both  parents  is  short,  then  the  head  of  the  puppies  is  usually  large 
and  round,  with  the  forehead  higli,  and  the  presentation  offers  grave, 
and  frequently  insurmountable  dilViculties.  This  is  more  especially  the 
case  if  the  puppies  are  few  in  number,  when  they  are  usually  larger. 
This  will  be  alluded  to  again  when  we  come  to  treat  of  dillicult  parturi- 
tion. 

It  may  also  be  observed  that  in  the  Anterior  Presentation,  the  foro 
limbs  of  the  ftetus — contrary  to  what  takes  place  in  the  ^lare  and  Cow 
— do  not  accompany  the  head,  but  are  placed  alongside  the  chest,  owing 
to  this  disproportionate  size  of  the  head,  which  is  as  voluniinous^if 
not  more  so — than  the  chest  in  some  instances  ;  but  then  the  latter, 
even  with  the  legs  alongside  it,  is  easily  reducible,  while  the  head 
is  very  slightly  so. 

The  Posterior  Presentation  is  frequent  in  Carnivorous  animals,  but 
birth  is  efifected  under  the  same  conditions  as  in  the  other  species. 


CHAPTER  III. 
Necessary  Aid  in  Normal  Parturition. 

Although,  as  a  rule,  j)arturition  is  generally  ellected  in  animals  in 
what  we  have  designated  a  "spontaneous  '  manner  (without  the  inter- 
vention of  man),  and  without  danger  or  prejudice  to  the  mother  or  ofT- 
spring  ;  and  although  these  do  not  require  that  luinute  and  scrupuloua 


256  NORMAL  PARTURITION. 

attention  bestowed  on  woman  and  infant,  even  when  birth  has  been 
easy  ;  yet,  from  the  nature  of  this  act  and  the  unfavourable  conse- 
quences which  are  sometimes  noted,  certain  precautions  should  be 
observed  by  the  owner  of  the  animals  at  this  period,  and  especially  if 
these  should  happen  to  be  valuable  and  very  artificially  kept.  These 
attentions  and  precautions  should  be  entrusted  for  their  carrying  out 
to  competent  persons  selected  by  the  owner ;  as  it  is  seldom  that  the 
veterinarian  is  called  in  unless  something  serious  has  occurred.  The 
mother  as  well  as  the  offspring  require  watching,  and  more  or  less 
nursing. 

SECTION  I.— ATTENTION  TO  THE  MOTHER. 

"With  the  smaller  animals,  except,  perhaps,  the  Bitch,  little  pre- 
paration is  needed,  and  the  act  of  parturition  is  accomplished  with- 
out any  trouble.  But  with  the  larger  and  more  valuable  creatures — 
such  as  the  Mare  and  Cow,  and  even  the  Sheep — certain  precautions 
should  be  adopted.  With  the  Mare  and  Cow  particularly,  this  function 
is  accompanied  by  pain,  restlessness,  and  a  certain  amount  of  excite- 
ment, which  necessitate  attention.  For  instance,  an  animal  tied  up  in 
a  stall  among  other  animals  of  the  same  or  different  species,  is  more 
exposed  to  accidents  than  one  which  is  in  a  place  by  itself,  or  which'  is 
.at  liberty  in  a  pasture  or  meadow.  Therefore,  the  Tvlare  about  to  foal 
should  be  allowed  a  roomy  loose-box,  well  supplied  with  soft  litter ; 
and  the  Cow  should,  if  possible,  be  similarly  provided.  If  either 
animal  must  be  kept  tied,  then  the  fastening  should  be  of  such  a  kind 
that  it  can  readily  be  undone  when  required.  The  Sow  should  have  a 
separate  sty,  and  even  the  Sheep  may  need  a  separate  allotment.  If 
kept  in  a  dwelling,  the  temperature  should  be  comfortable  and  the 
ventilation  good. 

A.  DuEiNG  Labour. — When  parturition  commences,  it  is  rare  indeed 
that  anything  requires  to  be  done  during  at  least  the  two  first  stages — 
those  of  preparation  and  dilatation  of  the  os.  Therefore,  the  animal 
should  be  allowed  perfect  quietude  ;  and  if  the  light  in  the  stable  is  too 
bright,  it  may  be  partially  excluded.  A  trustworthy  person  may  re- 
main with  it,  in  order  to  avert  accidents  ;  but  he  should  keep  himself 
out  of  sight,  and  meddle  with  the  animal  as  little  as  possible.  Some 
■creatures,  and  particularly  primiparas,  are  rendered  peevish  and  fidgety 
if  they  see  anyone  present  during  parturition. 

Unless  something  irregular  or  abnormal  occurs  during  this  act,  all 
should  be  left  to  nature.  In  the  case  of  the  Mare,  however,  it  has  been 
recommended  to  empty  the  rectum  either  manually  or  by  means  of  oily 
enemas,  if  the  faeces  are  hard,  in  order  to  avert  rupture  of  the  intestine. 
The  irregularities  are  few  in  number,  the  principal  being  hurried  and 
jji'otracted  parturition,  they  being  only  modifications  of  natural  labour  ; 
the  difficult  cases  coming  under  the  head  of  dystokia  will  be  treated  of 
in  another  division  of  this  volume. 

Whether  called  in  to  a  case  of  irregular  or  abnormal  parturition,  the 
first  care  of  the  veterinary  surgeon  will  be  to  assure  himself  as  to  the 
state  of  the  animal  and  the  progress  made  in  the  act.  In  this  direction, 
it  must  be  remembered  that  for  the  accomplishment  of  this  function  in 
a  physiological  manner — i.e.,  by  the  forces  of  nature  only^ — and  without 
prejudice  to  the  mother  or  offspring,  there  is  required  a  definite  action 
— proportionate  to  the  constitution  of  the  former — -of  the  forces  destined 


XECfSS.inr  AH)  IX  X>>J;MAL  rAltTCHITloX.  257 

for  the  expulsion  of  the  latter.  The  labour-pains  should  be  normal, 
and  the  act  should  neither  be  hurried  nor  abrupt,  nor  yet  too  slow  ;  and 
the  mother  should  not  exhibit  any  constitutional  weakness  or  physical 
debihty.  In  addition,  the  foetus  should  be  normal,  as  well  as  its  mem- 
branes ;  and  the  genital  passages  of  the  motlier  ought  to  be  in  a 
properly  formed  and  healthy  condition.  The  foetus  should  be  alive  and 
natural  in  form  and  size,  particularly  with  regard  to  the  volume  of  the 
head  and  thorax  ;  and  it  ought  to  be  in  such  a  position  that  it  can  be 
expelled  without  assistance.  The  fojtal  envelopes  should  possess  a 
certain  degree  of  tliickness  and  resistance,  so  that  they  may  not  rupture 
too  soon,  nor  yet  resist  the  action  of  the  uterus  too  long.  The  pelvis  of 
the  mother  should  have  a  convenient  shape  and  capacity ;  the  genital 
passages  soft  and  elastic  ;  the  os,  vagina,  and  vulva  properly  formed 
and  extensible  ;  and  the  other  pelvic  organs  in  a  normal  state. 

If  the  act  of  parturition  is  not  sufficiently  advanced,  and  the  soft 
parts  through  which  the  foetus  has  to  pass  are  not  enough  dilated,  time 
ought  to  be  allowed  for  this  to  take  place.  As  a  rule,  there  should  be  no 
hurry  to  interfere  with  the  progress  of  the  case,  as  a  somewhat  long 
period  is  often  required  for  preparation  ;  and  if  this  is  accelerated  by 
the  intervention  of  art,  accidents  are  more  likely  to  occur  than  if  the 
labour  had  been  long  and  protracted. 

Vitulary  or  parturient  collapse  has  been  remarked  as  more  connnon 
in  Cows  which  have  calved  quickly  or  abruptly  ;  and  in  such  instances 
it  has  also  been  noticed  that  the  uterine  contractions  do  not  sufficiently 
detach  the  fa^tal  membranes. 

In  parturition,  there  is  as  much  wisdom  shown  in  remaining  a  spec- 
tator sometimes,  as  in  interfering  at  other  times  when  circumstances 
require  it.  It  is  only  when  obstacles,  insurmountable  by  the  natural 
efforts  of  the  animal,  offer  themselves  that  aid  nmst  be  rendered.  So 
long  as  the  course  of  parturition  remains  normal,  nothing  should  be 
done,  under  ordinary  circumstances. 

With  the  Mare,  however,  delay  should  not  be  pushed  too  far,  as  the 
fcetal  placenta  is  very  easily  detached  from  the  uterine  surface,  and  the 
fa'tus  may  perish  of  asphyxia  or  inanition. 

The  intelligent  owner  of,  or  attendant  on,  an  animal  which  is  about 
to  bring  fortli,  should  be  able  to  ascertain  the  position  of  the  fcetus,  and 
decide  as  to  whether  parturition  may  terminate  in  a  natural  manner, 
or  if  the  existing  obstacles  are  easy  to  overcome.  If  they  are  not,  he 
certainly  should  not  venture  to  attempt  delivering  the  animal  himself, 
or  to  pull  about  the  mother  or  fcetus  ;  as  this  may  only  tend  to  aggra- 
vate the  accident,  and  render  relief  more  diilicult.  The  veterinary 
surgeon  should  be  sent  for,  as  his  knowledge  and  practised  manipula- 
tive skill  will,  in  the  majority  of  cases,  bring  the  most  comphcated 
labour  to  a  prompt  and  happy  termination — preserving  the  mother,  and 
often  the  progeny. 

This  appeal  to  the  veterinarian  is  not  always  made,  however,  until 
great  damage  has  been  done  by  the  owner,  his  servants  and  neighbours, 
or  the  empiric,  and  the  loss  of  valuable  time  caused  ;  then  he  is  sent 
for,  but  now  the  case  may  be  one  of  extreme  difficulty  or  hopelessness, 
from  exhaustion  or  injury. 

We  shall  only  notice  in  this  place  what  has  been  designated  abrupt, 
tumultuous,  disordered,  or  false  labour  {partus  pracipitatus),  and  pro- 
tracted labour,  both  due  to  anomalies  in  the  expelling  forces. 

1.  Tumultuous  Labour. — In  this  kind  of  labour  the  act  of  parturition 

17 


258  XOIUIAL  PAETUPJIIOX. 

is  irregular  and  precipitate  ;  and  though  the  pains  are  excessive  and 
frequent,  yet  no  progress  appears  to  be  made,  the  parts  not  being  pre- 
pared, while  the  cervix  is  often  in  a  state  of  spasmodic  contraction, 
rigid,  and  painful.  Otherwise  the  maternal  organs  may  be  well  formed, 
the  passage  roomy  enough,  and  the  foetus  in  a  good  position. 

Sometimes  the  uterus  itself  is  in  a  state  of  contraction,  the  con- 
tractions assuming  the  opposite  direction  of  those  occurring  in  healthy 
labour, — commencing  at  the  cervix,  they  pass  towards  the  fundus  of 
the  uterus. 

This  condition,  in  which  the  phenomena  are  at  first  alarming,  is 
most  frequently  observed  in  young,  well-fed,  vigorous,  irritable  animals, 
and  especially  primiparae,  which  are  excited  and  troubled  at  the  first 
pains,  and  give  themselves  up  to  violent  expulsive  efforts  that  hinder 
the  natural  course  of  parturition. 

In  the  majority  of  cases,  amendment  is  ensured  by  diverting  the 
animal's  attention,  walking  it  about  for  a  short  time,  wisping  the 
abdomen  gently,  and  keeping  it  in  a  quiet  and  dark  place.  If,  how- 
ever, the  pains  are  violent,  and  the  agitation  great  and  persistent, 
other  measures  must  be  resorted  to.  Some  authorities  recommend 
bleeding,  but  this  should,  if  possible,  be  dispensed  w^th.  Blankets 
steeped  in  hot  \vater  should  be  applied  to  the  loins  and  abdomen, 
warm  enemas  administered,  and,  if  deemed  necessary,  chloroform, 
ether,  opium,  or  chloral  given  in  draught  or  in  enema — the  latter  being 
generally  preferable.  Not  infrequently  good  results  are  produced  by 
injecting  tepid  water  into  the  vagina,  and  raising  the  animal's  hind 
quarters ;  and  at  other  times,  when  the  cervix  is  in  a  state  of  spasm, 
relief  is  soon  obtained  by  applying  a  little  extract  of  belladonna  to  it. 
With  small  animals,  a  few  drops  of  laudanum,  either  in  draught  or 
enema,  and  a  warm  bath,  are  usually  sufficient. 

Quiet,  soothing,  and  simple  treatment  will  generally  bring  about  a 
normal  state  of  affairs  ;  the  agitation  and  irregular  straining  subside, 
and  easy  parturition  occurs  in  six,  twelve,  or  twenty-four  hours. 

2.  Protracted  Labour. — Pi'otracted  labour,  due  solely  to  the  inability 
of  the  uterus  to  expel  its  contents,  or  to  pathological  weakness  of  the 
expelling  forces,  is  rare,  except  in  those  cases  in  which  exhaustion 
results  from  violent  and  long-continued  attempts  to  overcome  some 
material  obstacle  to  birth.  Then,  most  commonly,  the  membranes 
have  ruptured,  the  waters  have  entirely  escaped,  and  the  uterus,  in  a 
state  of  general  tonic  contraction — tetanus  uteri — is  closely  applied  to 
the  foetus,  but  makes  no  effort  to  expel  it.  This  usually,  if  not 
always,  happens  when  the  foetus  is  dead.  But  primary  inertia,  due 
to  constitutional  weakness,  and  in  the  absence  of  any  material  obstacle 
to  the  expulsion  of  the  foetus,  is  not  common. 

It  is  observed,  nevertheless,  in  emaciated,  puny,  and  frequently  old 
animals,  w^hich  are  debilitated  from  lack  of  sufficient  and  good  food, 
prolonged  lactation,  overwork,  or  worn  by  chronic  wasting  diseases. 
It  may  also  be  due  to  congenitally  feeble  development  of  the  uterine 
muscular  fibres,  and  to  diminished  contractility  of  these  by  over-disten- 
tion  of  the  uterus  during  pregnancy,  or  by  disease. 

The  symptoms  in  the  Mare  and  Cow  are  :  comparatively  shallow  and 
repeated  inspirations,  feeble  and  unfrequent  straining,  weak  pulse, 
restlessness  and  symptoms  of  suffering,  extremely  slow  progress  in 
birth, — parturition  in  the  Cow  being  extended  to  twenty-four,  and  even 
forty-eight  hours,  though  the  foetus  may  be  in  a  good  position,  of  ordi- 


XECEss.UiV  A  III  i.\  .\i>i:Mji,  r.urri  i:iTwx.  2r.9 

nary  size,  and  the  passaj;e  clear.  If  the  hand  is  introduced  hito  the 
va-^ina,  it  will  he  discovered  that  the  uterine  contractions  are  weak. 

There  is  no  ur^'ent  dan<;er  to  the  mother  in  this  condition  ;  though 
the  life  of  the  fcitus  is  often  imperilled,  as  the  placenta  may  he  de- 
tached more  or  less  from  the  uterus,  und  this  may  lead  to  fatal 
consequences. 

An  examination  is  of  course  necessary,  in  order  to  ascertain  whether 
there  is  any  ohstacle  to  parturition.  Should  such  not  be  found,  then 
stimulants  may  be  given  ;  such  ecbolics  as  rue,  satt'ron,  savine,  and 
particularly  ergot  of  rye,  have  been  recommended  by  various  writers. 
These  may  be  useful,  but  it  will  generally  be  found  that  active  inter- 
vention is  preferable,  and  more  especially  as  there  is  little,  if  anything, 
to  prevent  the  fcitus  being  easily  reached  ;  for  should  the  os  be  in- 
sutliciently  dilated,  it  may  readily  be  made  wide  enough  for  the  hand 
to  pass  into  the  uterus.  Moderate  and  judicious  traction  on  the 
parts  which  present,  when  the  mother  makes  expulsive  efforts,  will 
bring  the  futus  into  the  pelvic  cavity  and  through  the  vulva. 

De.\th  of  the  FtETUs. — When  parturition  is  retarded,  it  is  often  a 
question  whetlier  the  foetus  is  dead  or  alive,  and  to  answer  it  correctly 
is  sometimes  dilVicult.  Auscultation  in  the  larger  animals  cannot,  as 
it  may  in  the  human  species,  furnish  any  certain  evidence  in  this  re- 
spect. The  fcDtor  of  the  liquor  amnii  has  been  held  to  prove  the  death 
of  the  fcctus  ;  but  though  it  is  a  good  sign,  yet  it  is  not  infallible. 
When  decomposition  has,  however,  well  advanced,  and  the  foetus  is 
emphysematous  and  its  hair  easily  removed,  then  there  can  be  no 
doubt  as  to  its  being  dead.  The  coldness  of  the  parts  external  to  the 
vulva  of  the  mother,  when  well  marked,  is  also  a  si.i;n  of  death.  Of 
course,  so  long  as  the  foetus  displays  active  movements,  it  is  alive  : 
but  tlie  absence  of  these  is  not  an  absolute  proof  that  it  no  longer 
lives ;  for  sometimes  when  it  is  partly  in  the  pelvis  and  the  waters 
have  escaped,  so  that  the  uterus  encloses  it  firmly,  though  still  living 
it  remains  passive,  and  cannot  be  stimulated  to  movement.  Should 
the  presentation  be  anterior,  then  passing  the  fingers  into  its  mouth 
and  titillating  the  tongue  will  prove  a  test  of  its  vitality,  as  the  jaws 
and  tongue  are  almost  certain  to  move  if  it  lives  ;  but  the  absence 
of  movement  will  not  be  decisive,  though  it  will  constitute  very  probable 
evidence  of  death.  If  the  umbilical  cord  can  be  reached  and  seized 
between  the  thumb  and  index  finger,  slight  compression  will  discover 
whether  or  not  the  arteries  pulsate.  The  absence  of  pulsation  afTords 
a  strong,  but  not  in  every  case  a  sure,  presumption  that  the  fcctus  is 
dead. 

Gelle,  many  years  ago,  gave  an  empirical  test  which,  he  asserted, 
was  constantly  successful;  though  it  is  ditVicult  to  say  why  it  should 
be.  This  method  consists  in  passing  a  blanket  or  sheet  under  the  belly 
ut  the  Cow,  and  lifting  it  up  by  assistants  at  each  side.  If  the  fcetus 
is  not  dead,  the  Cow  exhibits  dislike  of  the  pressure  ;  but  if  dead,  then 
it  rests  on  the  sheet. 

Another  authority  states  that,  with  the  Mare,  the  expulsive  efforts 
cease  for  the  time  being  as  soon  as  the  Foal  is  dead,  and  if  it  has  not 
entered  the  pelvic  inlet ;  if  it  has  passed  into  this,  the  pains  continue  as 
usual. 

In  the  Cow  the  fcetus  may  be  alive  though  the  labour-pains  have 
ceased  for  some  hours,  or   only  occur  at  long  intervals.      With  the 


260  NORMAL  PARTURITION. 

Bitch,  it  has  been  remarked  that  when  the  pains  are  weak,  the  first 
puppy  that  presents  is  usually  dead. 

The  causes  of  death  of  the  foetus  during  parturition  are  not  numerous, 
and  may  be  enumerated  as  follows: — 1.  Knots  on  the  umbilical  cord, 
which,  though  not  unfrequent  in  the  human  foetus,  appear  to  be  very 
rare  in  animals  ;  2.  Twists  of  the  cord  around  the  body,  neck,  or  limbs 
of  the  foetus,  and  which  may  be  sufficiently  tight  to  interrupt  the  circu- 
lation in  the  umbilical  vessels  ;  3.  Prolonged  compression  of  the  umhilical 
cord,  due  to  the  foetus  remaining  a  long  time  in  the  passage,  whereby 
the  circulation  of  blood  is  checked ;  4.  Premature  rupture  of  the  mem- 
branes and  escape  of  the  whole  of  the  liquor  amnii,  which,  if  parturition 
is  not  soon  completed,  exposes  the  foetus  to  great  danger  from  imme- 
diate pressure  of  the  uterus  upon  it;  5.  Disunion,  moi-e  or  less  com- 
plete and  extensive,  between  the  uterus  and  foetal  envelopes,  by  which 
the  vital  connection  between  the  mother  and  foetus  is  interrupted,  and 
if  the  latter  is  not  quickly  expelled  it  must  die  from  asphyxia.  Owing 
to  the  difference  in  the  placentation  of  the  various  animals,  it  happens 
that  this  foetal  asphyxia  is  not  equally  common  in  all — a  fact  which 
experience  and  clinical  observation  have  abundantly  demonstrated. 

Many  veterinarians,  and  among  them  Saint-Cyr,  have  been  struck  by 
the  fact,  that  no  matter  how  soon  they  were  called  in  to  a  case  of  diffi- 
cult parturition  in  the  Mare,  nor  how  trifling  the  difficulty  might  be 
and  rapid  the  delivery,  the  living  foal  was  never  produced  ;  while  in 
cases  in  Cows,  though  incomparably  more  difficult,  and  requiring 
manipulation  for  more  than  an  hour,  living  Calves  were  the  rule.  So 
common  is  this  experience,  that  a  very  distinguished  French  veterinary 
surgeon — Donnarieix — has  laid  it  down  as  a  maxim  that  the  Foal  does, 
not  live  more  than  three  hours,  often  less,  in  the  uterus  after  the  first 
expulsive  efforts ;  while  the  Calf  in  the  same  conditions  can  live  much 
longer — sometimes  for  several  days — after  the  commencement  of  labour. 
The  explanation  he  gives,  and  which  we  think  is  correct,  is  based  on 
the  manner  in  which  the  foetal  placenta  is  inserted  into  the  uterus.  In 
the  Cow,  the  placentulse,  multiple  and  independent  of  each  other, 
adhere  firmly  and  closely  to  the  uterine  cotyledons,  so  that  the  placental 
circulation  may  persist  for  a  long  time,  notwithstanding  the  energy  of 
the  uterine  contractions  ;  while  in  the  Mare,  the  placental  apparatus,, 
being  everywhere  distributed  over  the  chorion,  adheres  but  feebly  to 
the  uterine  mucous  membrane,  and  gives  way  as  soon  as  labour  com- 
mences, so  that  foetal  asphyxia  is  imminent  if  birth  be  not  prompt. 
There  are  exceptions,  of  course,  to  this  rule,  and  another  practitioner 
asserts  that  he  has  delivered  four  living  Foals  three  and  a  half  hours 
after  the  parturient  straining  began  ;  one  of  them  was  even  four  hours- 
in  the  uterus  before  it  was  born,  and  underwent  this  straining  without 
injury. 

The  foetus  may  also  perish  when  it  is  in  a  wrong  position,  or 
is  of  unusual  size,  and  force  has  to  be  employed  in  delivering  it,  in 
which  case  undue  compression  of  the  chest  may  impede  the  action  of 
the  heart. 

It  was,  and  still  is,  believed  by  many  that  the  foetus  plays  an  active 
part  in  delivery,  and  particularly  in  rupturing  its  membranes  ;  while 
others  consider  that  its  death  increases  to  a  marked  degree  the  diffi- 
culties of  parturition,  because  it  does  not  then  stimulate  the  contrac- 
tions of  the  uterus,  and  its  flaccid  tissues  do  not  afford  that  resistance 
to  the  uterine  muscles  which  they  do  when  it  is  alive.     But  Saint-Cyr 


XECEssAnv  .-iff)  r.y  \(>/:.\f.iL  pahtl'ritiox.  261 

denies  that  tlie  death  of  the  foetus  renders  parturition  slower  or  more 
dillicult ;  tliough  he  admits  that  if,  at  the  commencement  of  tliis  act, 
there  may  chance  to  be  any  trifling  irregularities  in  presentation  or 
position,  tiiese  may  be  recti^ed  to  a  certain  extent  by  the  automatic  or 
more  or  less  instinctive  movements  of  the  living  fcetus.  Jle  concludes 
that  though  the  death  of  the  foetus  has  certainly  a  great  importance,  so 
far  as  the  interests  of  the  breeder  are  involved,  as  well  as  with  regard 
to  obstetrical  operations  in  ditiicult  cases ;  yet  it  has  little  or  none  so 
far  as  parturition  itself  and  its  results  to  the  mother  are  concerned. 

In  the  expulsive  period,  or  third  stage  in  parturition,  it  is  usual  to 
consider  such  matters  as  when  to  rupture  the  water-bag,  and  when  to 
use  traction  on  the  fa'tus.  This  custom  will  be  followed,  and  these 
points  noticed. 

liupture  of  the  Water-bag. — This  sliould  not  be  artificially  ruptured 
too  early  ;  indeed,  in  the  Cow  it  should  never,  as  a  rule,  be  opened 
artificially,  as  it  is  always  spontaneously  ruptured  at  the  proper  time, 
and  not  infrequently  sooner  than  it  should  be.  Besides,  the  want  of 
tenacity  in  the  membranes,  their  thinness,  and  the  firmness  of  their 
adhesion  to  the  uterus,  render  this  non-interference  all  the  more 
necessary. 

With  the  Mare,  however,  matters  are  different.  In  this  animal  the 
fcetal  membranes  are  thick,  firm,  and  feebly  adherent  to  the  uterus; 
so  that  the  Foal  is  sometimes  born  completely  enveloped  in  them.  It 
is,  therefore,  well  to  incise  them  when  the  water-bag  appears  as  a  large 
tumour  beyond  the  vulva ;  until  this  happens  nothing  should  be  done, 
unless  the  os  is  completely  dilated,  and  the  head  and  feet  of  the  fcrtus 
are  well  in  it.  The  membranes  may  be  torn  by  the  fingers,  or  cut  by 
scissors  or  a  knife,  care  being  taken  not  to  injure  the  Foal. 

When  the  water-bag  is  ruptured  too  early,  the  uterus  contracts  on 
the  foetus,  as  has  been  said,  and  becomes  moulded  on  it ;  this  is  opposed 
to  birth.  Besides,  the  genital  passage  becomes  dry  and  adherent,  and 
this  is  an  additional  obstacle.  To  remedy  this,  recourse  must  be  had 
to  injections  into  the  vagina  of  mucilaginous  fluids,  milk,  glycerine  and 
water,  oil,  lard,  bran  and  water,  or  even  simple  tepid  water,  wliich  may 
be  introduced  by  a  funnel,  the  Cow's  hind  quarters  being  slightly 
raised. 

Traction  of  the  Fir t us.  —V^'hcxi  the  membranes  arc  once  ruptured,  the 
natural  expulsion  of  the  foetus  should  be  waited  for.  In  some  instances, 
however,  this  expulsion  may  be  conveniently  assisted  by  judicious 
traction  on  the  fa;tus.  If  it  is  in  the  dor.'in-.sacral  position,  gentle 
traction  may  be  made  on  the  pastern  of  each  fore  leg  when  these  and 
the  head  have  cleared  the  vulva,  the  tractions  coinciding  with  the 
throes  of  the  mother,  which  they  should  supplement,  but  must  not 
supplant.  They  ought  to  be  made  in  a  slightly  oblique  direction  down- 
wards, towards  the  hocks  of  the  mother,  so  as  to  allow  the  body  of  the 
ftctus  to  follow  tlie  curve  of  the  pelvis  ;  inclining  the  traction  a  little  to 
the  right  and  left,  will  also  aid  in  passing  the  shoulders  and  afterwards 
the  haunches.  The  head  and  neck,  wlien  they  are  clear  of  the  vulva, 
should  be  supported.  If  the  fa-tus  is  in  the  dorso-ilio-sacral  position, 
the  direction  of  the  feet  must  be  watched  and  directed,  as  they  have  a 
tendency  to  press  against  the  sacrum,  and  may  seriously  injure  the 
passage.  They  should  therefore  be  seized  while  they  are  yet  in  the 
vagina,   and  brought  gently  outside  the  vulva  along  with  the  head, 


■262  XOILVAL  PAKTrillTlUX. 

when  traction  may  be  employed.  This  should  at  first  be  made 
upwards,  so  as  to  clear  the  withers  from  the  brim  of  the  pelvis,  against 
which  they  sometimes  jam.  \Yhen  this  is  effected,  the  same  proce- 
dure as  in  the  other  case  is  to  be  adopted. 

In  the  dorso-ilial  positions,  it  is  alwaj's  useful,  when  they  are  recog- 
nised in  time,  and  before  the  chest  has  entered  the  pelvis,  or  even  when 
it  is  in  the  vagina,  to  attempt  to  modify  them  by  converting  them  into 
one  of  the  preceding  positions,  and  particularly  the  dorso-sacral,  or 
dorso-ilio-sacral — though  this  modification  requu'es  the  manipulative 
skill  of  an  experienced  veterinary  sui-geon.  If  the  foetus  is  already  in 
the  canal,  delivery  must  be  attempted  according  to  the  principles 
already  indicated  :  directing  the  feet  towards  the  centre  of  the  passage 
and  outside  the  vulva,  and  by  seizing  the  fore-arms  using  them  to  turn 
the  withers  towards  the  sacrum  of  the  mother,  then  employing  moderate 
traction  on  the  limbs. 

If  the  foetus  presents  posteriorly,  in  the  hiinho  -  sacral  position, 
with  the  croup  towards  the  maternal  sacrum,  the  only  way  in  which 
birth  can  be  effected  naturally  is  when  the  feet  of  the  hinder  extremities 
lead  and  dilate  the  os.  This  position  is  recognised  by  the  coronary  and 
pastern  joints  being  bent  upwards,  and  by  the  hocks,  which  are  deeper 
situated,  are  flexed  in  the  opposite  direction,  and  are  distinguished 
by  their  broad  flat  sides  and  the  blunt  point  of  the  calcis,  which  points 
in  a  contrary  direction  to  the  flexure  of  the  joint.  In  this  position,  the 
two  limbs  are  to  be  seized  at  the  pastern,  and  traction  exercised  at  first 
slightly  upwards,  in  order  to  carry  the  stifles  over  the  brim  of  the 
pubis,  which  sometimes  checks  them ;  then  downwards,  to  bring  the 
croup  below  the  sacrum  ;  and  lastly,  an  alternate  movement  from  right 
to  left  and  left  to  right,  to  free  the  haunches,  one  after  the  other.  It  is 
well  to  see  that  the  tail  of  the  foetus  is  in  a  right  direction  before  traction 
has  been  much  practised. 

In  the  lumho-ilio-sacral  and  luviho-illal  positions,  the  foetal  croup 
passes  along  easily  when  the  pelvis  is  deeper  than  it  is  wide — as  in  the 
Cow,  for  instance.  The  limbs  onty  need  careful  direction  through  the 
vagina,  and  when  the  croup  has  entered  the  pelvic  cavity  the  body 
should  be  so  rotated  as  to  bring  the  large  diameter  of  the  chest  to  corre- 
spond with  the  vertical  diameter  of  the  inlet.  If  the  Mare  has  a  wide 
pelvis,  it  would  be  preferable  to  place  the  foetus  in  the  lumbo-sacral 
position. 

We  may  remark,  however,  with  regard  to  gemellar  parturition,  that  this 
kind  of  pregnancy  is  not  usually  recognised  in  uniparous  animals  until 
birth  takes  place.  The  escape  of  only  a  small  quantity  of  liquor  amnii, 
and  the  small  size  of  the  creature  first  delivered,  when  compared  with  the 
size  of  the  mother's  abdomen,  are  not  infallible  indications  that  more 
young  will  be  produced.  Soon,  however,  another  water-bag  appears, 
and  another  foetus  presents  at  the  vulva.  Not  unfrequently,  when  the 
position  of  the  two  foetuses  is  natural,  they  present  one  after  the  other 
successively,  and  without  any  assistance  being  required.  This  is  the 
case  more  particularly  with  the  Sheep  and  Goat — animals  which  so 
often  produce  twins.  But  sometimes,  and  especially  with  the  larger 
animals,  the  two  foetuses  present  themselves  simultaneously  at  the 
pelvic  inlet,  and  neither  can  pass  through.  In  such  a  case,  which  it 
must  be  confessed  is  rare,  it  is  necessarj-  to  push  back  the  one  least 
favourably  presenting,  and  to  keep  it  away  until  the  fore  limbs  of  the 
other  are  engaged  in  the  passage.     If  the  two  foetuses  chance  to  be  in 


NECESSARY  AID  IX  XORMAL  PAIITURITIOX.  263 

an  unfavourable  position,  the  anterior  extremities  of  one  should  be 
sou^lit  for  (recognised  by  the  knees,  and  to  a  certain  extent  by  the 
pasterns),  or  the  hind  limbs  (recognised  by  the  pasterns  and  hocks)  if 
they  are  convenient  for  the  purpose,  and  traction  exercised  as  in  the 
case  of  a  single  fojtus,  and  according  to  the  directions  given  above, 
taking  care  to  keep  the  other  fietus  out  of  the  way.  Should  it  not  be 
possible  to  extract  this  fcctus,  it  may  be  that  certain  parts  of  tlae  other 
stop  its  progress,  or  that  the  expulsive  forces  are  expended  on  the  latter, 
although  it  is  farthest  from  the  os.  It  is  tlien  necessary  to  push  back 
and  turn  the  former,  and  endeavour  to  extract  it  by  the  extremity 
opposite  to  tliat  which  was  first  tried.  But  if  the  fore  limbs  have  been 
got  into  the  passage,  as  well  as  the  head,  the  position  need  not  be 
changed,  the  procedure  being  then  the  same  as  for  a  fuetus  dispropor- 
tionately large. 

Another  remark  is  with  reference  to  the  operator.  In  exploring  tlie 
genital  passages,  gentleness  and  tact  should  be  scrupulously  observed, 
and  the  hand  and  arm  ought  to  be  well  oiled,  the  nails  of  the  lingers  being 
cut  at  least  moderately  short.  It  requires  some  experience  to  be  able  to 
ascertain,  by  the  sense  of  touch,  what  parts  of  the  foitus  present,  and 
those  which  are  an  obstacle  to  birth  ;  as  well  as  knowledge  to  guide 
one  in  placing  the  parts  in  a  favourable  position,  and  particularly  in 
one  whieli  approaches  what  we  have  designated  the  "natural"  presenta- 
tion. The  time  chosen  for  exploration  should  be  tlie  interval  between 
the  labour  pains,  and  care  must  be  taken  not  to  rupture  the  membranes, 
if  they  are  still  intact.  The  exploration  may  be  made  while  the 
animal  is  standing  or  lying ;  both  positions  have  certain  advantages, 
though  the  lirst  is  generally  preferable,  and  is  certainly  less  fatiguing. 

It  must  not  be  forgotten  that,  when  traction  is  required,  this  should 
be  slow  and  moderate,  and  only  applied  when  the  animal  itself  makes 
expulsive  elTorts.  In  many  cases  tiie  resistance  to  be  overcome  is  often 
very  slightly  superior  to  the  forces  exerted  by  the  parturient  animal. 
Violent  and"  sudden  traction  is  to  be  deprecated,  as  it  may  inflict  serious 
injury,  while  doing  little,  if  anything,  in  aiding  delivery ;  and  even 
should  this  be  etTected,  it  must  be  remembered  that  the  contractile 
power  of  the  uterus  is  deranged  when  the  contents  of  the  organ  are 
attempted  to  be  suddenly  and  forcibly  removed.  The  simplest  and 
safest  traction  is  that  made  by  the  hands  of  the  operator — for  both 
hands  may,  in  some  cases,  be  introduced  into  the  vagina.  Should  he 
not  have  suQicient  strength  or  purchase,  an  assistant  may  clasp  him 
around  tlie  chest  and  pull  at  and  with  him— gradually  and  steadily 
during  the  throes.     But  we  shall  recur  to  this  subject  again. 

B.  Aftku  I.Anoru. — The  attention  to  be  paid  to  the  mother  after 
parturition  will  ditTer  not  only  according  to  the  species  to  which  it 
belongs,  but  also  according  to  its  temperament,  strength,  and  the  kind 
of  labour  which  it  has  undergone.  When  this  has  been  natural,  and  the 
animal  is  vigorous  and  not  much  fatigued,  simple  hygienic  measures  are 
all  that  is  necessary.  It  should  be  kept  comfortable,  with  plenty  of  pure 
air,  but  away  from  draughts.  If  it  has  been  perspiring,  the  body,  and  par- 
ticularly the  belly,  should  be  well  wisped  if  it  is  a  large  animal  ;  indeed 
this  friction  is  always  to  be  recommended,  as  it  often  allays  the  restless- 
ness which  sometimes  persists  after  delivery ;  it  also  regulates  the  circu- 
lation, and  appears  to  hasten  the  retraction  of  the  uterus.  It  may  be 
necessary  to  cover  the  body  with  a  blanket,  as  the  animal  is  very  sus- 


264  NORMAL  PARTURITIOX. 

ceptible  to  cold  at  this  period.  A  gallon  or  so  of  nourishing,  tepid  gruel, 
or  even  soup,  may  be  given  ;  after  which  the  diet  should  be  moderate 
and  easily  digested.  Clean  dry  litter  should  be  plentifully  supplied,  and 
the  animal  left  alone  for  half  an  hour  or  so,  after  which  it  may  be 
visited,  offered  more  gruel,  and  the  offspring  assisted  to  the  teat,  if  it 
has  not  already  found  it.  From  three  to  eight,  or  even  fifteen  days'  r€st 
should  be  allowed,  according  to  circumstances,  and  in  order  to  permit 
lactation  to  be  fully  established,  and  the  animal  quite  recovered. 

When  parturition  has  been  protracted,  and  the  animal  has  suffered 
much,  and  especially  if  the  generative  organs  have  been  bruised  and 
lacerated,  nursing  should  be  continued  longer,  and  greater  precautions 
adopted.  Every  care  ought  to  be  taken  to  prevent  metritis  or  metro- 
peritonitis ;  and  with  this  object  in  view  tepid  vaginal  injections,  to 
which  may  be  added  a  little  permanganate  of  potassium  or  chloral,  may 
be  employed :  warm  cloths  being  applied  to  the  loins,  the  animal  allowed 
light  diet,  with  small  doses  of  sulphate  of  magnesia,  and  kept  clean  in 
a  good  stable,  and  in  a  pure  atmosphere. 

When  the  animals  are  old,  weak,  or  exhausted  by  protracted  labour, 
or  if  there  has  been  hgemorrhage,  stimulants  should  be  administered, 
and  strengthening  food  allowed.  Sometimes  the  debility  is  so  extreme 
that  the  animal  scarcely  gives  any  indication  of  life.  There  is  then  all 
the  more  need  for  careful  nursing  and  quietude.  Friction  to  the  surface 
of  the  body,  clothing,  and  a  good  bed  are  particularly  necessary  ;  and  as 
lactation  is  established  with  difficulty  in  these  cases,  this  must  be 
attended  to.  It  must  be  borne  in  mind  that  cold  and  damp  are  danger- 
ous immediately,  and  indeed  for  some  time  after,  parturition.  There- 
fore, when  turned  out  to  pasture  care  should  be  taken  to  afford  protec- 
tion in  bad  weather,  and  damp  cold  localities  should  be  avoided. 

With  regard  to  Ewes,  if  the  weather  is  mild  and  the  situation 
favourable,  protection  is  not  required  ;  but  if  cold  w^inds  and  wet  pre- 
vail, then  shelter  is  necessary.  When  more  than  one  Lamb  is  likely 
to  be  produced,  the  first  should  be  kept  warm  and  receive  a  little  Cow's 
milk  diluted  with  water,  until  the  Ewe  has  finished  lambing.  Twin 
Lambs  may  easily  be  reared  by  a  strong  mother,  if  supplied  with  a 
sufficiency  of  suitable  food  ;  but,  as  a  rule,  if  there  are  more  than  two, 
they  should  be  put  to  another  Ewe  or  reared  artificially.  In  order  to 
overcome  the  repugnance  so  often  manifested  by  the  Ewe  to  a  strange 
Lamb,  if  its  own  has  died,  the  foster-Lamb  may  be  rubbed  with  the 
skin  of  the  dead  creature,  or  the  two  may  be  placed  together  during 
the  night,  or  even  put  into  a  dark  shed  along  with  a  Dog,  which  will 
induce  the  Ewe  to  protect  and  take  to  the  Lamb. 

The  Goat  is  more  exposed  to  long  and  difficult  parturition  than  the 
Sheep,  and  not  unfrequently  requires  assistance.  The  same  care  is 
necessary  as  for  the  Sheep. 

The  Sow  generally  suffers  from  weakness  and  prostration  after 
parturition,  and  requires  plenty  of  nourishing  and  easily-digested  food. 
When  this  is  given  there  is  less  likelihood  of  the  animal  devouring 
its  young,  and  all  the  more  so  if  it  is  not  irritated  by  the  presence  of 
people. 

The  Bitch  should  not  be  allow^ed  to  rear  too  many  Puppies,  and 
w^armth,  a  dry  abode,  and  good  food  must  not  be  withheld.  The  Bitch 
does  i:iot  readily  take  to  strange  puppies  ;  sprinkling  these  with  some  of 
its  milk  has  been  sometimes  successful.  Constipation  is  not  unfrequent 
after  parturition,  and  this  may  be  removed  by  castor-oil  or  manna. 


XECESSAIIV  All  I  l.\  .\ni;.\iAI.  /'.Um'/.'/Tloy.  265 

SECTION  11.  — ATTENTION  TO  THE  OFFSPRING. 

No  special  rules  can  be  laid  down  for  the  management  of  new-born 
animals,  as  this  nmst  vary  more  or  less  according  to  tlie  species.  How- 
ever, there  are  some  general  rules  which  it  may  be  well  to  observe,  and 
these  we  will  refer  to. 

With  regard  to  the  Foal  or  other  creature  which  may  be  born  in  the 
fa^tal  membranes,  it  is  evident  that  it  nmst  be  freed  from  them  imme- 
diately, or  it  will  perish  from  suffocation  ;  for  having  no  longer  any 
conmiunication  with  the  mother  by  means  of  the  umbilical  cord,  the 
blood  cannot  be  oxygenated.  If  the  umbilical  cord  is  not  ruptured,  it 
may  be  double-ligatured  about  two  inches  from  the  umbilicus,  and  then 
divided  between  the  ligatures  ;  or  it  may  be  severed  by  scraping  it 
through  with  a  jagged  knife. 

Immediately  after  delivery,  and  having  removed  the  nmcus  which 
sometimes  clogs  the  mouth  and  nostrils  and  hinders  respiration,  the 
young  animal  should  be  examined  to  ascertain  whether  it  be  strong  or 
weak,  whether  all  the  natural  apertures  exist — such  as  the  eyes,  mouth, 
anus,  vulva,  urethra — and  if  any  of  them  chance  to  be  absent,  to  make 
artificial  ones  soon,  if  possible,  by  a  kind  oi  puncture,  enlarging  after- 
wards by  the  knife  and  sound,  and  preventing  union  by  pledgets  of 
lint,  etc. 

Suspended  Animation. — Whenever  the  connection  with  the  mother  is 
interrupted  by  rupture  or  occlusion  of  the  umbilical  cord,  the  young 
creature  must  breathe,  respiration  being  now  carried  on  by  the  lungs, 
through  the  nostrils. 

The  establishment  of  respiration  is  a  purely  reflex  act.  The  foetus, 
hitherto  maintained  at  a  certain  and  always  uniform  degree  of  warmth 
in  its  liquid  bed  in  the  uterus,  is  suddenly  usliered  into  the  cold  and 
dry  air  of  tlie  outer  world  ;  and  this  transition  operates  chiefly  on  the 
skin,  producing  a  peculiar  impression— such  as  we  ourselves  experience 
in  being  suddenly  immersed  in  cold  water  ;  this  impression  is  at  once 
transmitted  to  the  cerebro-spinal  centre,  whence  the  reflex  influence  of 
the  spinal  cord  is  called  into  play,  and  the  respiratory  nmscles  are 
excited  to  movement  by  the  centrifugal  nerves  issuing  therefrom.  All 
these  muscles  contract  simultaneously,  the  chest  is  dilated,  and  the  air 
rushes  into  the  air-passages  and  lungs,  distending  the  air-cells  in  the 
latter,  and  instituting  the  process  of  respiration,  which  is  only  to  cease 
with  the  death  of  the  creature.  This  rellex  act  may  also  be  produced 
by  pressure  on  the  umbilical  cord,  or  anything  which  hinders  the  oxy- 
genation of  the  blood  in  the  fcctus  ;  hence  it  has  been  inferred  that  the 
excess  of  carbonic  acid  in  the  circulating  fluid  acts  as  a  stimulus  to  the 
medulla  oblongata. 

It  sometimes  happens  that  the  young  creature  is  in  a  state  of  syncope 
when  born,  or  very  soon  after,  and  gives  no  sign  of  life.  Observers 
have  distinguished  syncope  from  weakness,  in  which  the  animal  is  cold 
and  does  not  breathe,  the  mucous  membranes  being  pale  and  the  body 
flaccid ;  and  syncope  from  plethora  or  cyanosis,  when  the  mucous 
membranes  are  of  a  livid  blue  tint,  the  lips  and  tongue  swollen,  and 
the  eyes  injected. 

In  the  first  form,  resuscitation  is  to  be  attempted  by  pouring  cold 
water  on  the  head,  beating  the  body  with  a  cloth  dipped  in  cold  water 
— particularly  about  the  face  and  chest — dry-rubbing  the  limbs,  titil- 
lating the  nostrils  with  a  feather,  pulling  tobacco-smoke  into  them, 


266  NORMAL  PARTURITION. 

imitating  the  respiratory  movements,  as  in  a  case  of  asphyxia,  and  in- 
flating the  lungs  by  means  of  a  pair  of  bellows,  acting  through  the 
nostrils.  So  long  as  the  heart  pulsates  there  is  a  probability  of  restora- 
tion to  life. 

In  the  second  form,  allowing  a  little  blood  to  flow  from  the  umbilical 
cord,  and  even  cutting  this  or  fomenting  it  w^th  hot  water  to  induce 
hcemorrhage,  is  very  useful,  in  conjunction  with  cold  water  to  the  head 
and  cold  water  enemas.  But,  as  a  rule,  death  is  always  imminent  in 
these  cases  of  syncope. 

Genebal  Care. — With  the  larger  animals,  the  newly-born  creature 
should  be  placed  before  the  mother,  if  it  is  not  near  her ;  and  it  gene- 
rally follows  that  she  instinctively  licks  off  the  viscid  matter  which 
30vers  its  skin ;  and  in  doing  this  the  cutaneous  circulation  is  excited, 
and,  by  sympathy,  the  other  organs  of  the  young  animal.  Conse- 
quently, it  becomes  revived,  soon  endeavours  to  get  up,  and  though  it 
may  fall  several  times,  yet  it  generally  quickly  succeeds  in  maintaining 
itself  on  its  limbs,  and  instinctively  seeks  the  maternal  teat.  It  is  very 
rare  that  the  mother  does  not  voluntarily,  and  at  once,  commence  to 
cleanse  its  progeny ;  nevertheless,  there  are  exceptions,  chiefly  among 
the  primiparffi,  and  especially  when  the  labour  has  been  long  and 
painful.  But  it  will  generally  be  found  that  sprinkling  the  young 
animal  with  a  little  flour,  bran,  or  salt  will  excite  the  attention  of  the 
mother  and  induce  the  cleaning  process.  Should  it  not  do  so,  then  the 
creature  must  be  well  dried  and  rubbed  with  a  sponge,  hay-wisp,  or  a 
cloth,  and  kept  warm.  This  is  more  particularly  necessary  when  the 
mother  is  indifi^erent  to  it,  which  sometimes  happens  with  primiparae 
when  people  are  present.  Indeed,  some  Mares  become  quite  savage 
after  parturition,  and  will  not  allow  their  Foal  to  come  near  them,  and 
will  even  kill  it ;  though  this  most  frequently  happens  when  they  are 
tormented  by  spectators.  Other  Mares,  vicious  before  parturition, 
sometimes  become  remarkably  quiet  when  they  have  a  Foal  by  their 
side.  When  they  exhibit  any  aversion  to  their  progeny,  it  is  well  to 
leave  them  quietly  together  for  some  time. 

If  the  Foal  or  Calf  is  weak,  and  cannot  reach  the  teat  within  half  an 
hour  or  so  after  birth  (for  in  uniparous  animals  the  mamniEe  are 
inguinal,  so  that  the  young  are  always  suckled  in  a  standing  posture), 
it  will  be  found  necessary  to  assist  it  by  bringing  it  to  the  mother,  and 
applying  the  teat  to  its  mouth,  at  the  same  time  caressing  and  soothing 
the  parent  if  disinclined  to  it  by  temper  or  by  painfulness  of  the  udder. 
This  coaxing  and  handling  should  be  performed  by  someone  accus- 
tomed to  the  animal.  It  may  be  necessary  to  have  a  second  person 
at  hand  to  hold  the  Mare  by  the  head  or  to  lift  up  its  fore  foot. 

Sometimes  from  weakness  or  inexperience  of  the  Foal,  and  temper 
of  the  Mare,  the  former  runs  the  risk  of  perishing  from  starvation. 
The  Mare  should  be  safely  secured,  and  two  persons  ought  then  to 
push  and  support  the  yotmg  animal  behind  by  joining  a  hand  of 
each,  while  the  other  hands  are  employed  in  directing  it  towards  the 
teat,  which  it  should  be  allowed  to  use  for  two  or  three  minutes. 
After  one  or  two  attempts  of  this  kind,  the  Foal  begins  to  find  its  way 
to  the  udder  by  itself,  while  the  Mare  becomes  reconciled  to  it.  When 
the  Foal  exhibits  great  debility,  it  may  be  preferable  to  feed  it  for  a  day 
or  two  with  the  milk  of  the  Mare,  which  has  been  drawn  by  hand. 

With  the  Cow,  these  difficulties  are  seldom  present,  and  if  an  animal 


XhVEss.u:}'  AiJ>  ix  .\i'I:m.\l  j'.t/rnj:/TJ'>.\.  -j.;? 

will  not  take  to  its  Calf  this  is  geiu'ially  transferred  to  another  Cow, 
or  it  may  be  artitjcially  reared.  The  Foal  may  even  be  reared  in  this 
manner,  thou^'h  not  so  easily  as  the  Calf.  The  milk  of  the  Cow  or 
Goat  will  sulfice,  and  there  is  generally  little  dilliculty  in  teaching  it 
to  drink  it  by  at  lirst  pouring  a  little  into  its  mouth  while  the  finger 
is  inserted  therein  ;  or  a  piece  of  cloth  steeped  in  milk,  or  even  a  bottle 
and  tube,  may  be  used. 

Calves  are  often  harshly  treated  after  birth ;  they  are  not  allowed 
to  suck,  even  for  a  number  of  days,  for  fear  of  damaging  the  Cow,  but 
are  kept  apart  and  fed  on  drawn  milk.  Calves  intended  for  slaughter 
may  be  artificially  fed,  and  especially  if  nutritive  substances  are  added 
to  the  milk  ;  but  for  those  intended  to  be  reared,  it  is  a  mistake  to 
separate  them  from  the  Cow  during  the  early  days  of  their  existence. 

Lambs,  when  able  to  stand,  and  if  they  do  not  readily  find  their 
way  to  the  teat,  should  have  a  little  milk  from  it  pressed  into  their 
mouth.  With  twin  Lambs,  if  the  Ewe  is  in  good  condition,  the  udder 
well  tilled,  and  the  weather  and  pasture  favourable,  both  may  be 
suckled  ;  in  the  opposite  conditions  it  may  be  necessary  to  remove  one. 
If  the  Ewe  does  not  yield  sullicient  milk,  this  may  be  largely  remedied 
by  giving  a  liberal  supply  of  good  food. 

Multiparous  animals,  such  as  the  Bitch  and  Sow,  usually  lie  when 
suckling  their  young;  so  that  there  is  seldom  any  dilliculty  with  them. 
The  only  care  generally  required  in  the  case  of  young  Pigs,  is  to  prevent 
their  being  crushed  by  the  Sow  in  the  act  of  lying  down  or  moving. 
If  the  litter  is  large,  plenty  of  good  food  is  necessary. 

It  is  well  to  remember  that  if  a  Sow  has  more  young  in  the  litter 
than  teats,  unless  watched  the  weakest  will  die  of  starvation.  Each 
young  Pig  has  its  own  particular  teat,  to  which  it  is  persistently 
attached  ;  and  if  the  creature  is  ill  and  does  not  suck,  or  if  there  is 
not  a  claimant  for  the  teat,  the  gland  there  will  cease  secreting  milk. 
The  pectoral  teats  and  glands  are  the  largest  and  most  active,  and  the 
weakest  of  the  litter  should  be  put  to  them.  In  general,  a  Sow  should 
not  be  allowed  to  rear  more  than  ten  in  a  litter.  Cleanliness  and 
warmth  are  required  for  young  Pigs. 

Puppies  do  not  require  any  special  care  beyond  a  warm,  clean,  and 
dry  abode. 

After  the  first  milk  has  been  taken,  there  is  usually  an  abundant 
evacuation  of  black  resinous  matter — meconium — from  the  intestines 
of  the  young  animal,  caused  by  the  '  colostrum,'  as  this  milk  is  named  ; 
and  it  is  well  to  notice  if  this  evacuation  occurs,  as  when  it  does  not, 
serious  constipation  may  ensue.  With  new-born  animals  which,  for 
some  reason  or  another,  are  deprived  of  this  colostrum,  a  nuld  laxative 
— such  as  castor-oil,  or  honey  or  liquorice  powder  and  water— should 
be  administered  to  obviate  this  condition. 

At  birth  the  feet  of  hoofed  animals  are  covered  with  a  soft  yellow 
horn,  which  in  some  countries  it  is  the  custom  to  remove,  from  a 
belief  that  this  removal  hardens  the  succeeding  horn.  It  is  unneces- 
sary' to  state  that  this  is  a  popular  fallacy,  and  that  it  is  really  injurious 
to  deprive  the  foot  of  this  temporary  protection. 

The  young,  with  their  parents,  should  be  kept  apart  from  others — 
for  some  time  at  least,  and  especially  the  Equine  species;  and  it  nmst 
not  be  forgotten  that  a  mild  dry  temperature  is  most  favourable  for  all 
young  creatures. 

Gentle  exercise  is  as  necessary  for  the  Foal  and  Calf,  as  it  is  for  their 


268  XORMAL  FARTUPJTIOX. 

parents,  a  few  days  after  birth.  Therefore  it  is  that  a  meadow  is 
preferable  to  a  stable,  as,  in  addition  to  the  more  favom-able  natui^e  of 
the  food,  sufficient  exercise  is  afforded.  Indeed,  with  the  Mare  light 
and  regular  work  may  be  imposed  a  short  time  after  foaling,  and  with 
much  benefit  to  it  and  the  Foal.  The  latter  will  follow  its  dam,  pro- 
vided the  pace  is  not  too  fast,  and  a  halt  be  frequently  allowed  for  it 
to  get  to  the  teat.  It  is  astonishing  sometimes  to  observe  how  well 
Foals  travel  soon  after  birth,  even  over  bad  roads  and  during  inclement 
weather,  and  for  great  distances,  provided  the  journey  is  short  each 
day.  Huzard  has  seen  Buffalo  Calves,  born  during  the  night,  follow 
their  mother  next  day,  and  make  a  daily  journey  of  six  or  eight  leagues 
without  appearing  fatigued. 

It  is  not  rare  to  find  newly-born  animals,  particularly  when  parturi- 
tion has  been  laborious,  injured  more  or  less,  from  the  manipulation 
of  the  obstetrist  during  birth,  the  lesions  being  more  or  less  serious. 
The  most  frequent  injuries  are  those  due  to  obstetrical  instruments 
and  appliances.  The  wounds  may  be  dressed  with  cold  water,  with 
slightly  alcoholised  water,  or  some  dilute  tincture — such  as  that  of 
arnica ;  but  salts  of  lead,  or  other  poisonous  salts,  should  not  be  em- 
ployed. Abrasions,  which  are  generally  superficial,  may  be  treated 
with  glj'cerine  and  water,  to  which  a  very  little  carbolic  acid  has  been 
added ;  or  by  lard,  or  any  mucilaginous  substance.  Sprains  should 
have  cold  water  irrigation  if  possible,  refrigerant  lotions,  or  friction 
with  soap  liniment.  Wounds  and  lacerations,  if  very  severe,  must  have 
appropriate  surgical  treatment. 


CHAPTEE  IV. 
Sequelae  of  Parturition. 

We  have  stated  that  gestation  and  parturition  are  physiological  pro- 
cesses, and  we  may  now  add  to  these  the  puerperal  state.  But  though 
in  one  respect  eminently  physiological,  the  puerperal  condition  is 
marked  by  special  features,  which  distinguish  it  from  other  physio- 
logical states,  and  which,  occurring  under  other  circumstances,  would 
be  more  allied  to  pathological  changes.  We  refer  now  more  par- 
ticularly to  the  functional  and  organic  alterations  which  take  place 
after  delivery.  True,  we  do  not  have  in  animals  such  important,  nor 
so  many,  sequelae  as  are  noted  in  women  at  this  period,  some  of  which 
are  really  pathological.  Nevertheless,  we  have  certain  phenomena 
occurring  during  the  return  of  the  economy  and  the  generative  organs 
to  the  condition  they  wei'e  in  previous  to  pregnancy,  which  are  not 
only  very  characteristic,  but  are  worthy  of  serious  attention.  These 
phenomena  have  been  divided  into  functional  and  organic. 

SECTIOX  I.— FUNCTIONAL  MODIFICATIONS. 

The  functional  modifications  include  the  after-pains,  lochia,  milk- 
fever,  and  lactation. 

1.  After-pains. — These  are  the  painful  sensations  in  the  abdomen, 
indications  of  which  are  frequently  observed  in  animals,  and  which 
persist  after  the  expulsion  of  the  foetus  and  the  secundines.  They  are 
due  to  the  contractions  of  the  uterus,  that  go  on  for  some  time,  and 


SKijrKL.K  i>F  r.inTI/KITIoX.  215!) 

eventually  reduce  the  organ  to  its  ordinary  volume  and  so  diminish 
its  cavity.  After  an  easy  labour,  there  are  generally  few  or  no 
symptoms  of  these  pains  ;  and  when  they  are  present  the  only  indi- 
cations are  whisking  of  the  tail,  at  which  time  the  walls  of  the  abdon)eu 
appear  to  be  harder.  They  seldom  continue  longer  than  twelve  or 
twenty-four  hours  in  these  cases,  and  do  not  require  special  treatment. 
In  other  cases,  however,  and  particularly  when  birth  has  been  very 
sudden  and  rapid,  they  persist  longer  and  are  more  severe.  The  animal 
paws  and  exhibits  suttering  ;  it  also  stretches  as  if  trying  to  micturate, 
arches  the  back,  contracts  the  abdominal  muscles,  and  strains.  The 
access  of  these  attacks  is  not  regular ;  and  when  they  are  frequent, 
severe,  and  continue  beyond  twenty-four  hours,  we  may  apprehend  the 
retention  of  a  portion  of  the  foetal  membranes  in  the  uterus,  or  com- 
mencing inversion  of  that  organ.  This  will  necessitate  an  exploration, 
in  order  to  discover  the  cause  ;  which,  when  ascertained,  should  receive 
appropriate  treatment,  to  be  hereafter  described. 

2.  Lochia. — The  term  lochia  has  been  given  to  the  sanguinolent,  sero- 
sanguinolent,  muco-purulent,  and,  finally,  mucus  evacuations  from  the 
vagina  occurring  after  parturition,  and  generally  persisting  until  the 
uterus  has  regained  its  ante-pregnant  condition.  The  existence  of  this 
evacuation,  so  marked  in  woman,  has  often  been  denied  in  animals  ; 
but  there  can  be  no  doubt  whatever  as  to  the  fact  of  its  presence.  It 
has  been  witnessed  by  several  veterinarians  in  the  Mare,  Cow,  Sheep, 
and  Bitch,  and  we  have  noted  it  repeatedly  in  the  Sow  and  Cat.  But 
it  is  considerably  less  in  these  animals  than  in  woman,  and  does  not 
flow  continuously  as  in  her,  but  at  irregular  peinods ;  the  discharge 
accumulates  in  the  uterus,  and  only  escapes  when  the  animal  undergoes 
exertion,  and  in  defecation  or  micturition.  In  the  Cat,  however,  we 
have  witnessed  this  discharge — very  "flight — flowing  constantly  for  four 
days  after  parturition  ;  and  with  the  Bitch  we  have  a  sanguinolent, 
then  a  mucus  discharge  persisting  almost  continuously  for  several  days 
subsequent  to  that  event. 

In  the  larger  animals,  this  discharge  can  be  seen  about  the  inferior 
commissure  of  the  vulva ;  it  sometimes  accumulates  about  the  thighs 
and  tail  in  flakes  and  patches,  as  well  as  on  the  litter ;  and  when  the 
animal  has  been  lying  it  forms  small  pools  on  tlie  ground. 

When  we  remember  that  the  uterus  has  for  a  long  period  nourished 
one  or  more  fcctuses,  we  can  scarcely  wonder  that  it  cannot  all  at  once 
cease  its  secretory  function,  and  that  its  mucous  membrane  should  con- 
tinue in  a  hypera3mic  condition  until  the  lacteal  secretion  in  the 
mammic  is  fully  established.  As  much  as  seven  to  eight  quarts  of 
sero-sanguinolent  fluid  have  been  removed  from  the  uterine  cavity  of  a 
Mare  which  had  foaled  three  days  previously. 

When  not  mixed  with  blood,  this  discharge  is  albuminous  and 
chylous-looking  ;  it  is  rarely  purulent,  and  then  probably  only  from 
traumatic  causes  ;  neither  does  it  have  a  bad  odour,  unless  the  uterus  or 
vagina  is  the  seat  of  some  pathological  process,  or  a  portion  of  the 
placenta  is  retained.  According  to  some  authorities,  the  average  dura- 
tion of  the  discharge  is  from  two  to  three  weeks  ;  but  Saint-Cyr  believes 
that  when  it  is  prolonged  beyond  five  to  eight  days,  it  is  no  longer  a  phy- 
siological, but  a  pathological  process.  This  is  about  the  period  which  is 
necessary,  in  the  larger  animals,  for  the  return  of  the  vulva  to  its 
normal  dimensions  and  ordinary  form.  -  ^ 


f\ 


270  NOIIMAL  FAETURITIOX. 

Of  the  importance  of  the  lochia  there  can  be  no  doubt.  By  them  the 
uterus  is  reheved  from  its  physiological  hypertrophied  condition,  aiid  of 
the  excitement  of  which  it  was  the  seat  during  pregnancy  and  parturi- 
tion. But  it  cannot  have  the  same  importance  as  in  woman,  in  whom 
the  lining  membrane  of  the  uterus  is  thrown  off  after  every  delivery, 
and  renewed.     It  is  not  so  with  animals,  as  we  shall  see  hereafter. 

One  or  two  veterinary  authorities  have  attached  so  much  importance 
to  the  lochia  in  animals,  that  to  their  suspension  or  suppression  they 
attribute  such  serious  results  as  sanguine  plethora,  articular  rheumatism 
in  the  Cow,  laminitis  in  the  Mare,  metro-vaginitis,  cystitis,  nephritis, 
peritonitis,  mammitis,  inflammation  of  the  intestines  or  spinal  cord, 
coryza,  vitulary  collapse,  etc.  But  there  is  evidently  exaggeration  in 
this  ;  and  we  are  inclined  to  think  that,  at  the  most,  the  untimely 
cessation  of  this  discharge  can  only  cause,  as  has  been  stated,  dulness, 
indifference  of  the  mother  to  its  progeny  and  surroundings,  inappetence, 
suppression  of  milk,  slight  fever,  with  dry  erect  coat,  and  constipation. 

To  avoid  this  untimely  cessation  of  the  lochia,  it  has  been  recom- 
mended that,  with  the  larger  animals,  before  and  after  parturition  the 
food  should  be  sound  and  nutritive,  but  moderate  in  quantity,  and  such 
as  will  not  predispose  to  plethora  or  congestion  ;  not  to  travel  or  fatigue 
animals  towards  the  end  of  pregnancy  ;  to  shelter  them  at  this  period ; 
not  to  hurry  labour,  and  only  to  render  assistance  when  necessary  ;  and 
after  delivery  to  attend  to  the  removal  of  the  secundines,  which  are 
sometimes  retained  in  the  Cow  for  an  abnormal  period,  but  should  not 
be  allowed  to  remain  longer  than  four  or  five  days. 

3.  MiLK-FEVEE. — In  woman  the  establishing  of  the  lacteal  secretion 
after  delivery — generally  forty-eight  hours — is  usually  accompanied  by 
a  general  febrile  condition,  in  which  this  fluid  changes  from  colostrum 
to  ordinary  milk.  This  is  the  so-called  "  milk-fever,"  a  pathological 
condition  said  by  some  authorities  to  be  present  in  animals,  and  denied 
by  others.  The  latter  assert  that,  when  parturition  has  been  quite 
normal,  there  is  only  observed  a  little  dulness,  lassitude,  the  pulse 
fuller  and  quicker  than  usual,  and  less  appetite  for  the  first  day — all 
consequences  of  the  suffering  undergone  dux'ing  even  the  easiest  partu- 
rition. In  a  day  or  two,  however,  all  this  has  disappeared,  except 
perhaps  a  little  weakness,  which  soon  vanishes  also.  But  when  par- 
turition has  not  been  altogether  natural,  and  complications  arise,  then 
there  may  certainly  be  fever,  though  this  has  nothing  to  do  with  the 
change  of  the  colostrum  to  milk — a  gradual  process  ;  indeed,  when 
traumatic  fever  sets  in  this  secretion  is  diminished  or  suspended. 

Saint-Cyr  is  disposed  to  deny  the  existence  of  this  so-called  "  milk 
fever"  in  animals,  and  he  quotes  eminent  accoucheurs,  who  are  inclined 
to  doubt  the  existence  of  this  fever  in  woman  as  related  to  the  lacteal 
secretion,  but  as  due  rather  to  traumatism  from  injury  to  the  genital 
organs  during  child-birtli.  His  own  observations  on  Cows  are  cer- 
tainly not  favourable  to  the  existence  of  a  fully  developed  fever  in 
these  animals  ;  and  even  among  those  who  believe  in  it,  there  are  many 
who  admit  that  it  is  scarcely  peixeptible. 

Rainard,  for  instance,  accounts  for  its  being  so  little  marked  in 
animals,  by  observing  that  in  woman  the  uterus  receives  its  blood  from 
the  abdominal  (inferior)  aorta,  but  the  mammas  from  the  pectoral  (or 
anterior)  aorta  ;  while  in  animals  the  uterus  and  mammae  are  supplied 
by  the  posterior  aorta.     In  w^oman,  when  lactation  is  established,  there 


sEvUKL.K  "/••  I'AirrrinTiox. 


271 


is  an  alteration  in  the  circulation,  and  consequently  a  -general  dis- 
turbance which  has  been  hitherto  desij^'nated  "  intlainniatory "  or 
"  an^iotenic  fever";  but  in  animals  this  change  in  the  circulation  does 
not  occur.     Therefore,  this  "  angiotenic  fever  "  should  not  be  present. 

4.  Lact.\tion. — Before  parturition,  preparation  for  the  secretion  of 
milk  is  already  being  made  in  the  mammary  glands,  and  immediately 
preceding  that  event  a  thin  serous  or  milky  fluid  can  often  be  expressed 
from  the  teat ;  while  immediately  after  delivery,  the  a'dematous  tume- 
faction which  had  been  observed  in  these  glands  for  some  time  begins 
to  disappear  as  they  increase  in  voluiiie,  become  firmer,  tenser,  and 
more  sensitive,  and  receive  a  larger  quantity  of  l)lood.  Tlien  their 
activity  is  suddenly  brought  into  full  operation,  and  their  secretion 
reaches  its  maximum.  At  the  same  time  this  fluid  is  modified  in  quality 
in  a  notable  but  gradual  manner,  so  that  it  is  very  dilTerent  tliree  or 
four  days  after  parturition  from  what  it  was  on  the  first  or  second  day 
— being  colostrum  at  the  early  period,  and  milk  subsequently. 

Colostrmn. — The  first  milk,  or  "colostrum,"  secreted  after  deliveiy 
is  a  viscid,  dirty-white,  or  yellowish  fluid,  sweet,  though  unpleasant  to 
the  taste,  and  of  a  greater  density  than  that  of  ordinary  milk,  being  in 
the  Cow  1-Oo6.  When  allowed  to  stand  for  some  time  it  has  a  thick 
layer  of  tough  cream  ;  it  coagulates  at  a  comparatively  low  temperature 
into  a  semi-solid  mass.  It  is  very  rich  in  solid  elements,  these  varying 
according  to  individuals,  and  even  breeds.  The  fat  globules  are  present 
only  in  comparatively  large  number,  and  are  less  in  size  than  in  milk 
at  a  later  period  ;  but  there  are  numerous  colostrum  corpuscles — bodies 
of  a  large  size,  spherical  or  ovoid  in  shape— often  agglomerated  in 
masses  by  a  tenacious  viscid  matter,  and  among  them  many  leucocytes 
endowed  with  movement,  as  well  as  pus  cells. 

The  colostrum  corpuscles  appear  to  be  only  leucocytes  or  epithelium 
from  the  walls  of  the  milk  ducts,  and  undergoing  degeneration. 
Boussingault  gives  its  composition  in  the  Cow  as  follows : — 
Water  ....     75-8 

Albumin  and  casein  -  -     150 

Butter         -  -  -  -       2-6 

Milk-sugar  -  -  -  -       3 "6 

Salts  -  -  -  -       3  0 

But  a  more  recent  analysis  by  Chapelle,  shows  it  to  be  composed  of : 
Albumin      -  -  -  -     15-997 

Casein         .  .  -  -       2552 

Butter         ...  -       5-390 

Lactose       ...  -       1-361 

Salts  ...  -       5-300 

Water          -  -  -  -     G9-700 

Dumas  gives  the  colostrum  of  various  animals  as  below  : — 


Cow, 

Aas. 

Goat. 

Water 

803-3 

828-4 

641-0 

Fat       

26-0 

5-6 

52  0 

Albninin 

150-7 

llfiO 

2450 

'  Mucus 

20  0 

7-0 

30  0 

Sugar  ..           

traces 

430 

.32-0 

272  NORMAL  PARTURITION. 

It  is  admitted  that  milk  is  due  to  a  fatty  degeneration  of  the 
epithelial  cells  of  the  gland  follicles,  in  which  they  are  greatly  multiplied 
and  developed  during  lactation.  These  cells  rupture,  and  nothing 
remains  but  the  fat  globules  of  the  milk. 

But  in  the  colostrum  the  epithelial  cells  have  not  undergone  this 
change  ;  their  wall  is  intact,  and  they  still  contain  their  oil  granules, 
and  consequently  constitute  the  colostrum  corpuscles.  Colostrum,  as 
has  been  mentioned,  is  coagulable  at  a  low  temperature,  and  it  may 
be  said  that  the  albumin  takes  the  place  of  casein ;  but  soon  after 
parturition  the  former  disappears  and  the  lacter  is  present.  Towards 
the  end  of  lactation,  however,  if  the  animal  is  pregnant,  the  milk  again 
loses  its  casein,  and  becomes  very  albuminous;  consequently,  coagulable 
by  heat.  Its  sugar  also  diminishes  or  disappears  altogether.  The 
leucocytes  seem  to  be  increased  in  number  in  the  colostrum,  when  the 
animal  is  disturbed  or  its  health  deranged ;  and  as  the  young  creatures 
are  often  attacked  by  diarrhoea,  this  is  ascribed  to  the  presence  of  these 
particles. 

Milk. — Towards  the  fifth  or  sixth  day,   or  even  longer,   after  par- 


B 
r9:}oy. 

r 


Fig.  80. 

Mammary  Gland  during  Lactation. 

A,  Lobule  of  the  Mammary  Gland  filled  with  Cells  ;  B,  Milk  or  Fat  Globules  ; 
C,  Colostrum,  a,  Cell  filled  with  Fat  Granules  and  with  a  visible  Nucleus  ; 
b,  Cells  from  which  the  Nucleus  has  disappeared. 

turition  in  the  Cow  and  Mare,  earlier  with  some  of  the  other  animals, 
the  colostrum  disappears,  and  then  we  have  the  ordinary  milk.  This 
is  an  opaque,  pure  white,  or  slightly  yellowish  fluid,  possessing  a  sweet 
taste,  and  a  faint  odour  somewhat  resembling  that  of  the  animal  from 
which  it  is  obtained  ;  it  is  unctuous  to  the  touch,  has  an  average  density 
of  1032  to  1041,  according  to  the  species  and  other  circumstances  •} 
and  is  composed  of  three  essential  parts — water,  butter,  and  casein. 
We  have  in  addition  albumin,  milk-sugar,  and  mineral  matters. 

The  three  principal  constituents  are  easily  separated— the  fat  or 
cream  by  allowing  the  fluid  to  stand  at  rest  for  some  time  ;  by  pressure 
the  casein  is  separated  in  a  solid  mass ;  and  the  remaining  portion 
contains  the  water. 

The  milk  varies  considerably,  as  has  been  said,  according  to  species, 
breed,  age,  food,  the  period  of  lactation  and  milking,  climate,  state  of 
health,  etc.  In  Herbivorous  animals  it  is  generally  alkaline  ;  in  Car- 
nivorous, acid. 

1  Cow's  milk  of  good  quality,  according  to  Voelcker,  has  a  specific  gravity  of  about 
1030  ;  Woman's  milk,  1020  ;  Goat's  and  Ewe's  milk,  1035  ;  Ass's  milk,  1019, 


SEQUELAE  OF  PAnTUUITlUX. 


273 


Vernois  and  Becqucrel  give  a  comparative  table  of  the  composition  of 
the  milk  of  various  animals,  as  below  : 


Cow. 

Goat. 

Sheep.  1  Camol. 

Maro.  1    Abs. 

Sow. 

Bitch. 

Specific  Gravity  - 

103-2  tw 

1033-38  io:w -53  iaio-9s 

1 
1033-74  1034-57       — 

10-11-62 

■Weight  of  Water- 

88'JOS 

804  00    844 -JO 

83-2-3-2 

iK)4-30    800-1-2   854-90:  772-08 

Wei;;lit    of    Solid 

1 

I'lirts 

110 -o-i 

135-94,  155  10 

107-68 

134-00 

95-70    109 -881  145-10    227-92 

Fat       - 

•26-66 

36121     56-87 

51-31 

36-00 

24-36      18-531     19  50      87-95 

Casein  ami  Extrac- 

tive Matters     - 

39  24 

65  15     55  14 

69-78 

40-00 

33-35 

35-65     84-50    116  88 

Milk-snjrar   - 

43-64 

38  03'     36-91 

39-43 

58  00 

32-76 

50-46'     30-30      15-29 

1  Salts  (by  iucinera- 

, 

tioii)  - 

1-38 

604,       6-18 

,16 

— 

5-23 

5-24|     10-90       7-80 

Doycre  furnishes  us  with  another  interesting   analysis,  which    we 
cannot  omit  publishing  here  : 


Constituents. 

Wom.in. 

Cow. 

Goat. 

Sheep. 

Llama. 

Ass. 

Marc. 

Water 

87-38 

87-60 

87-30 

81-60 

86-60 

89-63 

91-37 

Fat    - 

3-80 

2-20 

4-40 

7-50 

310 

1-50 

0-55 

Casein 

0-34 

3-00 

3-50 

4-00 

3-00 

0-60 

0-78 

Albumin    - 

1-30 

1-20 

1-35 

1-70 

0-90 

1-35 

1-40 

Sugar 

7-00 

4-70 

3-10 

4-30 

5-60 

6-40 

5-50 

Salts - 

0-18 

0-70 

0-35 

0-90 

0-80 

0-32 

0-40 

The  salts  contained  in  the  milk  vary  with  the  character  of  the  food, 
and  also  according  to  the  time  that  has  elapsed  since  parturition  ;  this 
fluid  being  particularly  rich  in  inorganic  elements  during  the  first  third 
of  the  period  of  lactation.  According  to  the  analyses  of  Haidlen  and 
Furstenberg,  there  are  in  it  1,000  parts  of  ash  ;  -iTo  phosphate  of  lime, 
magnesia,  iron,  etc.  ;  219  carbonate  of  lime  and  salts,  which  are  more 
especially  combined  with  the  casein  ;  343  of  sodium  salts,  with  traces 
of  sulphur  and  tluonde  of  calcium.  Milk  also  contains  such  gases  as 
carbonic  acid,  oxygen,  and  nitrogen,  in  solution. 

In  the  Cow  the  flow  of  milk  becomes  very  plentiful  in  about  a  week 
after  calving,  but  after  a  month  or  so  it  gi-adually  diminishes  in  quantity 
for  about  ten  montlis,  when  the  animal,  as  a  rule,  "  runs  dry."  In  the 
first  and  second  months  after  calving,  when  tlie  yield  is  abundant,  it  is 
generally  more  watery  than  after  the  fourth  or  fifth  month ;  and  the 
furtlier  the  diminution  in  quantity  proceeds  the  better  it  becomes  in 
quality,  other  circumstances  being  equal. 

It  will  be  seen  from  the  above  table,  that  the  milk  of  the  Cow  closely 
approaches  that  of  woman,  and  this  accounts  for  the  readiness  with 
which  it  can  be  substituted  for  the  latter  without  injury  to  the  child. 
It  is,  when  compared  with  that  of  Solipeds,  more  rich  is  casein  and  fat. 
The  milk  of  the  Goat  is  the  most  nutritive,  and  contains  more  casein  ; 
but  it  is  viscid  and  has  a  peculiar  odour,  something  like  that  of  the 
cutaneous  transpiration  of  this  animal,  and  particularly  during  the 
rutting  season  ;  this  odour  is  not  so  powerful  in  white  Goats,  nor  in 
those  without  horns,  if  they  are  properly  kept.  The  milk  of  the  Sheep 
contains  more  fat  than  that  of  the  Cow  and  Goat,  while  the  casein  is  in 
larger  quantity,  but  is  also  viscid.     It  has  less  water  than  that  of  the 

18 


274 


XOBMAL  PABTUFJTIOX. 


Cow,  and  altogether  is  particularly  rich,  esjoecially  soon  after  lambing. 
This  is  well  seen  in  the  subjoined  analysis,  and  it  will  explain  the  diffi- 
culty which  is  experienced  in  bringing  up  a  Lamb  when  the  Ewe  has 
died  soon  after  parturition  : 


Ewe's  Milk     I     Ewe's  Milk 

Three  Weeks    |      Six  Weeks 

after  Lambing.  .  after  Lambing. 


Water 

Fat     - 

Casein 

Milk-sugar  - 

Mineral  Matters  (Ash) 


75-00 

12-78 

6-58 

4-66 


•70 
•67 

•44 
•00 
•19 


100^00 


10000 


The  milk  of  the  Mare  apx3ears  to  contain  the  largest  proportion  of 
water  and  the  smallest  quantity  of  fat,  the  milk  of  the  Ass  coming  next 
to  it  in  these  constituents.  This  contains  little  casein,  scarcely  any  fat, 
and  a  small  quantity  of  ash.  On  the  other  hand,  it  is  comparatively 
rich  in  milk-sugar,  which  is,  according  to  Voelcker,  a  very  digestible 
material  and  a  good  aperient,  particularly  for  children.  But  of  all 
animals,  the  Carnivora  have  the  richest  milk  ;  the  casein  and  fat  being 
particularly  abundant,  and  no  other  food  will  at  all  compare  with  it  in 
these  constituents.  Solid  butcher's  meat  contains  less  real  nutriment 
and  more  water  than  this  description  of  milk.  This  explains  at  once  the 
extreme  difficulty  of  bringing  up  a  Puppy  by  hand.  No  kind  of  food  is 
sufficiently  concentrated  adequately  to  provide  for  the  nourishment  of 
a  Puppy,  strong  beef-tea  being  perhaps  the  best  substitute  for  that 
purpose.  The  milk  of  Carnivorous  animals  has  another  peculiarity,  in 
the  very  small  proportion  or  entire  absence  of  milk-sugar.  This  sub- 
stance is  very  abundant  in  the  milk  of  Herbivorous  animals  ;  and  when 
Carnivorous  creatures  are  put  on  more  or  less  of  a  vegetable  diet,  it 
appears  in  their  milk,  and  increases  as  this  diet  is  increased  ;  whereas, 
by  feeding  them  entirely  on  flesh,  the  sugar  vanishes.  The  proportion 
of  salts  is  also  comparatively  large. ^ 

According  to  the  richness  of  milk  in  fixed  constituents,  Colin  classes 
that  of  animals  in  the  following  decreasing  order  : 

Bitch  Sow  Woman 

Ewe  Cow  Ass 

Goat  Camel  Mare 

Milk  is  a  typical  food,  and  when  healthy  and  in  sufficient  quantity, 
contains  all  the  constituents  for  the  maintenance  and  growth  of  the 
young  creature."     This  is  particularly  noted  immediately  after  birth, 

^  According  to  a  French  medical  journal,  Montbrun-les-Bains,  in  the  Drome,  is  cele- 
brated for  nurses,  who  continue  to  give  the  breast  for  two  j-ears  and  more.  When  one 
of  these  women  loses  her  nursling,  she  takes  a  puppy-dog  instead,  which  then  becomes 
one  of  the  family.  But  it  has  been  observed  that  all  these  dogs  become  affected  with 
rickets,  and  this  has  led  a  medical  man  to  conclude  that  woman's  milk  is  deficient  in 
some  principle  contained  in  dog's  mik,  and  that  consequen'  ■  "he  latter  might  be  a  cure 
for  rickets.     An  observation  published  by  him  would  seem  to  confirm  this  view. 

-  The  mammary  secretion  may  be  present  in  animals  without  their  being  in  the  preg- 
nant or  parturient  state,  or  ever  having  been  so.  We  have  already  alluded  to  Bitches 
yielding  milk  without  having  Puppies.  Rabbits  have  done  the  same  without  having 
been  fecinidated,  and  have  reared  the  young  of  other  Rabbits  ;  Bitches  have  done  the 
same.  Virgin  or  barren  Ewes  have  also  yielded  milk,  as  have  likewise  Mares — Mule 
and  Horse — and  Fillies. 


sEijuL.E  iiy  I'Anrrniriox.  j;.') 

and  before  it  he,c;ins  to  seek  for  other  food.  It  is  at  this  period,  also, 
that  growth  is  most  rapid  ;  and  it  has  been  observed  that  Puppies 
double  their  initial  weight  in  six  days  only.  Colin  has  stated  that,  in 
thirty  days,  ten  Puppies — reduced  to  nine  on  the  twenty-lifth  day — 
living  on  the  milk  of  the  mother  alone,  except  for  the  last  ten  days, 
showed  a  total  increase  of  3o^  lbs.,  the  entire  weight  having  been 
trebled  since  birth.  A  similar  increase  maybe  observed  in  other  young 
creatures  while  being  suckled.  When,  from  some  cause  or  another,  the 
progeny  cannot  obtain  milk  sufficient  in  quantity  or  proper  in  quality, 
it  is  necessary  that  this  be  remedied.  A  Calf  can  be  readily  artifici- 
ally reared  in  an  ordinary  establishment,  if  it  has  had  one  or  two  days' 
colostrum  ;  or  a  substitute  for  the  mother  in  another  Cow  may  be  pro- 
cured. It  is  not  so  witli  the  Foal,  which  is  much  more  dilVicult  to  rear, 
and  another  Mare,  even  if  procured,  will  not  always  readily  play  the 
part  of  nurse.  Nevertheless,  many  animals  can  be  reared  by  judicious 
and  patient  management,  and  if  artificial  food  must  be  resorted  to,  this 
should  come  as  near  as  possible,  in  chemical  composition,  to  that 
furnished  by  Nature. 

In  some  instances,  the  mammary  secretion  may  become  a  source  of 
embarrassment,  or  even  of  danger,  when  it  is  too  abundant  or  is  not 
withdrawn  when  secreted.  This  happens  more  particularly  with  the 
Bitch,  Cat,  Mare,  or  other  animal  which  is  suddenly  deprived  of  its 
young  by  death,  or  for  special  reasons ;  and  the  retention  of  the  milk  is 
often  a  cause  of  discomfort  and  disturbance,  culminating  not  unfre- 
quently  in  inflammation  of  the  gland.  In  such  cases  the  milk  should 
be  withdrawn  until  its  secretion  is  diminished  or  altogether  ceases,  the 
diet  limited  and  modified,  and  mild  diuretics  or  purgatives  may  be 
administered  to  hasten  this  end.  Camphor,  in  small  and  frequent 
doses,  has  been  recommended  with  this  object,  as  well  as  an  effusion  of 
walnut-leaves  and  powdered  white  agaric. 

Whatever  general  treatment  may  be  adopted  in  such  instances,  local 
treatment  must  not  be  overlooked  ;  and  in  addition  to  removing  as 
much  of  the  contents  of  the  mammary  glands  as  possible,  these  may  be 
kept  healthy,  or  cured  when  congested  or  inflamed,  by  suitable  treat- 
ment. Soothing  liniments  or  embrocation  should  be  timeously  applied 
by  friction  to  the  skin  covering  them. 

SECTION  II.— ORGANIC  MODIFIC.VTIONS. 

Gestation  and  parturition  being  completed,  it  is  necessary  that  the 
genital  organs  should  return  to  their  non-puerperal  state.  Indeed,  this 
return  to  their  ordinary  physiological  condition  is  commenced  in  the 
uterus  even  during  labour,  and  remarkable  modifications  occur  more 
particularly  in  the  uterus  and  its  membranes  then,  and  for  some  time 
afterwards'  These  changes  are  connected  with  the  diminution  of  the 
uterus  in  volume,  alterations  in  its  mucous  membrane,  and  the  reform- 
ing of  its  cei-vix. 

The  powerful  contractions  of  the  uterus  during  parturition,  iudul)it- 
ably  tend  to  use  up  the  contents  of  the  cells  of  the  non  striped  muscular 
fibre  composing  its  middle  coat ;  the  simultaneous  compression  of  the 
capillaries  and  afferent  vessels  preventing  the  expended  protoplasm 
from  being  replaced.  After  the  expulsion  of  the  ftetus  and  its  mem- 
branes, this  wasting  or  degeneration  of  these  fibres  continues:  the 
uterus  still  contracting  at  inten-als,  and   producing  those  sensations 


276  NOBMAL  PAIITUIUTIOX. 

known  as  "after-pains" — the  contractions  being  slow,  gradual,  and 
continuous,  and  lasting  until  the  whole  of  its  inner  surface  is  more  or 
less  in  contact,  and  its  cavity  has  regained  its  ordinary  dimensions. 
In  this  process  the  muscular  fibres  continue  to  undergo  alteration,  the 
contractions  of  the  organ  diminishing  in  force  as  this  change  goes  on  ; 
and  this  change  is  essentially  related  to  the  conversion  into  fat  of  the 
albuminous  substance  of  the  protoplasm  of  which  their  cells  are  com- 
posed. The  fibres  become  degenerated  and  absorbed,  and  it  is  some 
time  before  they  are  replaced  by  others  which  have  much  smaller  cells. 
The  bloodvessels  of  the  organ  also  undergo  similar  alterations,  after  the 
uterine  contractions  have  more  or  less  suspended  the  flow  of  blood  in 
their  interior.  They  become  wrinkled  and  sinuous  and  gradually  less 
permeable  to  the  circulating  fluid,  the  walls  of  the  veins  and  capil- 
laries are  attacked  by  fatty  degeneration,  and  are  absorbed  in  large 
numbers. 

This  gradual  interstitial  absorption  occurring  after  parturition,  brings 
about  a  considerable  reduction  in  the  weight  and  volume  of  the  organ. 
Thus  the  uterus  of  the  Cow,  which,  immediately  after  delivery,  will 
weigh  from  thirteen  to  fifteen  pounds,  will  be  no  more  than  seventeen 
to  twenty-one  ounces  when  this  process  is  completed ;  and  the  uterus 
of  a  Ewe  w'ill  be  found  reduced  to  a  twelfth  or  thirteenth  of  its  weight 
at  parturition. 

At  the  same  time,  the  mucous  membrane  lining  the  organ  is  under- 
going corresponding,  but  perhaps  less  profound,  modifications  to  those 
observed  in  woman  after  the  uterus  has  got  rid  of  its  contents.  "When 
treating  of  the  physiology  of  pregnancy,  we  described  the  manner  in 
■which  this  membrane  became  enormously  thickened,  either  wholly  or 
partially,  to  constitute  a  most  important  glandular  and  vascular 
structure  for  the  development  of  the  young  creature.  But  after 
parturition,  fatty  degeneration  attacks  this  structure  and  completely 
destroys  it  in  Solipeds  and  Euminants,  and  this  destruction  takes 
place  in  a  remarkably  brief  period  in  some  animals.  With  the  Bitch, 
Cat,  and  Eabbit,  as  with  woman,  the  whole  of  the  glandular  layer  of 
the  membrane  corresponding  to  the  insertion  of  the  foetal  placenta — 
the  decidua  vera — is  completely  detached  and  eliminated. 

In  the  former  two,  this  exfoliation  of  the  maternal  placenta  leaves 
a  depressed  surface  of  equal  extent,  around  which  the  thicker  mucous 
membrane  forms  a  border  like  that  seen  in  a  cutaneous  wound  after 
removal  of  the  scab.  On  the  surface  of  this  exposed  part,  the 
mucous  membrane,  being  deprived  of  its  epithelium,  is  very  thin, 
and  so  transparent  that  the  muscular  coat  shines  through  it. 
The  uterus  soon  retracts  and  the  placental  wounds  diminish  in 
size,  becoming  covered  with  granulations  like  other  wounds.  In  a 
Bitch  which  had  only  one  puppy,  five  weeks  afterwards  the  wound 
was  not  quite  healed,  and  its  width  was  then  about  one  centimetre  ; 
there  were  also  observed  other  small  annular  surfaces,  narrower  than 
the  preceding,  separated  from  each  other  by  nearly  equal  intervals, 
and  having  the  mucous  membrane  very  smooth,  slightly  thickened 
and  pigmented,  and  which,  being  found  in  all  the  pluriparous  Bitches 
and  Cats  examined,  were  believed  to  be  old  placentular  cicatrices. 

In  Euminants  the  cotyledons,  which  had  gradually  acquired  such 
large  dimensions  during  pregnancy,  shrink,  their  follicular  receptacles 
contract  so  as  to  be  scarcely  visible  to  the  naked  eye,  and  many  of 
these  maternal  placenta  even  appear  to  subside  altogether,  or  to  be 


SEQEL.E  OF  I'Airrri'JTloX.  -211 

reduced  to  exceedingly  small  porportions.  With  Solipeds  and  the 
Sow,  which  have  a  diffused  placenta,  the  follicles  which  received  the 
placental  papilhr  of  the  chorion  also  disappear ;  and  the  membrane, 
greatly  thinned,  assumes  its  ordinary  ridged  appearance,  though  the 
ridges  or  folds  are  larger  and  more  numerous  than  before  conception. 
In  a  Mare  killed  eighteen  or  twenty  hours  after  parturition,  lircolani 
found  the  maternal  portion  of  the  placenta  reduced  to  one-half  its 
thickness  ;  its  colour,  instead  of  being  a  dull  red,  had  become  yellowish  ; 
the  follicles,  from  being  one  to  two  millimetres  in  length,  were  reduced 
to  one  and  half  a  millimetre,  and  the  capillary  network  around  them 
was  no  longer  visible 

The  evacuation  of  the  detached  elements  is  accompanied  by  an 
apparently  large  mucous  secretion,  which,  often  sanguinolent,  con- 
stitutes what  we  have  described  as  the  "  lochia." 

Finally,  a  new  epithelium  is  formed  in  the  place  of  that  which  has 
been  shed,  and  the  uterine  interior  presents  the  appearance  it  had 
before  impregnation.  According  to  Friedlander,  the  formation  of  the 
new  mucous  membrane  takes  place  in  the  following  manner  :  All  that 
has  remained  behind  of  the  cellular  layer  richly  infiltrated  with  blood, 
as  well  as  the  upper  portions  of  the  glandular  layer,  gradually  exfoliates 
and  is  discharged  in  the  lochia.  The  flatly  compressed  glandular  tubes 
situated  close  to  the  muscular  coat  are  opened  up,  and  their  cylindrical 
epithelium  forms  the  new  mucous  epithelium  of  the  internal  surface 
of  the  uterus.  The  connective  tissue  situated  between  the  tubular 
glands  accordingly  proliferates,  and  becomes  reorganised.  In  con- 
sequence of  the  increase  in  thickness  of  the  mucous  membrane,  the 
previous  shallow  depressions  of  the  epithelium  are  deepened,  and  in 
that  way  the  uterine  glands  are  also  reformed  in  the  new  mucous 
membrane. 

Coincidently  with  this  return  to  small  proportions,  the  uterine  cervix 
also  regains  its  former  shape.  During  the  passage  of  the  fcitus,  in 
process  of  dilatation  the  os  and  vagina  form  a  continuous  canal  without 
any  interruption,  and  the  cervix  is  effaced.  Immediately  after  the 
ftt'tus  has  passed  througli,  however,  the  latter  reappears,  the  os  is 
closed,  and  the  uterus  and  vagina  are  again  separated  by  the  sphincter- 
like ring  which  the  uterine  neck  exhibits  in  the  cavity  of  the  latter. 
The  cervix  is  at  this  time  soft  and  flabby,  and  the  os,  not  entirely 
closed,  is  readily  dilated  by  the  fingers.  But  it  gradually  contracts 
and  closes,  as  its  texture  becomes  firmer,  and  in  doing  so  it  elongates 
towards  the  vagina,  into  which  it  projects,  until  it  has  regained  its 
natural  form  and  consistence ;  though  it  is  always  shorter  and  less 
regular  in  shape,  particularly  at  the  os,  in  animals  which  have  had 
several  young,  than  in  tho'^'^  which  have  never  been  pregnant.  The 
uterus  itself  does  not  completely  assume  the  dimensions  it  had  in  non- 
pregnant animals,  but  is  always  larger  after  it  has  contained  one  or 
more  foetuses. 

It  may  be  noted  that  the  broad  ligaments  of  the  utenis  become 
shortened  after  parturition,  and  consequently  raise  the  organ  towards 
the  lumbar  region,  and  in  the  direction  of  the  pelvis ;  while  their 
muscular  fasciculi  undergo  fatty  degeneration  and  absorption. 

Such  are  the  organic  modifications  the  genital  organs  undergo  after 
labour,  when  everjthing  occurs  regularly.  But  it  sometimes  happens 
that  the  muscular  layer  of  the  uterus  appears  to  be  stnick  with 
paralysis  soon,  or  even  immediately  after  birth  ;    so  that  it  remains 


278  NORMAL  PARTURITION. 

distended,  and  its  cavity  is  so  large  that  the  arm  can  easily  be  intro- 
duced into  it.  This  inertia  is  not  so  much  to  be  dreaded  in  animals 
as  in  woman,  though  it  is  often  troublesome  and  sometimes  serious  in 
them.  The  cUbris  of  the  decidua  vera,  and  other  effete  matters,  ac- 
cumulate in  its  cavity,  and  the  os  being  always  more  or  less  patent, 
the  air  obtains  admission,  putrefaction  commences,  and  grave  results 
may  follow.  An  exploration  will  discover  a  variable  quantity  of  sanious, 
and  more  or  less  foul-smelling,  matter  in  the  cavity  of  the  organ ;  and 
until  this  is  removed,  and  the  organ  made  to  contract  on  itself,  danger 
may  be  apprehended. 

The  gradual  and  steady  involution  of  the  uterus  is  therefore  of  much 
importance  after  expulsion  of  the  foetus. 


I'AJiT    SI-COXJ). 
DYSTOKIA. 

GENERAL    CONSIDERATIONS. 

In  studyiiij^  the  physiology  of  parturition,  we  saw  that  a  favourahle 
termination  of  hxhour  clepended  on  two  factors,  one  of  which  was  a 
proper  degree  of  activity  of  the  expelhng  powers,  and  the  other  a 
normal  condition  of  the  obstacles  to  be  overcome  by  these  powers. 
When  tliese  are  out  of  proportion  to  each  other,  then  we  have  dilVicult 
parturition,  or  Dystoki.v  (oi's,  difficult ;  tokos,  birth).  Diflicult  par- 
turition may  be  due  to  too  feeble  pains,  or  to  an  obstacle  which  the 
unaided  efforts  of  the  animal  cannot  surmount  except  after  an  unusual 
period  of  labour,  or  not  at  all. 

We  have  already  alluded  to  the  nature  of  and  variations  in  the 
expelling  forces,  and  also  to  the  causes  of  protracted  labour.  We  have 
now  to  treat  of  the  ditliculties  attending  parturition,  with  their  con- 
sequences— proximate  or  remote,  and  the  means  to  be  adopted  for 
overcoming,  preventing,  or  remedying  these.  This  involves  a  study  of 
the  necessary  obstetrical  operations,  the  accidents  attending  or  follow- 
ing parturition,  and  the  diseased  conditions  more  or  less  related  to  the 
puerperal  state — all  of  which  may  be  included  under  the  head  of 
"  pathology  of  parturition." 

The  dilliculties  attending  parturition  depend  upon  the  resistance 
opposed  to  tlie  expelling  powers,  and  this  is  determined  by  the  relation 
of  the  object  to  be  expelled — the  presenting  part  of  the  foetus,  to  the 
maternal  genital  passages.  Consequently,  an  exaggerated  resistance 
may  be  due  to  abnormal  conditions  of  the  parturient  passages,  or  to 
some  unnatural  condition  of  the  young  animal.  In  the  first  we  have 
MatcriKil  Dystokia,  and  in  the  second  Fcital  Dijslohia.  These  necessitate 
particular  operations,  some  of  which  demand  much  study,  address,  and 
manipulative  power  on  the  part  of  the  obstetrist.  In  addition,  we  have 
dangerous  accidents  sometimes  occurring  during  parturition,  which,  if 
they  do  not  happen  to  interfere  with  the  mechanism  of  that  act,  may 
nevertheless  recjuire  the  highest  degree  of  surgical  skill  to  remedy. 
And,  linally,  there  are  the  maladies  which  accompany  the  parturient 
state,  some  of  them  being  serious,  and  needing  great  clinical  and 
therapeutical  knowledge  for  their  successful  treatment. 

These  dilliculties,  accidents,  and  diseases  do  not  occur  with  the  same 
gravity,  nor  with  the  same  frequency,  in  all  the  domesticated  animals  ; 
indeed,  with  regard  to  the  latter,  some  species  appear  to  be  altogether 
exempt  from  at  least  one  or  more  of  them. 

Cases  of  dystokia  are  much  more  frequent  in  the  Bovine  species  than 
in  any  other  ;'  and  least  so,  perhaps,  in  the  Equine  species.     These  two 

'  The  Camel — and  particul.irly  the  Bactrlan  varii'ty  which  i.s  characteristic  of  Mongolia 
— apjifars  generally  to  re<iiiire  aiiiiiatance  during  parturition.  At  least  we  may  infer  this 
from  the  statement  of  Colonel  Prejevalsky,  who,  in  speaking  of  the  Mon;;olian  Camel, 
says  : — "The  males  Injcome  vicious  during  the  rutting  season,  which  is  in  February,  and 
they  will  then  fight  with  one  another,  and  sometimes  attack  mankind.  The  interference 
of  man  is  needed  to  bring  the  sexes  together.  The  period  of  gestation  is  thirteen  months, 
at  the  expiration  of  which  the  dam  gi%e3  birth  to  one,  or,  as  an  exception,  to  two  P'oals. 


280  DYSTOKIA. 

species  are  those  which  the  obstetrist  is  generally  called  upon  to  attend 
during  protracted  or  difficult  parturition  ;  and  every  practitioner  who 
has  had  any  experience  in  this  matter,  will  testify  that  for  one  case  in 
the  Mare  or  other  animal  there  will  be  at  least  ten  in  the  Cow.  Two 
Danish  veterinarians,  Nielsen  and  Tallich,  have  estimated,  that  while 
they  have  had  ten  cases  in  the  Mare,  the  first  has  had  190,  and  the 
second  159  in  the  Cow  ;  and  yet  these  writers  practised  in  a  district 
where  more  Horses  than  Cows  were  reared. 

We  have  already  said  that  the  Mare  is,  of  all  quadrupeds,  the  one 
which  brings  forth  its  young  most  easily — a  fact  noted  by  Aristotle. 
But  this  remark  only  applies  to  normal  parturition  in  that  animal ;  in 
abnormal  cases  there  is,  as  a  rule,  more  urgency  and  danger  than  in 
the  Cow,  as  well  as  more  difficulty  in  affording  relief.  Indeed,  a  very 
able  veterinarian,  Donnarieix,  who  has  had  an  extensive  experience  in 
obstetricy,  declares  that  obstetrical  operations  in  the  Mare  are  a  labour 
of  Hercules  ;  while  in  the  Cow  they  are,  comparatively,  child's  play. 
This  experience  will  not  quite  accord  with  that  of  every  practitioner  ; 
as  in  both  animals  difficulties  in  parturition  will  be  sometimes 
encountered,  which  baffle  the  skill  of  the  most  competent  obstetrist, 
and  often  prove  insurmountable.  One  of  these  difficulties  in  the  Mare 
is  related  to  the  difference  in  the  vitality  of  the  Foal  and  Calf  when 
parturition  has  commenced — a  difference  which  we  have  before  pointed 
out  as  due  to  the  particular  arrangement  of  the  maternal  and  foetal 
placentae  in  each  species,  and  which  it  is  of  great  importance  to 
remember  in  choosing  the  means  to  be  employed  in  overcoming  obstacles 
to  parturition  in  either  the  Mare  or  Cow.  The  following  comparison 
has  been  drawn  by  Donnarieix,  between  parturition  in  the  Mare  and 
Cow,  and  fairly  accounts  for  the  differences  in  each  animal : — 

Mare.  Cow. 

1.  Delivery  is  often  followed  by  1.  Delivery  always  terminates 
insuccess.  favourably. 

2.  A  wound  inflicted  on  the  2.  A  wound  of  these  organs 
genital  organs  is  generally  fatal.  rarely  causes  death. 

3.  Inversion  of  the  uterus  is  3.  Inversion  of  the  uterus  is 
nearly  always  irremediable.  often  curable. 

4.  Mares  nearly  always  succumb  4.  This  accident  is  not  generally 
to  penetrating  wounds  of  the  abdo-  fatal  in  Cows. 

men  during  parturition. 

5.  Delivery  of  the  most  simple  5.  Delivery,  even   in   the  most 
kind  is   occasionally  followed  by  complicated  cases,  generally  proves 
bad    results.      In    abnormal   and  comparatively    easy,    and    obste- 
laborious   parturitions   not   unfre-  trical  operations  successful, 
quently  Mare  and  Foal  succumb. 

6.  Difficult  parturition  proves  a  6.  Such  parturitions  are  not  of 
Herculean  task  to  the  operator.           much    account   to    a    practitioner 

skilled  in  the  necessary  operations. 

Human  assistance  is  also  required  at  the  time  of  parturition.  The  new-born  Camel  is  the 
most  helpless  creature  imaginable  ;  it  must  be  lifted  by  hand  and  placed  under  the 
mother's  teats  ;  but  as  soon  as  it  can  walk,  it  follows  her  about  everywhere,  and  the 
latter  is  so  attached  to  her  offspring,  that  she  cannot  bear  to  be  separated  from  it.  The 
female  Camel  is  granted  its  liberty  for  a  whole  year  after  parturition  ;  so  that  it  only 
foals  every  other  year." — Mojigolia,  the  Tangut  Country,  and  the  Solitudes  of  Northern 
Tibet,  voL  i.,  p.  124.     London,  1876. 


(7KX/:/!,l  L  <  •nXSlDEHA  T/i>Xs: 


281 


Cow  — con  tin  ued. 

7.  Under  the  same  circumstances 
the  calf  may  live  four  or  five  days 
/;/  ntcro,  as  life  is  maintained  by 
the  placental  connections.  These 
ditferences  are  oxjilaincd  by  the 
mechanism  of  fatal  life  in  the  two 
species  of  animals,  as  well  as  by 
the  anatomy  of  the  uterus  and 
fcetal  membranes. 

8.  The  neck  of  the  fcetus  being 
shorter  and  thicker,  the  head  is 
less  twisted,  and  the  operator  can 
with  <,'reater  ease  bring  it  back 
into  its  normal  position.  In  addi- 
tion, there  are  teeth  in  the  lower 
jaw,  the  neck  of  which  is  narrow  ; 
so  that  the  slipknot  does  not  leave 
it,  and  straightening  of  the  head 
and  neck  becomes  an  easier  affair. 


yiMiK^con  fill  ued. 
7.  The  duration  of  the  life  of 
the  foetus,  in  a  case  of  abnormal 
labour,  does  not  extend  beyond 
the  fourth  hour,  on  account  of  the 
young  animal  having  to  maintain 
its  independent  existence,  as  if 
already  born. 


8.  The  neck  of  the  Foal  being 
very  long,  the  head  is  usually 
found  deeply  buried  in  the  Hank 
whenever  it  is  turned  backwards. 
The  operator  has  very  great  ditli- 
culty  in  reaching  the  head  with 
his  hand  ;  indeed,  it  is  often  im- 
possible to  bring  it  into  its  natural 
position.  The  loop  slips  off  the 
neck  of  the  lower  jaw,  and  has 
constantly  to  be  replaced  ;  it  is 
scarcely  possible  to  fix  a  cord 
there,  this  portion  of  the  jaw  being 
so  short  and  the  foetus  having  no 
teeth. 

0.  When  once  the  amniotic  fluid 
has  escaped,  the  introduction  of 
the  hand  is  difficult,  owing  to  the 
genital  organs  becoming  dry  ;  this 
dryness  causes  an  efflux  of  blood 
to  the  mucous  membranes.  The 
resistance  made  by  the  fo'tal 
membranes  to  manipulation,  when 
made  to  ascertain  either  the  posi- 
tion of  the  foetus  or  for  correcting 
the  position,  together  with  the 
stniggles  and  violence  of  the  Mare, 
which  now  and  then  drops  as  if 
dead,  are  all  difticulties  to  be  over- 
come. 


Presentations  which,  in  the  Cow — owing  to  its  phlegmatic  tempera- 
ment, intenals  of  quietude,  and  more  gentle  and  tractable  nature — arc 
common,  and  as  a  rule  adjustable,  are  yet  most  diflicult  in  the  Mare, 
and  if  not  quickly  attended  to,  rapidly  lead  to  a  fatal  termination. 
With  regard  to  diflicult  parturition  in  the  other  domesticated  animals, 
the  Goat  and  Ewe  come  next  to  the  Cow  in  the  order  of  frequency ; 
though  cases  of  dystokia  are  not  so  often  noted  in  them  as  in  that 
animal.  It  is  to  be  remarked,  however,  that  assistance  is  not  so 
easily  rendered  them,  owing  to  the  introduction  of  the  hand  into  the 
uterus  not  being  always  possible.  In  th?  (loat  the  act  is  sometimes 
very  prolonged,  though  on  account  of  the  multiple  placenta)  the  fa'tus 
may  live  as  long  as  in  the  Cow.  With  the  Ewe  the  same  occurrence 
is  observed,  but  in  this  creature  it  is  sometimes  possible  to  introduce 


9.  The  genital  organs  are  con- 
tinually lubricated  by  a  mucus 
fluid  which,  while  it  facilitates  the 
introduction  of  the  hand,  renders 
easy  any  necessary  correction  of 
position,  and  favours  parturient 
operations.  Besides,  any  move- 
ment made  is  not,  in  general,  of 
much  consequence. 


282  BYSTOKIA. 

the  hand  into  the  genital  passages.  It  is  rare  indeed  that  the  ob- 
stetrist  is  required  to  attend  upon  the  healthy  Sow,  this  animal 
appearing  to  be  almost  exempt  from  difficulties  in  parturition.  In 
cases  of  rachitism,  however,  there  is  sometimes  so  much  deformity  of 
the  pelvis,  that  aid  is  required.  Notwithstanding  the  narrowness  of 
the  passages,  the  hand  or  fingers  may  be  passed  into  them. 

Cases  of  dystokia  ai'e  not  infrequent  in  the  Bitch,  and  particularly 
if  it  is  of  small  size,  or  belongs  to  a  breed  with  a  large  round  head  and 
short  nose.  Numbers  of  Bitches  perish  every  year  from  non-delivery 
of  their  Puppies  ;  these  latter  may  also  succumb  before  the  decease  of 
their  parent,  as  it  often  happens  that  the  death  of  one  entails  destruc- 
tion on  the  others.  Cats  are  sometimes  subjects  of  difficult  parturition, 
and  from  the  same  causes  as  Bitches. 

A  very  great  disadvantage  under  which  the  veterinary  obstetrist 
labours  in  cases  of  dystokia,  is  the  late  period  at  which  his  services  are 
generally  called  into  request,  and  often  after  serious,  and  even  irre- 
parable, injury  has  been  done  by  unskilful  hands  ;  and  this  in  instances 
in  which  a  little  scientific  manipulation  and  some  surgical  knowledge 
would  have,  perhaps,  made  all  right  and  safe  in  a  few  minutes.  Saint- 
Cyr  justly  says,  in  commenting  on  some  remarks  made  with  regard  to 
the  services  a  veterinary  surgeon  may  render  in  difficult  partmntion, 
that  these  can  be  beneficial  only  on  the  absolute  condition  that  he  is 
present  in  good  time.  Called  upon  too  late,  when  the  "  waters  "  have 
escaped  for  a  long  period,  and  the  neighbouring  empiric  has  exhausted 
his  science,  aggravated  a  bad  presentation,  irritated  the  generative 
organs  by  manipulations,  tractions,  and  violent  means  ;  then  all  the 
ability  of  the  most  experienced  practitioner  may  be  useless.  He  will 
find  the  passages  dry,  burning,  swollen  by  inflammation,  the  fcetus 
more  or  less  advanced  into  the  pelvic  cavity,  where  it  is,  it  may  be  said, 
"wedged,"  or  like  a  nail  driven  into  wood  ;  with  the  uterus  spasmodi- 
cally contracted  on  itself,  and  so  closely  applied  to  the  body  of  the 
foetus  that  it  is  almost  impossible  to  pass  the  hand  between  them. 
How  is  it  possible  to  manipulate  in  such  a  place — how  change  the 
vicious  position  of  a  foetus  which  the  greatest  efforts  cannot  make 
advance  or  retire  ?  How  can  a  sharp  instrument  be  carried  into  the 
uterine  cavity  and  used  with  safety,  when  the  hand  alone  can  scarcely 
be  made  to  enter  it  ? 

It  is  in  these  circumstances  that  a  practical  knowledge  of  obstetricy 
is  most  valuable,  and  renders  he  who  possesses  it  a  very  great  acquisi- 
tion to  an  agricultural  or  pastoral  district.  And  this  knowledge  may 
be  said  to  be  special ;  for  obstetricy  is  not  like  the  other  branches  of 
veterinary  surgery,  in  forming  a  portion  of  every  veterinarian's  practice. 
On  the  contrary,  it  is  rarely  practised  in  towns  or  cities,  but  is  almost 
exclusively  limited  to  animal-rearing  localities  ;  there  alone  is  to  be 
found  the  school  in  which  the  practitioner  may  be  initiated  into  all  the 
difficulties  of  this  complex  art,  and  the  best  and  readiest  means  of  sur- 
mounting them.  And  it  must  be  confessed  that  the  practice  of  this  art 
is  not  particularly  alluring,  and  is  attended  with  many  more  incon- 
veniences, hardships,  and  difficulties  than  fall  to  the  lot  of  the  human 
obstetrist  :  indeed,  we  know  of  no  more  arduous  and  anxious  occupa- 
tion than  that  of  the  country  practitioner  in  a  cattle-breeding  district, 
and  he  requires  physical  endowments  which  are  certainly  not  needed 
by  the  attendant  on  woman. 

Veterinary  accouchments  are  generally  difficult  and  perplexing,  as 


aKXElHL  rOXSIDEn.iriOXS.  283 

well  as  fatif^^uing.  Lon^  and  powerful  arms  are  necessary,  as  well 
as  much  address  in  usin;^  them  and  the  linj^ers ;  bodily  activity  is 
above  all  essential,  in  order  to  go  about  an  animal,  to  place  one's  self 
in  the  most  favourable  position  for  exploring  and  operating,  and  to 
avoid  injury  from  the  creature.  The  veterinary  obstetrist  should  also 
be  gifted  with  presence  of  mind,  coolness,  and  fertility  of  resource ;  so 
as  to  take  into  consideration  all  the  circumstances  of  the  case,  devise 
his  method  of  procedure,  and  carry  it  out  promptly. 

The  conditions  under  which  the  veterinarian  has  to  perform  his  task 
are  not  favourable  or  encouraging.  It  is  anything  but  easy  to  practise 
the  necessary  manipulations  in  the  larger  animals — such  as  the  Mare 
or  Cow — in  such  a  great  cavity  as  the  abdomen,  and  in  the  uterus 
which  lies  deep  in  it,  and  contains  a  voluminous  fcetus.  In  practising 
these  manipulations,  the  operator  has  to  contend  with  the  struggles 
and  disordered  movements  of  the  animal,  which  sometimes,  in  the 
midst  of  its  sufferings,  does  not  hesitate  to  use  its  feet,  horns,  or  teeth 
as  weapons  of  offence,  or  to  crush  its  medical  attendant  against  the 
adjacent  wall.  In  addition,  the  violent  contractions  of  the  uterus,  and 
especially  of  the  cervix,  fatigue  the  operator  extremely.  Sometimes 
these  manipulations  have  to  be  continued  for  hours,  until  the  various 
obstacles  to  delivery  arc  successively  overcome,  or  the  creature  is 
doomed  to  perish. 

Add  to  this,  that  Cows  and  ^Nlares  during  i)arturition  often  inhabit 
close,  foul  stables,  with  an  almost  poisonous  atmosphere,  destitute  of 
light,  and  perhaps  also  cold  and  damp.  Here  the  veterinarian  must  do 
his  duty — cold,  wet,  and  dirty,  exposed  to  draughts  and  every  kind  of 
discomfort.  Most  frequently,  too.  he  is  left  to  his  own  resources;  for 
it  is  rare  that  intelligent  and  obedient  assistants  can  be  found  in  such 
places.  And  all  this  after  driving  long  distances,  often  at  night  and  in 
bad  weather.     How  different  to  the  accoucheur  of  woman ! 

All  the  inconveniences,  risks,  and  hardships  of  the  veterinary  obstet- 
rist do  not  end  here.  After  manipulations,  sometimes  long  continued,  in 
a  uterus  containing  infective  matter  resulting  from  retention  of  a  dead 
foetus,  or  foetal  membranes  in  process  of  decomposition,  he  is  exposed  to 
the  most  serious  septic  diseases,  and  may  even  lose  his  life.  A  cutaneous 
eruption,  indeed,  often  appears  on  the  arms  of  the  operator,  merely 
through  having  manipulated  for  some  time  in  genital  organs,  the  mucous 
membrane  of  whicii  was  only  irritated  and  inflamed,  or  simply  swollen 
and  bruised — no  putrefaction  or  suppuration  being  present.  Most 
frequently  the  disease  is  only  local,  and  is  sometimes  a  simple,  limited, 
erythematous  redness  which  disappears  in  twenty-four  hours  ;  at  other 
times  it  is  a  trifling  eczema  without  pustules,  but  with  intense  itching ; 
frequently  it  is  a  pustular,  sometimes  confluent,  ecthyma,  the  crusts 
on  which  are  occasionally  not  detaciied  for  months ;  in  other  cases 
there  arc  furuncles,  abscesses  on  the  arm,  or  even  over  the  body.  In 
the  majority  of  cases,  the  atTection  is  accompanied  by  fever,  anorexia, 
great  uneasiness,  and  pains  so  acute  that  sleep  is  impossible ;  there 
niay  also  be  tumefaction  of  the  axillary  glands.  The  course  of  the 
disease  is  generally  irregular,  relapses  are  common,  and  it  is  a  long  time 
before  its  effects  pass  off.  Death  sometimes  occurs,  and  amputation  of 
a  portion  of  the  arm  has  been  necessary. ^  Such  are  the  difficulties  and 
risks  of  the  veterinary  accoucheur.  We  will  now  refer  more  particularly 
to  his  line  of  conduct  in  practice. 

^    I'et^rinar;/  Journal,  vol.  ii.,  p.  21 S. 


284  DYSTOKIA. 

Proprietors  of  animals  should,  in  their  own  interests,  suffer  no  delay 
to  occur  in  sending  for  the  veterinary  surgeon  as  soon  as  they  perceive 
that  parturition  is  not  progressing  regularly  ;  and  they  should  carefully 
abstain  from  any  violent  handling  of,  or  traction  on,  the  foetus  which 
might  render  irremediable  a  difficulty  often  easy  to  surmount  at  the 
commencement,  by  anyone  sufficiently  acquainted  with  obstetrics. 

On  his  part,  the  veterinarian  should  not  lose  time  in  giving  his 
services ;  as  every  minute's  delay  may  render  the  case  more  difficult, 
and  tend  to  compromise  the  life  of  not  only  the  young  animal,  but  also 
that  of  the  mother,  as  well  as  the  interests  of  the  owner  and  his  own 
reputation.  It  is  essential  that  he  should  be  provided  with  certain 
instruments,  as  obstetrical  operations  are  partly  performed  by  means  of 
these,  as  well  as  by  the  unarmed  hand,  which  is,  after  all,  the  most 
perfect  instrument,  and  should  always  be  preferred  to  instruments  when 
possible.  Some  operations,  however,  can  only  be  undertaken  with 
instruments,  and  it  is  therefore  necessary  that  the  obstetrist  be  pro- 
vided with  at  least  those  which  are  most  useful  and  indispensable :  such 
as  one  or  two  knives,  cords,  hooks,  Schaack's  head-collar  or  some  other 
pattern,  etc.,  and  these  should  be  so  portable  as  to  be  carried  in  a 
leather  or  canvas  bag,  or  a  small  box. 

On  reaching  the  patient,  all  information  concerning  it  should  be 
gathered  at  once  and  an  examination  immediately  made  into  its  condition. 
The  period  when  labour  commenced  ;  if  the  "  water-bag  "  has  ruptured, 
and  when ;  if  the  animal  has  gone  its  full  time,  or  exceeded  it ;  if  it  is  a 
primipara,  or,  if  not,  if  its  previous  parturitions  were  favourable — all 
these  and  other  useful  points  in  its  history  should  be  obtained. 

The  examination  should  comprise  :  the  general  appearance  of  the 
animal ;  whether  weak  or  strong ;  the  character  of  the  j)ulse  ;  and  the 
nature,  frequency,  and  intensity  of  the  expulsive  efforts  ;  as  well  as  the 
condition  of  the  mammae,  and  external  genital  organs.  After  this,  if 
further  examination  is  necessary,  direct  exploration  of  the  internal 
genital  organs  should  be  made.  We  have  already  described  the  mode 
of  procedure  to  be  adopted  in  this  exploration  ;  but  because  of  its  im- 
portance, we  will  again  notice  it. 

If  possible,  the  Mare  and  Cow  should  be  examined  in  a  standing 
attitude,  as  this  is  the  best.  If,  however,  the  animal  is  lying,  and  from 
exhaustion  or  paralysis  it  cannot  get  up,  then  of  course  the  examination 
must  be  made  in  this  position  ;  indeed,  it  may  be  advantageous  to 
examine  in  both  positions. 

When  standing,  it  should  be  approached  gently  and  coaxingly,  and 
rigorous  restraint  is  seldom  necessary ;  for  the  pains  of  labour  usually 
render  the  most  vicious  animals  tractable.  With  the  Mare  it  generally 
suffices  to  have  one  of  the  fore-feet  held  up  by  an  assistant,  while  the 
examination  is  made  ;  if  young  and  dangerous,  it  may  be  necessary  to 
employ  a  side-line  on  a  hind  pastern,  or  hobbles  on  both  hind  pasterns, 
and  perhaps  a  twitch  on  the  nose.  With  the  Cow,  a  strong  man  hold- 
ing the  animal's  head  is  sufficient  to  make  it  stand  quiet. 

Lateral  movements  may  be  prevented  by  placing  the  animal  against 
a  wall  or  partition  on  one  side,  and  a  powerful  man  at  the  other  side  ; 
or  a  man  at  each  side.  The  operator  must  be  on  his  guard  against  the 
animal  suddenly  dropping,  which  would  expose  him  to  serious  injury. 
When  the  floor  inclines  from  the  tail  towards  the  head  of  the  animal  it 
is  most  favourable  for  an  exploration,  as  the  mass  of  intestines  is  thrown 
forward  against  the  diaphragm  ;  so  that  they  do  not  press  on  the  uterus. 


I 


HEXEJLiL  CoySIDEHATWXS.  285 

which  is  then  more  free  and  better  adapted  for  niancmvivs  in  its 
interior. 

When  the  operator  has  to  explore  in  the  lyin<;  position,  he  liiuls  it 
much  more  fati^'uin;^  and  dillicult,  as  he  has  then  to  kneel,  and  to 
acconnnodate  himself  to  the  animal.  In  the  decubitus,  it  is  still  more 
necessary  that  the  croup  shoidd  be  higher  than  the  front  part  of  the 
body,  in  order  to  get  the  digestive  organs  out  of  the  way ;  the  lateral 
pressure  of  the  viscera  should  also  be  diminished  by  having  the  spine 
higher  than  the  limbs  ;  and  it  must  be  borne  in  mind  that  the  more  an 
animal  is  raised  above  the  ground  when  it  is  lying,  the  easier  is  the 
manipulation.  For  the  same  reason,  the  smaller  animals  should  be 
raised  as  high  as  the  operator's  hand  :  the  Sheep,  Sow,  and  Goat  on 
several  bundles  of  straw  ;  the  Bitch  and  Cat  on  a  table  covered  with 
straw  or  a  cloth.  The  two  latter  animals  must  be  so  seciu'ed  that  they 
will  not  bite  or  scratch  the  operator. 

To  compel  a  Cow  to  get  up,  Schaack  recounnends  that  a  small  Dog 
be  introduced  into  the  stable,  and  made  to  bark  at  and  excite  the 
animal 

The  coat  must  be  removed,  and  the  shirt-sleeve  rolled  as  high  as  the 
shoulder  ;  indeed,  with  large  animals,  when  there  is  a  likelihood  of  much 
manipulation  bein^  required  with  the  cavity  of  the  uterus,  it  has  been 
recommended  to  remove  the  shirt  and  underclothing  from  the  arm  and 
shoulder  altogether. 

My  friend,  Mr.  Cartwright,  of  Whitchui'ch,  employed  a  large,  thick, 
and  long  woollen  sleeveless  vest  that  buttoned  close  up  around  the  neck ; 
this  is  very  suitable  for  such  cases,  as  it  not  only  admits  of  the  shirt 
being  removed,  but  besides  keeping  the  operator's  clothes  clean,  it 
prevents  him  catching  cold.  Other  operators  wear  a  long  gown,  like  a 
dissecting-room  gown. 

The  back  of  the  hand  and  arm  should  be  well  smeared  with  oil, 
grease,  or  even  butter,  not  only  to  render  their  introduction  into  the 
genital  passages  more  easy,  and  less  irritating  to  the  lining  membrane, 
but  also  to  some  extent  to  protect  the  operator  against  infection.  It  is 
scarcely  necessary  to  add  that  rings  should  not  be  worn  on  the  fingers. 
The  right  hand  is  usually  introduced,  but  it  is  well  to  be  able  to  use 
both  hands — certain  manipulations  being  more  easily  executed  with 
the  left  than  the  right  hand ;  and,  besides,  in  protracted  operations 
one  hand  relieves  the  other. 

Before  commencing  the  examination  of  the  genital  passages,  it  is 
well  to  empty  the  rectum,  and  if  possible  the  bladder.  While  emptying 
the  former  viscus,  useful  information  may  be  gleaned  as  to  the  condi- 
tion of  the  uterus,  as  well  as  of  the  pelvis  and  pelvic  cavity. 

The  fingers  being  gathered  together  in  a  cone-like  form,  the  hand — 
which  should  not  be  cold — is  inserted  carefully  and  steadily  into  the 
vagina  at  a  moment  when  the  animal  is  not  straining — the  outer  margin 
(little  finger)  being  downwards,  thumb  towards  the  rectum,  and  pushed 
gently  inwards  by  a  slight  rotatory  movement ;  but  the  advance  of  the 
hand  must  be  momentarily  checked  if  the  straining  is  at  all  severe,  or 
until  the  animal,  if  irritable,  has  become  reconciled  to  it.  When  once 
through  the  vulva,  more  room  is  found  in  the  vagina,  and  the  hand 
and  fore-arm  can  then  penetrate  with  ease  as  far  as  the  cervix  uteri. 

The  object  of  exploration  being  to  ascertain,  in  the  first  place,  the 
condition  of  the  genital  passages,  as  well  as  the  state  of  the  pelvic 
cavity  in  general,  the  operator  has  to  satisfy  himself  whether  the  vagina 


286  DYSTOKIA. 

is  empty,  or  if  it  already  contains  some  portion  of  the  foetus  or  its 
membranes,  and  what  these  are  ;  if  there  is  any  normal  condition  or 
contraction  of  the  vagina,  or  any  tumours  either  within  or  external  to 
that  canal,  as  well  as  the  seat  of  these,  and  if  possible  their  nature. 
He  has  also  to  satisfy  himself  that  the  pelvis  is  wide,  regular  in  form, 
or  more  or  less  deformed  and  diminished  in  size  from  exostoses,  frac- 
tures, or  other  causes. 

The  state  of  the  soft  parts  will  likewise  engage  his  attention,  and  he 
must  learn  whether  the  vulvo-uterine  canal  is  dry,  or  contains  suffi- 
cient mucus  to  facilitate  manipulation  or  delivery,  as  well  as  its  tempera- 
ture. Having  satisfied  himself  on  these  points,  the  fingers  are  again 
brought  together,  and  their  extremity  pushed  as  far  as  the  cervix  uteri, 
the  condition  of  which  is  carefully  studied.  The  chief  points  to  be 
noted  are  :  whether  it  still  projects  into  the  vagina,  or  if  it  is  completely 
effaced  ;  whether  the  uterus  has  descended  on  the  floor  of  the  abdomen, 
or  is  yet  in  its  ordinary  position  ;  whether  the  os  is  closed  or  open,  and 
the  extent  of  its  dilatation;  whether  the  texture  of  the  cervix  is  hard 
or  soft,  healthy  or  altered  by  morbid  degeneration,  and  if  it  lies  in  the 
axis  of  the  vagina  or  deviates  therefrom,  or  is  more  or  less  twisted. 
Passing  the  hand  into  the  uterine  cavity,  if  necessary  and  possible, 
and  with  all  care  and  gentleness,  the  explorer  will  meet  with  the 
"  water-bag,"  if  it  is  not  already  ruptured,  and  the  foetus,  if  he  has  not 
already  encountered  it ;  at  the  same  time  the  ene^'gy  and  frequency  of 
the  labour  pains  can  be  ascertained.  If  the  membranes  are  ruptured, 
the  hand  must  be  passed  into  them  in  order  to  discover  the  situation  of 
the  foetus — the  kind  of  presentation  and  position,  the  manner  in  which 
the  limbs  are  disposed,  and  any  complications  which  may  be  present. 
If  the  membranes  are  not  ruptured,  and  it  is  deemed  necessary  to  open 
them — which  not  unfrequently  happens  when  an  exploi'ation  has  to  be 
made,  and  labour  is  advanced,  the  pains  being  well  marked,  the  os 
dilated,  and  the  water-bag  in  the  vagina — the  hand  may  be  passed 
between  them  and  the  uterus,  the  palm  being  towards  the  foetus  ;  or  it 
may  not  be  required  to  pass  so  deeply. 

When  the  membranes  are  tense,  pressure  against  them  with  the  end 
of  the  index-finger  during  a  throe  is  usually  sufficient  to  open  them  :  if, 
however,  they  are  flaccid,  a  portion  is  seized  between  the  thumb  and 
middle  finger  and  torn  by  their  nails,  or  by  the  nail  of  the  first  finger 
against  that  of  the  thumb.  Sometimes  the  fingers  alone  are  not 
sufficient,  as  when  the  envelopes  contain  but  little  fluid  ;  then  a  pair 
of  scissors,  a  small  trocar,  or  even  an  ordinary  pen,  will  effect  this 
object. 

In  examining  for  presentation  and  position,  each  region  of  the  body 
of  the  foetus  should  be  familiar  to  the  touch,  as  it  can  be  distinguished 
by  its  own  proper  characters.  Under  ordinaiy  circumstances,  the  hand 
of  the  operator  first  meets  with  the  limbs  of  the  foetus ;  if  they  are  the 
anterior  limbs,  and  the  plantar  surface  of  the  feet  is  turned  downwards, 
then  the  foetus  is  in  the  natural  or  vertebro- sacral  position,  anterior 
presentation  ;  but  if  the  plantar  surface  of  the  feet  is  inclined  upwards, 
and  they  really  belong  to  the  fore  limbs,  then  it  is  in  the  vertebro-pubic 
position.  To  distinguish  the  fore  from  the  hind  limb,  the  shape  of  the 
joints  and  their  mode  of  flexion  must  be  taken  into  account — the  fetlock 
and  knee  of  the  former  bend  in  the  same  direction,  while  in  the  latter 
the  fetlock  and  hock  flex  in  opposite  directions  ;  the  knee,  in  addition, 
is  large,  round,  and  rather  flattened  in  front,  while  the  hock  is  flattened 


GEN  ERA  L  COXSIDKIL  /  TK  >\S.  287 

on  each  side,  and  offers  the  calcis  as  an  unmistakable  f;uide.  Thei-e  is 
also  a  diflerence  in  the  shape  of  the  feet. 

The  explorer  should  take  time  to  assure  himself  of  the  real  state  of 
atTairs,  and  conduct  his  examination  with  all  the  care,  attention,  and 
^'entleness  possible.  The  ftrtus  may  present  in  a  variety  of  positions, 
in  which  hind  and  fore  limbs  may  offer  first,  either  alone  or  together  ; 
and  in  the  case  of  twins  or  monstrosities,  the  limbs  of  ditTeront  crea- 
tures may  be  encountered  at  the  same  time.  If  the  presentation  is 
anterior,  the  head  will  be  met  with,  and  this  is  distinguished  by  the 
presence  of  the  mouth,  eyes,  and  ears  ;  if  it  is  a  posterior  presentation, 
then  we  have  the  rounded  croup,  tail,  hocks,  and  external  genital 
organs.  In  other  presentations,  the  neck  is  recognised  by  the  mane,  if 
it  be  a  Foal,  in  addition  to  its  shape,  whether  Foal  or  Calf ;  the 
shoulders  by  the  acromion  processes  and  withers  ;  the  chest,  by  the 
ribs  and  intercostal  spaces  ;  and  so  on.  In  addition  to  all  this,  the 
obstetrist  should  judge  at  the  same  time  of  the  volume  of  the  foetus, 
and  its  proportions.  This  is  particularly  necessary  in  the  case  of  mon- 
strosities ;  and  in  some  instances  it  is  most  dillicult  to  decide  what  the 
hand  may  alight  upon  in  such  an  examination.  Kopp  alludes  to  the 
case  of  a  Mare  which  he  examined  during  parturition,  when  he  found  a 
foetus  affected  with  hydrocephalus  to  such  a  degree,  that  for  a  long  time 
he  thought  the  head  was  the  thorax. 

It  cannot  be  too  strongly  impressed  upon  the  minds  of  those  who 
are  commencing  obstetric  practice,  that  such  an  exauiination  should 
be  so  complete  as  to  furnish  all  the  requirements  of  a  sound  diagnosis, 
on  which  the  indications  for  affording  assistance  can  b-  readily  based  ; 
and  this  exploration  can  only  be  said  to  be  complete  when  the  obstetrist 
is  as  well  acquainted  with  the  position  of  the  ftotus  and  the  obstacles 
to  its  birth,  as  if  he  had  scrutinized  the  whole  with  his  eyes. 

Then  he  can  decide  as  to  the  measures  which  are  indicated  by  his 
diagnosis,  in  order  to  bring  the  young  creature  into  one  of  the  best 
positions  for  delivery — either  natural  or  artificial — so  that  this  may  be 
effected  with  certainty  and  rapidity. 

These  measures  being  decided  upon,  a  methodical  jn-ocedure  is  as 
necessary  in  carrying  them  out,  as  in  exploring  the  vagina  and  uterus. 
The  required  assistants  should  be  selected,  and  to  each  should  bo 
allotted  his  share  in  the  operation,  in  which  he  ought  to  be  instructed 
briefly  and  clearly  ;  the  instruments,  cords,  and  other  apparatus  ought 
next  to  be  placed  m  readiness  ;  and  then  the  task  may  be  begun. 
When  this  is  once  commenced,  it  should  be  conducted  with  prudence, 
and  yet  with  decision,  all  irrational  and  unnecessary  manci-uvres  being 
avoided  ;  while  every  precaution  being  at  the  same  time  observed,  tliere 
should  be  no  fear  of  irritating  the  organs  or  textures  by  manipulation, 
as  they  appear  to  be  endowed  with  a  greater  amount  of  tolerance  at 
this  than  at  any  other  time. 

In  such  cases,  the  operator  should  bear  in  mind  that  his  task  is 
to  remove  or  overcome  everything  whicli  suspends,  hinders,  or  inter- 
feres with  the  natural  course  of  parturition,  and  to  bring  this  as  near 
as  possible  to  a  normal  termination.  He  should  understand  and  appre- 
ciate the  part  Nature  plays  in  this  act ;  only  seeking  to  second  her 
efforts  so  long  as  she  is  competent  to  attain  the  desired  end,  by  remov- 
ing any  obstacles  in  the  way.  When  Nature's  efforts  cease  to  be  effec- 
tive, tliey  should  be  imitated  as  closely  as  possible  ;  and  no  more  ought 
to  be  attempted  than  Nature  herself  would  have  accomplished  under 


288  DY ST  OKI  A. 

more  favourable  circumstances.  Art  should  never  undertake  what 
Nature  can  effect  ;  and  remembering  this,  the  obstetrist  will  not  only 
seek  to  learn  and  appreciate  the  powers  of  Nature,  but  will  be  in  a 
better  position  to  calculate  how  far  he  should  himself  interfere. 

Whatever  is  necessary  to  be  done  should  be  accomplished  without 
delay,  so  as  to  spare  the  animal  pain  and  exhaustion.  Sometimes  par- 
turition is  difficult  because  of  the  insufficiency  of  the  expelling  forces, 
as  we  have  already  noticed,  and  this  may  be  remedied  by  hygienic  and 
therapeutic  means ;  but  more  frequently,  while  the  expulsive  efforts  are 
normal,  there  is  undue  resistance.  To  increase  the  expelling  forces  in 
the  latter  instances  would  evidently  be  unwarrantable  and  injurious, 
and  we  must  attack  the  resistance  by  various  means,  according  to  its 
character.  Obstacles  in  the  genital  passages  must  be  overcome  either 
by  altering  the  position  of  the  foetus  hy  manipulation,  in  changing  the 
position  of  the  mother,  or  by  other  means  ;  and  it  often  happens  that 
we  must  combine  extraneous  force  with  the  expulsive  efforts  of  the 
mother,  in  order  to  extract  the  foetus  artificially.  At  other  times  the 
size  of  the  fcetus  must  be  reduced  by  embryotomy,  and  in  extreme  cases 
an  artificial  passage  has  to  be  made  for  it  by  hysterotomy  ;  though 
these  dangerous  operations  may  be  occasionally  averted  by  causing 
artificial  abortion,  at  a  period  when  the  foetus  is  sufficiently  small  to  be 
safely  expelled  through  a  contracted  pelvis. 

There  is  no  occasion,  in  veterinary  obstetrics,  to  hesitate  in  sacrific- 
ing the  life  of  the  foetus  in  serious  cases ;  and  in  this  respect  the 
practitioner  is  in  a  different  position  to  the  accoucheur  of  woman-kind. 
With  animals  there  is  only  a  material  loss  to  be  looked  at,  and  the 
foetus  must  always  be  greatly  inferior  in  value  to  the  mother  ;  therefore, 
in  order  to  save  the  latter,  it  is  more  profitable  to  sacrifice  the  former. 

Such  are  the  general  principles  w^hich  we  believe  to  be  applicable  to 
all  cases  of  dystokia.  These  cases  are  numerous  and  various — more 
varied  even  in  animals  than  in  woman  ;  and  in  order  to  study  them 
beneficially,  it  is  advisable  to  classify  them  in  a  methodical  manner. 
We  will  follow  Saint-Cyr  in  arranging  and  studying  them  in  the  order 
given  below. 

Synoptic  Table  of  the  Causes  ob'  Dystokia  in  the  Principal 
Domesticated  Animals. 

(Pelvic  Constriction. 
Displacement  and  altered  relations  of  the  Uterus. 
Morbid  alterations  of  the  Maternal  Organs. 
Umbilical  Cord. 

TExcess  in  Volume  ^ 

Independent    of    Excess  in  Growth  of  Hair 

the  Presenta--!  Diseases  Vof  the  Fcetus. 

tions,  by :  Monstrosities  I 

Iroetal  ...\  iMultiparity  j 

■n         J     i.  I  Anterior. 

Dependent      on    ,,     ,     . 
.  V,     -r,  .        Posterior, 

the  Presenta-  i-^         ,       , 
tions  •  Dorso-lumbar. 

ISterno-abdominal. 


Dystokia 


PVsroKIA  FROM  rELVlC  UOA.STRJrTJoX.  28» 

BOOK   I. 

MATERNAL  DYSTOKIA. 

TnK  pathology  of  parturition,  as  has  been  mentioned,  includes  disturb- 
ances produced  by  excessive  or  tumultuous  pains  and  too  feeble  pains, 
and  derangement  caused  by  too  great  an  obstacle  to  birth.  We  have 
sufticiently  described  the  first  ;  and  we  have  now  to  deal  with  the 
second,  in  so  far  as  the  mother  is  concerned.  The  maternal  obstacles 
to  parturition  are  related  to  the  too  great  resistance  offered  by  the 
parturient  passages,  either  in  their  hard  or  soft  parts.  These  obstacles 
have  been  grouped  in  the  preceding  table  under  the  heading  of  j^clvic  con- 
strictio)i,  displacement  or  change  in  relations  of  the  uterus,  and  morbid 
alterations  of  tlie  maternal  organs. 


CHAPTER  I. 

Dystokia  from  Pelvic  Constriction. 

DvbTOKiA  from  constriction  of  the  pelvis  is  sometimes  observed  in 
animals  ;'  though  less  frequently,  perhaps,  than  in  woman,  in  whom 
constitutional  causes  and  the  different  position  (vertical)  of  tliis  region, 
operate  largely  in  producing  diminished  dimensions  of  its  cavity.  Any 
alteration  in  the  dimensions  or  shape  of  the  pelvis,  whether  general  or 
partial,  is  a  more  or  less  serious  cause  of  dystokia,  and  in  some  cases 
may  render  delivery  absolutely  impossible.  A  pelvis  generally  reduced 
in  all  its  dimensions  is  sometimes  noticed  in  the  lai'ge,  as  well  as  tlie 
small  domesticated  animals. 

On  the  Continent  of  Europe,  this  has  been  observed  miOre  particularly 
among  some  of  the  small  common  breeds  of  Cattle — such  as  tlie 
liretonnc,  and  certain  of  the  grey  Swiss  breeds,  as  the  Fribourgeoise. 
These  have  the  ischia  pointed  and  the  tail  attached  high  above  them. 
Leconte  has  observed  this  conformation  in  animals  the  produce  of  a 
cross  between  large  Norman  Mares  and  pure-bred  Horses,  which 
have  a  sharp  croup.  There  is  often  a  relative  narrowness  of  tlie  pelvis 
in  animals  of  small  size  that  have  been  put  to  larger  males.  This  has 
been  witnessed  in  the  Mare  and  Bitch  ;  and  as  the  young  are  propor- 
tionately larger  than  the  pelvis  can  accommodate  in  parturition,  we 
have  here  a  cause  of  dystokia. 

An  abnormal  inclination  of  the  pelvis  has  been  supposed  by  some 
writers  to  exercise  an  unfavourable  inlluence  on  parturition,  but  this 
has  been  denied  by  others.  Provided  the  other  conditions  of  normal 
parturition  are  present,  no  ditViculty  should  be  experienced  in  delivery ; 
but  if,  added  to  this  state,  there  is  a  narrow  pelvis,  then  obstetrical 
operations  would  certainly  be  rendered  more  serious. 

Deformities  which  occasion  irregular  constriction  of  the  pelvic  cavity 

'  A  naturally  wide  polvis — <>r  r.ither  an  excea«  in  width--observfd  more  particularly 
in  aninialK  of  a  Ijinphatic  temperament,  and  especially  in  Cows,  al'-ni;  with  an  extra- 
ordinary -supplenesis  and  laxity  of  the  soft  parts  in  thi.s  region,  h.'us  the  inconvenience  «>f 
renderini;  i)4irturition  tmi  ea-^y,  it  would  .ipjiear.  For  this  facility  is  supposed,  and  not 
without  re;i'<on,  to  bring  about  such  complic.iti<ms  as  inversion  of  the  vagina  and  uterus, 
placenta)  retention,  and  even  predispose*,  according  to  some  authorities,  to  Titulary 
apoplexy  in  the  Cow,  and  metritis  in  the  other  animals. 

19 


290 


3fA  TERNAL  D YSTOKIA. 


are  various.  They  may  belong  to  the  bones  of  this  region,  or  to  its 
connective  tissue  ;  and  they  always  more  or  less  diminish  one  or  more 
of  the  dimensions  of  the  parturient  canal,  and  offer  an  obstacle  to  the 
passage  of  the  foetus.  These  cases,  however,  are  somewhat  rare  ;  they 
are  generally  found  to  be  due  to  complete  deformity  of  the  pelvis, 
exostoses,  fractures,  or  tumours. 

Complete  Deformity  of  the  Pelvis. 

As  has  been  observed,  complete  deformity  of  the  pelvis  is  very  rare 
among  animals.  "When  due  to  rachitism,  it  is  most  frequently  noted 
in  the  Pig.  In  this  animal  the  pelvis  is  sometimes  greatly  distorted, 
and  not  unfrequently  there  is  accompanying  deviation  in  the  vertebral 
spine.     This  condition  is  seldom  seen  in  other  creatures. 

Saint-Cyr  informs  us  that  in  the  Museum  of  the  Lyons  Veterinary 
School,  there  is  the  pelvis  of  a  Mare  and  another  of  a  Female-Ass,  which 


Fig.  81. 
Completely  Defoejied  Pelvis  :   Mare. 


present  a  very  remarkable  degree  of  general  constriction,  and  which 
must  have  offered  a  very  serious  obstacle  to  parturition  if  the  animals 
had  ever  been  pregnant.  That  of  the  ]\Iare  (Fig.  81)  is  singularly 
depressed  on  both  sides,  the  ischia,  and  especially  the  pubis,  being 
atrophied  with  respect  to  size.  The  oval  foramina  and  cotyloid 
cavities  are  close  together,  the  floor  of  the  pelvis  is  extremely  con- 
tracted and  angular,  and  the  pubic  arch  is  hypertrophied.  In  this 
specimen  there  is  a  very  notable  diminution  in  the  different  diameters 
of  the  pelvic  cavity  ;  the  supero-inferior,  instead  of  being  about  Qh  inches 
is  only  about  6,  and  the  bis-iliac  diameter  is  but  4J,  instead  of  being 
7J  to  8  inches. 

The  diagnosis  of  this  deformity  ought  not  to  be  difficult,  especially 
when  it  is  so  marked  as  in  this  instance.  Vaginal  exploration  should 
soon  discover  it,  and  the  diminution  in  size  may  be  approximately 
determined  by  spreading  the  fingers,  and  in  this  way  measuring  the 


DYSTOKIA  FIKHI  fELl'IC  CONSTRICTION.  291 

two  diameters.     The  dia^'nosis  may  not  be  so  easy,  however,  when  the 
canal  is  partly  or  wholly  occupied  by  the  fcetus. 

Another  kind  of  deformity  described  by  several  authorities,  consists 
in  a  depression  of  the  sacrum  (lordosis),  which  is  recognised  externally 
by  an  abrupt  hollow  existing  towards  the  posterior  third  of  the  croup. 
By  rectal  exploration  the  sacrum  is  found  to  constitute  a  projection 
in  the  roof  of  the  pelvis,  at  the  lower  face  of  the  bone,  and  this 
diminishes  the  supero-inferior  diameter  of  the  cavity  to  an  extent 
corresponding  to  the  protuberance. 

Exostoses. 

Exostoses  on  the  pelvic  bones,  and  particularly  when  they  project 
into  the  pelvic  cavity  or  encroach  on  its  openings,  may  become  a 
more  or  less  serious  obstacle  to  the  passage  of  the  fuetus  (Fig.  82). 


ffe= 


.^ 


Pelvic  Exostosls. 

Favre,  of  Geneva,  states  that  bony  tumours  situated  beneath  the 
croup,  at  the  inner  and  upper  surface  of  the  pelvis,  render  parturition 
ditBcult,  even  if  they  are  not  large  and  near  the  root  of  the  tail.  lie 
atlds  that  such  cases  are  not  rare  in  old  Mares. 

Fractures. 

Like  the  exostoses,  more  or  less  completely  consolidated  fractures 
of  the  sacrum  or  coxa;,  which  have  been  united  by  an  irregular  callus, 
may,  for  the  same  reason,  prove  an  obstacle  to  birth.  As  animals 
suffering  from  a  fracture  of  any  of  the  bones  of  this  region  are  often 
destroyed,  laborious  parturition  from  such  a  deformity  is  not  so  frequent 
as  from  some  other  causes  ;  nevertheless,  it  does  occur  now  and  again. 

It  must  be  remembered  that  fractures  of  the  pelvic  bones  are  some- 
what frequent  in  animals,  and  may  occur  at  any  part.  The  most 
common  seat  of  fracture  is  perhaps  the  external  angle  of  the  ilium  ; 


292 


MATERNAL  JDV^^TOAIA. 


and  the  least  frequent,  the  posterior  part  of  the  ischium  and  the  pubis. 
Fracture  of  the  sacrum  and  the  internal  angle  of  the  ilium  is  also  very 
rare.  Simultaneous  compound  fracture  of  the  two  coxse  has  been 
observed  in  two  cases  by  Lafosse ;  in  one  case  by  Crepin,  and  in 
another  by  Philippe. 

D'Arboval  has  witnessed  a  fracture  of  the  pubis  in  a  Dog ;  and 
Carsten  Harms  alludes  to  fractures  of  the  ischium  occurring  in  the 
Mare  and  Cow.  The  latter  authority  has  likewise  found  the  two  iliums 
of  a  Goat  united  at  their  posterior  angle  by  a  mass  of  bone  as  thick  as 
a  finger.  Professor  Ercolani  has  well  described  twelve  important 
cases  of  pelvic  fracture  exhibited  in  the  Pathological  Museum  of  the 
Bologna  University. ^  The  first  of  these  is  a  compound  fracture  of  the 
ossa  innominata,  the  solution  of  continuity  involving  all  the  border  of 
the  foramina  ovale  in  the  pelvis  of  a  Mare ;  the  second  is  a  fracture  of 
the  left  ilium  near  its  neck,  and  extending  to  the  cotyloid  cavity,  also 


Fig.  S3. 
Fkactuke  of  the  Pelvis. 


in  the  pelvis  of  a  Mare ;  the  third  is  a  compound  comminuted  fracture 
of  the  left  innominate  bone  in  a  Mare,  the  piece  being  divided  into  six 
principal  portions  ;  the  fourth  is  a  compound  fracture  of  the  right  ilium 
of  a  Mare,  extending  to  the  arch  of  the  pubis  on  the  left  side  ;  the  fifth 
is  a  longitudinal  fracture  of  the  right  ilium  of  a  Filly  ;  the  sixth,  a 
fracture  of  the  external  angle  of  the  right  ilium  and  the  left  ischiatic 
tuberosity  of  a  Mare ;  the  seventh  is  a  slightly  oblique  fracture  of  the 
ilium  extending  to  the  cotyloid  cavity  of  a  Mare  ;  the  eighth  is  a  com- 
pound fracture  of  the  pelvis  of  a  Mare,  involving  the  internal  angle  of 
the  ilium,  the  external  part  of  the  ischial  tuberosity,  the  arch  of  the 
pubis,  and  the  union  of  the  pubis  with  the  ischium  ;  the  ninth  is  a 
fracture  of  the  superior  and  posterior  crest  of  the  ihum  of  a  Mare ; 
the  tenth  is  an  oblique  fracture  of  the  neck  of  the  left  ilium  of  a  Mare  ; 
the  eleventh  is  a  compound  fracture  of  the  right  coxa  of  a  Mare,  the 

1  Descrizione  Metodica  dei  Preparati  del  Museo  di  Anatomia  Patologica  Comparata 
della  R.  University  di  Bologna.  Memoria  I.  Bologna,  1867,  p.  38  : — Fratture  della- 
Pelvi. 


JiYSTOKIA   Fi:OM  I'ELl'IC  CONSTRICTION.  IW 

cotyloid  portion  being  completely  isolated  from  the  ischium,  ilium, 
and  pubis  ;  the  twelfth  is  a  fracture  of  the  external  angle  of  the  ilium. 
Lanzillotti-Buonsanti  states  that  the  Pathological  Museum  of  the 
Milan  Veterinary  School  contains  a  coxa  which  shows  a  fracture  of 
the  neck  of  the  ilium,  with  overlapping  of  the  disunited  portions;  and 
also  a  pelvis  in  wliich  the  pubic  portion  of  the  symphysis  has  sustained 
a  comminuted  fracture. 

Much  will  depend,  of  course,  upon  the  nature  and  the  scat  of  the 
fracture.  When  it  is  only  the  outer  angle  of  the  ilium  (point  of 
haunch),  and  even  when  the  fractured  bone  is  displaced  by  the  action 
of  the  small  oblique  muscles  of  the  abdomen  and  the  fascia  lata,  pro- 
ducing nmch  external  deformity,  no  gi^eat  effect  can  be  produced  on 
the  act  of  parturition,  as  this  part  has  notliing  to  do  with  the  pelvic 
cavity.  But  when  the  whole  of  one  side  of  the  haunch  is  lower  than 
the  other,  delivery  is  then  undoubtedly  interfered  with,  and  perhaps 
to  a  most  serious  extent ;  inasmuch  as  some  one  of  the  parts  which 
concur  in  forming  the  pelvic  cavity  is  implicated  in  the  fracture,  and 
consequently  the  external  deformity  corresponds  to  an  internal  diminu- 
tion and  irregularity  in  its  diameters,  from  displaced  fragments  of  bone, 
overlapping  of  fractured  ends,  the  approach  of  the  sacrum  to  the  pubis, 
and  consequent  lessening  of  the  inlet  of  this  cavity,  as  well  as  to  the 
more  or  less  voluminous  deposit  of  bone  around  the  fractured  portions 
(Kig.  <s3).  Many  cases  are  on  record  of  ditticulty  in  parturition  from 
this  deformity. 

Fractures  of  the  pelvis  are  by  no  means  infrequent  in  animals,  and 
are  due  to  falls,  crushing,  blows,  or  other  causes  ;  and,  as  the  above 
instances  testify,  they  may  prove  insurmountable  obstacles  in  parturi- 
tion. Female  animals  which  have  sustained  an  injury  of  this  kind 
should  not  be  employed  for  breeding  purposes,  unless  a  careful  exami- 
nation has  shown  that  it  has  not  altered  the  pelvic  diameters  in  such  a 
way  as  to  render  delivery  difficult. 

Such  an  alteration  may  be  diagnosed  by  depression  of  the  haunch  or 
croup,  and  lameness  to  a  more  or  less  appreciable  extent ;  while  rectal 
or  vaginal  exploration  will  discover  the  presence  of  a  variable-sized 
hard  tumour  forming  part  of  the  bone,  and  projecting  into  the  cavity. 
Tl>e  previous  history  of  the  animal  may  also  aid  in  confirming  the 
diagnosis. 

Fractures  of  the  pelvis  may  also  take  place  durin</  parturition,  and 
RuetT  mentions  two  instances  in  which  they  have  occurred  sponta- 
neously during  very  violent  labour  pains. 

In  the  latter  instances,  there  may  have  existed  a  predisposition  due 
to  a  diseased  condition  of  the  bones — a  predisposition  not  uncommon 
in  breeding  animals. 

TUMDUiiS    IN    THK    PkLVIC    C.WITY. 

Tumours  of  various  kinds — such  as  fibromata,  melanotic  and  cancerous 
tumours,  in  addition  to  those  of  a  bony  character  due  to  injury — 
may  prove  a  cause  of  dystokia ;  abscess  may  also  co-exist  with 
pregnancy,  and  be  a  source  of  ditliculty  in  parturition.  But  that  form 
of  melanosis  which  appears  in  grey  animals,  and  particularly  manifests 
itself  in  the  form  of  tumours  at  the  root  of  the  tail,  around  the  anus, 
and  in  the  connective  tissue  of  the  pelvis,  should  oflfer  the  most  frequent 
obstacle  to  delivery. 


294  MATERNAL  DYSTOKIA. 

A  case  has  occurred  in  my  own  experience,  in  which  an  aged  Mare,  nearly  white, 
belonging  to  a  friend,  was,  on  my  recommendation,  taken  by  a  farmer,  who  attempted 
to  breed  from  it ;  but  at  the  termination  of  pregnancy,  and  during  parturition,  it  died 
without  giving  birth  to  the  Foal. 

When  opened,  it  was  found  that  delivery  could  not  take  place  owing  to  great  masses 
of  melanotic  deposit  in  the  pelvic  cavity.  When  given  to  the  farmer  there  were  only  a 
few  small  nodular  masses  observed  about  the  tail  and  vulva. 

Leconte  [Mem.  de  la  Societi  Centrale  de  Med.  VeUrinaire,  vol.  v.,  p.  180)  was  con- 
sulted with  regard  to  a  Mare,  about  twelve  years  old  and  about  five  months  pregnant, 
which  bad  such  a  large  melanotic  deposit  around  the  anus  that  defecation  was  impossible 
without  assistance.  Rectal  exploration  discovered  a  very  voluminous  tumour  situated 
at  the  left  side  of  the  pelvis,  in  the  centre  of  which  a  slight  fluctuation  could  be  per- 
ceived. With  a  view  to  accelerate  the  maturation  of  the  tumour,  vesicatory  agents  were 
applied  to  the  left  flank  and  croup;  five  days  later  the  tumour  was  larger  and  more 
fluctuating,  and  it  was  punctured,  when  about  two  pints  of  a  dark,  purulent,  but  almost 
odourless  fluid  escaped.  On  the  hand  being  introduced  into  the  softening  mass,  a 
portion  was  found  about  the  size  of  two  fists,  and  partially  detached  ;  this  was  removed, 
and  weighed  nearly  seven  pounds.  In  twelve  days  the  wound  had  cicatrised  ;  and  in 
five  and  a  half  months,  gestation  being  nearly  completed,  another  melanotic  tumour, 
situated  somewhat  deeply  towards  the  right  side  of  the  pelvic  cavity,  was  also  removed. 
Cicatrisation  took  place  rapidly,  and  delivery  occurred  without  any  difficulty. 

Cases  have  been  recorded  in  which  a  large  quantity  of  hardened  fwces  in  the  rectum 
was  a  cause  of  dystokia. 

Indications  for  Surgical  Treatment. 

The  surgical  treatment  of  those  cases  in  which  dystokia  is  due  to 
any  of  the  causes  just  enumerated,  will  greatly  depend  upon  circum- 
stances, not  onl}'  with  regard  to  the  kind  of  treatment,  but  also  as  to 
its  expediency. 

For  instance,  if  total  or  partial  deformity  of  the  pelvis  is  present  to 
such  a  degree  as  to  endanger  the  life  of  the  animal  during  parturition, 
or  if  there  exist  obstacles  due  to  fractures  or  tumours,  and  which  can- 
not be  removed,  then  it  may  be  advisable,  if  the  animal  be  fit  for  food 
and  in  good  condition,  to  send  it  to  the  butcher ;  or  if  it  be  pregnant 
and  in  inferior  condition,  to  produce  abortion  at  a  sufficiently  early 
period.  But  if  parturition  has  already  commenced,  then,  of  course, 
surgical  or  obstetrical  treatment  must  be  had  recourse  to  ;  and  the 
nature  of  this  will  depend  upon  the  constriction  of  the  pelvic  cavity, 
and  the  kind  of  obstacle  which  causes  the  diminished  space.  The 
indications  are  :  to  forcibly  extract  the  foetus  through  the  narrowed 
2}assage ;  to  widen  the  i^assage ;  to  diminish  the  size  of  the  fcet^is  ;  or  to 
make  an  artificial  ^oassage.  But  as  artificial  abortion  may  be  necessary 
during  pregnancy,  should  the  veterinarian  be  consulted,  and  from 
examination  be  led  to  conclude  that  parturition  will  be  dangerous  or 
impossible,  we  shall  include  this  as  one  of  the  indications,  and  com- 
mence with  it. 

1.  Artificial  Aboetion.  —  Artificial  abortion  may  be  rendered 
necessary  not  only  during  pregnancy,  when  the  condition  of  the  pelvic 
cavity  leads  to  the  supposition  that  delivery  at  full  term  is  dangerous 
or  impossible,  but  also  in  metrorrhagia,  serious  inversion  of  the  vagina, 
hydramnios,  debility,  or  exhaustion,  etc. 

Artificial  abortion  may  be  produced  in  several  ways,  and  is  generally 
more  successful  with  the  Mare  than  the  Cow,  because  of  the  greater 
excitability  of  the  cervix  uteri,  and  the  readiness  with  which  it  can  be 
dilated  in  that  animal.  Three  modes  of  procedure  have  been  adopted 
with  the  domesticated  animals,  each  being  attended  with  success,  and 
each  offering  special  advantages  in  particular  cases.     These  are  :  irrita- 


DYSTOKIA  FROM  PELVIC  CONSTRICTION.  29r. 

tion  of  the  cervix  uteri  by  the  hand;  puncture  of  the  envelopes;  and 
caginal  irriijations. 

Dujital  Irritation  of  the  Cervix  Uteri. — Tliis  is  accomplished  in  the 
following  manner  :  The  hand  is  introduced  into  the  vagina,  and  first 
one  finger,  then  two  are  insinuated  into  the  os  by  a  semi  rotatory 
movement,  and  finally  the  whole  hand  is  inserted,  as  the  part  dilates. 
If  the  operation  is  repeated  several  times,  labour  pains  soon  ensue.  As 
the  manual  exertion  is  rather  fatiguing,  the  sponge  tent,  elastic  bags, 
or  other  dilators  of  the  os  uteri  may  be  employed.  A  better  and  more 
successful  mode  is  the  introduction  of  a  long  elastic  catheter,  strong 
pieces  of  catgut,  or  even  a  quill,  between  the  fcctal  membranes  and  the 
uterus.  Labour  may  be  promoted  by  passing  the  hand  through  the 
OS,  and  separating  the  membranes  from  the  uterus. 

This  procedure  is  to  be  recommended  for  Mares,  the  uterus  of  which 
is  so  irritable  that  abortion  sometirnes  takes  place  after  manipulations 
in  the  rectum  for  some  time.  In  ordinary  cases,  the  expulsion  of  the 
foetus  occurs  in  from  six  to  twelve  hours.  It  is  not  applicable  to  Cattle, 
Harms  having  once  manipulated  a  Cow  in  this  manner  for  a  whole 
night  without  producing  any  result ;  neither  is  it  to  be  recommended 
for  smaller  animals. 

Puncture  of  the  FuHal  Envelopes. — The  envelopes  are  punctured  by 
pushing  a  long,  and  more  or  less  pointed,  sound  through  the  os  uteri, 
into  the  "  water-bag";  the  liquor  amnii  soon  escapes,  and  the  uterine 
contractions  begin.  P^xpulsion  of  the  fa-tus  follows  in  from  twelve  to 
forty-eight  hours.     This  method  is  particularly  etficacious  with  Cattle. 

Vaginal  Irrigations. — Irrigation  of  the  vagina  with  cold  water  (oi- 
water  at  a  temperature  of  about  90°  Fahr.),  made  by  means  of  a  syringe 
or  injection-tube,  and  continued  for  a  quarter  of  an  hour  every  three 
hours,  will  induce  labour  pains  about  the  fourth  injection,  and  effect 
the  expulsion  of  the  foetus  towards  the  second,  third,  or  fourth  day. 
This  method  is  more  particularly  adapted  for  the  smaller  animals  ; 
though  it  will  also  succeed  with  the  larger.  The  only  danger  to  be 
apprehended  from  it  is  an  attack  of  metro-peritonitis. 

2.  Forcible  Extraction. — The  first  impulse  which  presents  itself 
when  the  foetus  meets  with  any  obstacle  to  its  passage  through  the 
pelvis,  is  to  "  force  it  through  ";  and  it  is  this  impulse  which  is  carried 
into  execution  by  unscientific  people.  Too  frequently,  however,  it 
happens  that  by  this  procedure  some  portion  of  the  foetus  is  so  tightly 
wedged  in  the  pelvis  that  no  amount  of  force  is  capable  of  moving  it 
farther,  and  renders  absolutely  impossible  those  other  operations  whicli 
might  be  the  means  of  saving  at  least  the  mother  or  ofi'spring,  or 
perhaps  both.  For  this  reason  it  is,  that  the  owner  of  an  animal  in 
this  condition  should  not  himself,  nor  sutler  others  to,  pull  at  the  fatus. 
or  attempt  any  similar  mancjcuvre,  until  the  arrival  of  the  veterinarian. 
And  the  latter  has  a  difVicult  task  before  him  in  solving  the  problem  as 
to  whether  he  ought  to  extract  the  foetus  forcibly,  or  resort  immediately 
to  the  other  measures  prescribed.  This  will  render  a  careful  examina- 
tion necessary,  in  order  to  ascertain  the  nature,  seat,  and  degree  of 
constriction. 

The  animal  is  making  excessive,  nay  violent  efforts,  and  the  foetus 
may  be  in  a  favourable  position,  but  it  does  not  advance  through  the 
pelvis.  The  parent  is  restless  and  sighs  deeply ;  the  flanks  are 
covered  with  perspiration,  and  sometimes,  through  sheer  exhaustion,  it 


296  MATERNAL  DYSTOKIA. 

falls,  utterly  prostrated  by  its  efforts.  As  the  uterine  contractions  gene- 
rally increase  in  violence  in  the  presence  of  obstacles  to  birth,  there  is 
the  gravest  danger  to  mother  and  offspring. 

In  such  a  case,  the  veterinarian,  having  introduced  his  hand  into  the 
pelvis  in  the  ordinary  way,  endeavours  to  discover  if  the  obstacle  is 
there.  With  this  object  in  view,  he  closes  his  hand  to  try  if  he  can 
move  his  shut  fist  about  in  every  direction,  and  with  ease.  Then  stretch- 
ing out  the  thumb,  he  can  approximately  judge  the  distance  which 
intervenes  between  opposite  points  of  the  pelvic  circumference,  and  in 
this  way  appreciate  to  a  certain  degree  whether  a  moderate-sized  foetus 
could  pass  through.  For  if  the  pelvis  is  so  contracted  that  the  closed 
hand  can  scarcely  move  about  in  it,  it  will  be  needless  to  attempt  forcible 
extraction,  as  the  foetus  cannot  be  brought  through. 

Saint-Cyr  has  calculated  that  the  closed  hand  of  an  adult  man  repre- 
sents an  irregular  mass  measuring  between  three  and  four  and  a  half 
inches  in  diameter;  but  the  head  of  a  Calf,  in  its  supero-inferior  diameter, 
measures  from  seven  to  ten  inches,  and  four  to  five  inches  in  transverse 
diameter.  It  is  therefore  obvious  that  the  head  of  a  Calf  could  not  pass 
through  an  aperture  in  which  the  hand  cannot  move  freely  ;  and  much 
less  the  chest  of  a  Foal,  which  is  at  least  twelve  to  thirteen  inches  in 
depth. 

It  is  also  necessary  to  take  into  consideration  the  cause  of  dystokia. 
If  this  is  due  to  a  complete  deformity  of  the  pelvis,  then  the  case  is 
serious,  and  there  is  little  hope  of  traction  alone  overcoming  the  difti- 
culty.  If  it  is  due  to  a  tumour,  and  localised,  then  it  must  be  ascertained 
if  this  is  of  a  bony  character,  arising  from  an  exostosis  or  fracture ;  or 
if  it  is  movable  and  independent.  If  the  latter,  the  case  is  not  so 
serious,  and  especially  if  the  tumour  is  connected  with  the  sacro-sciatic 
ligament  ;  as  it  may  be  pushed  out  of  the  way  of  the  foetus,  and  birth 
take  place. 

As  Saint-Cyr  insists,  all  these  considerations  should  be  weighed  before 
deciding  to  terminate  parturition  by  mechanical  traction  ;  for  if  the  im- 
possibility of  accomplishing  it  by  this  means  is  discovered  when  too 
late,  the  other  operations  are  rendered  more  difficult  and  dangerous,  in 
consequence  of  the  ineffectual  attempts  at  forced  extraction. 

If  extraction  of  the  entire  foetus  is  discovered  to  be  practicable  and 
the  position  is  favourable,  then  there  should  not  be  much  difficulty  in 
effecting  delivery,  which  may  be  achieved  as  in  ordinary  circumstances. 
It  will  be  much  facilitated,  should  the  foetus  and  the  passage  be  dry  and 
tenacious,  if  these  are  lubricated  with  oil  or  soapy  fluid. 

If,  however,  the  foetus  has  become  wedged  in  the  passage  and  cannot 
be  pulled  through,  it  may  be  useful  to  push  it  back  a  little  into  the 
uterine  cavity,  and  then  lubricate  it  and  the  vagina  with  some  oily 
matter  to  assist  movement,  before  another  attempt  is  made. 

3.  Enlargement  of  the  Passage. — This  is  nearly  always  impossible 
in  practice,  unless  the  cause  be  a  tumour  which  can  either  be  excised 
or  moved  temporarily  out  of  the  way,  so  as  to  permit  dehvery. 

4.  Diminution  of  the  Size  of  the  Fcetus. — With  the  domestic 
animals,  as  we  have  repeatedly  said,  thex-e  are  no  moral  considerations 
to  oppose  us  when  it  comes  to  a  question  of  sacrificing  the  foetus  to  save 
the  life  of  the  parent.  And  with  the  Mare  there  should  be  no  hesitation 
in  this  direction,  when  a  careful  examination  has  proved  delivery  of  the 


DYSTOKIA   F/:ti.]f  l>lsl'LA<'h:.\i EST  i>F  Tllh:  CTERUS.  -I'M 

living  or  entire  fct'tus  to  he  impossible,  particularly  when  we  remember 
that  the  young  creature  soon  perishes. 

With  the  Cow,  however,  the  case  is  somewhat  dillVreiit,  as  when 
delivery  is  unsuccessful  this  animal  may  be  killed  and  utilised  as  food. 
Kmbryotomy  is,  nevertheless,  often  resorted  to  before  the  case  is  con- 
sidered hopeless ;  and  not  at  all  infrequently  with  good  results,  so  far 
as  the  Cow  is  concerned. 

We  shall  treat  of  embryotomy  hereafter ;  but  it  may  be  useful  to 
mention  here  that,  in  an  anterior  presentation,  removal  of  one  or  both 
of  the  fore  limbs  at  the  scapula  of  the  fditus,  will  often  allow  the  remain- 
ing portions  to  be  removed  by  traction.  With  a  posterior  presentation, 
excision  of  one  hind  leg  is  frequently  suflicient  to  permit  the  body  of  the 
fcttus  to  be  drawn  through  the  passage. 

o.  Establish  .\n  Artifici.vl  Pass.\ge  ioh  thk  Fcetus. — When  all 
the  preceding  means  have  been  recognised  as  impracticable  or  too 
dangerous,  there  yet  remains  another  which,  though  it  may  place  the 
life  of  the  mother  in  great  jeopardy,  and  should  be  considered  only  as 
a  last  and  a  most  serious  expedient,  may  be  I'esorted  to :  this  is  the 
Cifsarian  section,  or  gastro-hysterotomy — an  operation  to  be  described 
hereafter.  It  may  only  be  noted  in  this  place,  that  a  formidable  opera- 
tion, such  as  this  is,  should  be  resorted  to  early,  and  before  the  female  is 
much  exhausted  by  inellicacious  manipulations  and  impotent  labour 
pains. 


CHAPTER  II. 


Dystokia  from  Displacement  or  Changed  Relations  of  the 

Uterus. 

Delivkry  may  be  rendered  dillicult  by  displacement  or  altered  relations 
of  the  organ  containing  the  foetus — the  uterus,  either  from  hernia  of 
that  organ  through  a  natural  or  accidental  opening  in  the  abdominal 
parietes  ;  from  deviations  in  its  direction,  whereby  the  os  is  no  longer 
in  the  axis  of  the  pelvis;  or  torsion  of  the  organ,  due  to  its  having  made  a 
revolution  or  become  twisted  on  its  own  axis — a  singular  displacement 
that  well  merits  attention. 

Hernia  of  the  Utekis — Hysterocele. 

Every  kind  of  ventral  hernia  may  be  viewed  as  more  or  less  tending 
to  dystokia,  from  the  important  share  the  abdominal  muscles  assume 
in  the  act  of  parturition  ;  and  when  there  is  a  tendency  to  hernia  of  any 
of  the  organs  in  this  cavity,  or  when  a  hernia  really  exists,  this  is  likely 
to  be  increased  during  labour,  and  may  complicate  delivery.  But  the 
case  is  generally  all  the  more  serious  if  the  displaced  organ  is  the  gravid 
uterus  itself. 

Hernia  of  the  uterus  is  certainly  not  a  vet}'  common  accident;  never- 
theless, it  is  far  from  being  rare,  if  we  are  to  judge  by  the  instances 
recorded  in  veterinary  literature,  and  it  has  been  observed  in  the  Mare, 
Cow,  Sheep,  Sow,  Goat,  and  Bitch— in  all  the  more  important  domesti- 
cated animals,  in  fact,  and  has  often  proved  a  very  serious  obstacle  to 
parturition. 


298 


MATERXAL  DYSTOKLA. 


Origin  and  Symptoms  in  Uniparous  Animals. 

The  symptoms  and  other  features  of  this  accident  rather  differ  [in 
uniparous  and  multiparous  animals.  In  such  uniparous  creatures  as 
the  Mare  and  Cow,  hernia  of  the  uterus  is  generally  not  observed  until 
pregnancy  is  pretty  well  advanced— towards  the  eighth  or  ninth  month, 
or  even  later  in  the  Mare,  and  the  seventh  or  eighth  month  in  the  Cow. 
This  delay  is  evidently  due  to  the  circumstance  that,  in  the  non-preg- 
nant animal,  the  uterus  is  small,  and  clnpoly  fixed  by  its  ligaments  to 
the  sub-lumbar  region;  so  that  if  Lhcro  is  a  lircaeh  in  the  abdominal 
walls,  it  is  either  the  intestine  or  omentum  which  pa-ses  through  it. 
When,  however,  pregnancy  is  advanced,  the  groat  size  of  the  organ, 


Fig.  84. 

Uterine  Hernia  :  Mare. 

A,  B,  Hernial  Tumour ;  C,  Teat  carried  down  bj'  the  Tumour. 


together  with  its  weight,  brings  it  in  contact  with  the  parietes  of  the 
peritoneal  cavity,  and  if  there  happens  to  be  a  weak  part  or  a  rupture, 
no  matter  how  slight,  the  heavy  uterus  gradually  forces  itself  through, 
and  may  in  time  escape  altogether  from  the  abdomen,  along  with  other 
viscera. 

It  would  seem  that  laceration  of  the  abdominal  walls  may  occur  in 
other  ways  than  through  external  traumatic  influences,  or  any  appre- 
ciable occasional  cause  ;  and  it  would  also  appear  that,  in  some  animals, 
there  is  a  kind  of  predisposing  relaxation  or  softening  of  the  abdominal 
muscles,  which  leads  to  their  being  unable  to  support  the  gradually 
increasing  strain  thrown  upon  them  by  the  heavy  uterus,  and  its  often- 
times very  lively  and  energetic  inmate.     The   muscles  are  stretched 


DYSTOKIA  FlinM  lilSl'LACKMEXT  I'F  THE  I'TKIU'S. 


l>i»!) 


and  attenuated,  their  fibres  are  separated  and  some  of  them  rupture, 
and  in  this  way  is  formed  a  rent  which  gradually  enlarges  from  the 
increasing  pressure.  Then  a  tumour  appears  externally  and  towards 
the  lower  part  of  the  abdomen,  though  always  a  little  to  one  side — 
usually  the  left  in  the  ^lare,  the  right  in  the  Cow,  and  not  infrequently 
in  front  of  the  pulns,  in  the  mammary  region.  This  tumour,  when  first 
noticed,  is  about  the  size  of  a  child's  head,  and  not  clearly  defined  ;  but 
it  rapidly  enlarges,  and  in  a  few  days  may  acquire  prodigious  dimen- 
sions— descending  as  low  as  the  hocks,  or  even  nearly  to  the  ground, 
pushing  the  mamnue  to  one  side  or  carrying  them  with  it,  extending 
as  high  as  the  vulva  and  almost  as  far  forward  as  the  sternum,  giving 
to  the  abdomen  a  singular  appearance  (Fig.  84). 

These  extraordinary  herniao  are  most  frequently  witnessed  in  Cows 
(Fig.  85),  though  several  veterinarians — among  others,  Lecoq,  Binz, 
Leconte,  Serres,  Lafosse — have  seen  them  in   Mares.     In  very  many 


Fig.  85. 
Uterine  Hebnia  :  Cow. 


instances  they  are  due  to  violent  efforts,  kicks,  blows,  and  other  external 
injuries. 

When  the  hernia  is  recent,  and  especially  if  it  occurs  in  the  mammary 
region,  it  is  generally  surrounded  by  a  considerable  ocdematous  swell- 
ing. This  swelling  disappears  after  parturition,  though  the  hernial 
tumour  itself  does  not  diminish  in  volume,  the  digestive  organs  having 
occupied  the  space  previously  held  by  the  fu?tus.  Then  the  animal  has 
a  still  more  singular  appearance,  perhaps ;  for  owing  to  this  emptying 
of  the  abdominal  cavity,  the  belly  is  wonderfully  retracted  and  the 
flanks  are  so  drawn  together  that  the  fingers  may  be  made  almost  to 
touch  througli  them  on  each  side. 

Before  parturition,  palpation  of  the  tumour  enables  the  foetus  to  be 
distinguished — the  head,  limbs,  and  body  being  felt,  while  its  movements 
are  perceptible  by  the  eye  or  hand. 

As  a  rule,  and  contrary  to  what  might  be  surmised,  this  uterine  hernia 
does  not  appear  to  cause  any  loss  of  condition  or  inconvenience  except 
in  progression,  which  it  interferes  with,  and  causes  the  animal  to  move 


300  MATERNAL  DY ST  OK  I  A. 

with  the  hind  legs  wide  apart.     Aptitude  for  labour  is  also  somewhat 
impaired,  as  may  be  imagined. 

Origin  and  Symptoms  in  Mnltiparous  Animals. 

As  has  been  mentioned,  uterine  hernia  is  observed  in  multiparous 
animals,  but  its  manner  of  production  would  appear  to  be  different 
to  what  it  is  in  uniparous  creatures,  this  taking  place  in  the  interval 
between  gestations.  The  length  and  mobility  of  the  cornua  in  such 
an  animal  as  the  Bitch,  together  with  their  close  proximity  to  the 
abdominal  walls,  sufficiently  explain  how  they  may  pass  into  an 
opening  in  these  walls.  There  is  formed,  at  first,  a  small  tumour  the 
size  of  a  pigeon's  or  hen's  egg  ;  this  tumour  is  soft,  indolent,  more 
or  less  easily  reduced,  and  attracting  perhaps  little  or  no  attention 
while  the  animal  is  unimpregnated,  it  remains  stationary.  After 
impregnation,  however,  it  daily  acquires  larger  dimensions ;  one  or 
more  ova  have  descended  into  the  hernied  portion,  localised  them- 
selves there,  and  become  developed  into  foetuses  without  the  Bitch 
showing  much,  if  any  disturbance. 

The  usual  seat  of  the  hernia  is  in  the  mammary  region,  to  the  right 
or  left  of  the  linea  alba,  though  it  may  be  also  inguinal,  or  even  vulvar. 

An  example  of  inguinal  uterine  hernia  will  be  given  hereafter ;  we 
will  now  briefly  allude  to  a  case  of  vulvar  uterine  hernia  described  by 
Eainard.  In  this  instance  the  uterus,  which  had  been  apparently 
carried  through  the  inguinal  ring,  was  pushed  backwards  through  the 
connective  tissue,  and  appeared  as  a  tumour  at  the  vulva.  The  owner 
of  the  animal,  not  knowing  what  the  swelling  contained,  opened  it  by 
means  of  a  penknife  ;  in  this  way  there  was  formed  a  fistulous  wound, 
from  which  a  viscid  fluid  escaped.  Eainard  incised  this  fistula,  and 
found  beneath  the  skin  a  second  membrane  having  some  analogy  to 
it,  and  which  afterwards  proved  to  be  the  uterus  ;  to  the  inner  face  of 
this  there  adhered  a  reddish-brown  vascular  network,  which  was 
the  placenta,  and  which  was  easily  detached  by  the  finger ;  within  it 
appeared  a  transparent  bladder — the  amnion — already  slightly  perfor- 
ated, and  looking  like  the  envelope  of  a  cyst.  Having  opened  this, 
there  escaped  a  quantity  of  fluid,  and  a  foetus  apparently  three  or  four 
weeks  old.     The  Bitch  died  next  day. 

When  the  hernia  occurs  in  the  abdominal  region,  it  usually  appears 
as  an  indolent  tumour,  the  skin  covering  it  being  destitute  of  redness, 
and  not  attenuated  in  any  way  ;  the  tumour  itself  is  soft  and  fluctuating 
at  different  points  where  the  liquor  amnii  is,  but  firm  and  resisting  at 
others  where  the  foetus  chances  to  be. 

It  may  be  noted  here,  that  there  may  be  other  herniae  of  the  uterus 
besides  ventral.  For  instance,  Gelle  describes  a  case  of  hernia  of  one  of 
the  uterine  cornua  which  contained  a  Calf,  and  which  had  passed 
through  a  rent  in  the  mesentery.  And  Eainard  has  observed  several 
cases  of  this  kind  in  the  Bitch. 

Pathological  Anatomy. 

The  pathological  anatomy  of  uterine  hernia  is  not  without  interest 
to  the  obstetrist ;  and  as  it  has  been  studied  in  animals  which  had 
died  during  attempts  at  parturition,  or  were  slaughtered  after  that  act, 
the  evidence  is  as  plentiful  as  it  is  reliable. 


DYSTOKIA  Fi;OM  DISPLACEMLWT  OF  THE  UTERUS.  301 

The  chief  and  essential  lesion  is,  of  course,  to  be  found  in  the 
abdominal  parietes.  The  fleshy  or  tendinous  fibres  of  the  oblique 
muscles  may  be  merely  separated,  especially  at  the  commencement ; 
though  most  frequently  some  of  them  are  ruptured.  The  great  rectus 
muscle  always  shows  a  solution  of  continuity,  the  rupture  being 
sometimes  as  clean  and  sharp  as  if  it  had  been  made  by  a  knife  ; 
though  at  other  times  it  is  irregular  and  lacerated.  In  every  case 
there  results  a  variable-sized  opening,  more  or  less  circular,  oval,  or 
triangular,  its  larger  diameter  corresponding  to  the  axis  of  the  animal's 
body  ;  Eodet  has  seen  an  opening  of  this  kind  measure  nearly  twenty 
inches. 

The  seat  of  the  rupture  varies  ;  sometimes  the  rectus  nmsclc  is  per- 
forated at  its  pubic  insertion,  as  Favre  has  seen  it  ;  in  other  cases  it  is 
elsewhere,  but  in  every  instance  it  is  inferior — posterior  to  the  umbilicus, 
;ind  to  the  right  or  left  of  the  linea  alba.  The  latter  structure  is  at 
lirst  never  involved  ;  but  when  the  hernia  increases  largely  in  size,  it 
may  in  its  turn  give  way  ;  so  long  as  it  I'emains  intact  it  forms  a  kind 
of  cord  extending  from  the  pubis  to  the  sternum,  and  by  partially 
dividing  the  tumour,  gives  it  a  bilobular  appearance. 

In  a  few  cases  the  tunica  ahdominalis  resists  the  strain  imposed  on  it, 
being  only  extended,  and  in  this  way  the  hernia  has  another  covering 
in  addition  to  the  skin  ;  but  in  many  instances  it  tears,  like  the  muscles. 
Delplancjue  has  shown  that  the  peritoneum  may  escape  rupture,  stretch 
and,  accompanying  the  descending  viscera,  constitute  a  serous  tunic  to 
the  hernia  ;  most  frequently,  however,  it  gives  way,  the  uterus  passes 
through  it,  and  then  there  is  no  hernial  sac. 

In  a  recent  hernia,  the  connective  tissue  surrounding  it  is  greatly 
ecchymosed  and  infiltrated,  and  the  muscular  fibres  broken  up  and 
separated ;  the  tendinous  fibres  are  also  disassociated  and  torn,  and 
numerous  red  and  partly  decolorised  blood-clots  lie  among  their  inter- 
stices. At  a  later  period  no  extravasated  blood  is  found  between  the 
skin  and  the  uterus,  but  the  parts  are  uniformly  red  ;  and,  later  still, 
attempts  at  repair  are  evidenced  by  cicatrisation  of  the  borders  of  the 
inapture,  which  have  then  a  rounded,  thickened,  and  fibro-tendinous 
aspect,  and  are  dense  and  resisting.  The  connective  tissue  beneath  the 
skin  is  condensed  into  a  kind  of  smooth  membrane,  continuous  with 
the  margin  of  the  rent,  and  forms  a  second  tunic  to  tiie  hernia. 

Before  parturition  the  hernia  is  occui)ied  exclusively,  or  nearly  so,  by 
tin-  gravid  uterus,  which  is  wlioUy  or  in  part  lodged  in  tliis  accidental 
diverticulum.  After  delivery,  however,  the  uterus  often,  though  not 
always,  ascends  into  the  abdominal  cavity  ;  but  whether  it  does  so  or 
not,  other  viscera — such  as  the  rumen  with  the  Cow,  and  the  colon  and 
small  intestine  with  the  Mare — find  their  way  into  the  pouch;  Rodet 
has  even  found  the  uterus  and  the  entire  intestinal  mass  included  in  it. 

Diagnosism 

The  diagnosis  of  uterine  hernia  in  the  larger  animals  is  not  difficult 
in  the  great  majority  of  instances,  and  especially  if  labour  has  com- 
menced. In  the  first  place,  it  is  usually  known  to  the  owner  that  the 
animal  is  pregnant  ;  and  in  the  second  place,  if  parturition  has  begun 
there  can  scarcely  be  any  mistake  made  as  to  the  nature  of  the  expul- 
sive efforts.  Besides,  there  is  the  abdominal  tumour  with  its  peculiar 
characteristics,  and   by  manipulating   it   the   fcctus  can  be  detected. 


802  MATERNAL  DYSTOKIA. 

It  will  also   be  discovered  that  the  tumour  does  not  adhere  to  the 
abdominal  parietes,  and  that  it  may  be  reduced  by  taxis. 

But  it  may  be  necessary  to  ascertain  the  presentation  and  position  of 
the  foetus,  and  if  it  cannot  be  born,  what  the  nature  of  the  obstacle  is 
which  prevents  delivery.  In  such  a  case  vaginal  exploration  must 
be  resorted  to ;  by  it  we  may  learn  that  the  os  is  not  dilated  from 
one  of  several  causes  to  be  hereafter  discussed ;  or  the  non-dilatation 
may  be  due  to  the  uterine  contractions  not  pressing  the  foBtal  mass 
directly  against  the  cervix,  in  consequence  of  the  altered  direction  of 
the  uterus,  or  the  margin  of  the  hernial  opening  strangulating  the  foetus 
and  hindering  its  advance.  These  obstacles  must  be  combated  by 
appropriate  measures. 

In  consequence  of  the  foetus  lying  so  far  below  the  pubis,  the  hand 
introduced  through  the  os  cannot  feel  it,  even  when  the  whole  length 
of  the  arm  is  inserted  ;  in  which  case,  if  the  animal  is  standing,  the 
abdomen  may  be  raised  by  means  of  a  sheet  or  blanket,  so  as  to  bring 
the  foetus  within  reach.  If  the  animal  is  recumbent  and  cannot  rise, 
then  it  should  be  placed  on  its  back  and  secured  in  that  position,  the 
croup  being  raised  by  bundles  of  straw.  The  tumour  may  then  be  ex- 
amined by  external  palpation,  as  well  as  by  rectal  and  vaginal  explora- 
tion, and  the  position  of  the  foetus  determined. 

As  a  rule,  the  position  is  never  quite  normal.  In  the  most  favour- 
able cases,  the  head  is  found  to  be  directed  backwards  and  near 
to  the  pubis — sometimes  partly  in  the  pelvis,  with  the  face  upwards 
and  slightly  forwards  ;  the  fore  feet  being  more  or  less  doubled  back 
against  the  body,  which  lies  deep  in  the  tumour,  and  the  buttocks 
resting  on  the  mammae  of  the  mother— the  foetus  being  altogether,  in 
the  recumbent  female,  in  the  position  of  a  sitting  dog. 

The  state  of  the  borders  of  the  hernial  orifice  should  be  carefully 
ascertained,  and  their  rigidity  and  tension,  together  with  the  degree 
of  constriction  they  exercise  on  the  body  of  the  foetus,  noted.  This 
important  examination  should  be  made  before  any  traction  is  exercised 
on  the  foetus ;  for  on  the  information  so  obtained  will  depend  the 
choice  of  means  to  effect  delivery. 

With  the  Bitch  uterine  hernia  is  frequently  most  difficult  to  diagnose, 
and  errors  are  far  from  infrequent ;  the  most  common  mistake  is  fixing 
on  the  tumour  as  a  cancerous  mass.  But  mammary  tumours  are  very 
different  to  that  of  hernia  ;  they  are  generally  nodulated,  very  hard,  and 
the  skin  is  closely  adherent  to  them  ;  whereas  the  uterine  hernia  has 
not  the  fluctuation  of  a  cyst  or  abscess,  neither  has  it  the  resistance  of 
a  carcinoma,  fibroma,  or  adenoma,  while  the  skin  covering  it  is  smooth, 
supple,  perfectly  natural,  without  ulceration,  discoloration,  and  other 
signs  which  mark  the  presence  of  mammary  enlargements.  The 
uterine  tumour  can  also  be  reduced  by  taxis  or  manipulation,  while  the 
fissure  in  the  abdominal  wall  can  be  felt.  This,  together  with  the  fact 
that  it  is  only  developed  rapidly  after  impregnation,  and  without  any 
local  or  general  inflammatory  symptoms,  or  disturbance  of  the  general 
health,  should  settle  the  question. 

However,  should  any  doubt  yet  remain,  or  if  it  is  desired  to  ascertain 
the  exact  state  of  affairs,  a  more  careful  examination  will  be  necessary, 
it  being  always  borne  in  mind  that  this  hernia  in  the  Bitch  appears  in 
different  regions.  Vaginal  exploration  cannot  be  resorted  to  with  this 
animal,  because  of  the  smallness  of  the  pelvis — unless  the  Bitch  is  a 
large  one,  and  then  the  fingers  are  too  short  to  explore  to  any  depth. 


DYSTOKIA  FROM  DISPLACEMENT  OF  THE  UTERUS.  303 

An  external  examination  must,  therefore,  be  relied  upon,  and  this  is 
easier  and  more  certain  than  with  the  larger  creatures.  By  it  the  size 
of  the  abdomiual  rent  will  be  ascertained,  and  also  whether  the  foetus 
can  bo  passed  through  it  into  the  abdomen  ;  though  this  is  rarely 
possible,  owing  to  the  hernia  occurring  when  the  uterus  was  empty, 
and  when  it  could  pass  through  an  opening  which  would  not  bo  sulli- 
cient  for  a  fcetus  when  fully  developed. 

All  manipulatory  operations  on  the  Bitch  should  be  practised  with  as 
much  tact  and  gcntleuess  as  possible,  as  the  young  are  readily  killed, 
while  the  female  itself  is  very  liable  to  metritis. 

Indications. 

Animals  suffering  from  uterine  hernia  sometimes  bring  forth  their 
young  spontaneously,  and  without  any  bad  results  to  themselves  or 
their  progeny  ;  thus  proving  that  the  uterine  contractions  alone  will 
expel  the  fcetus,  and  that  the  aid  of  the  abdominal  muscles  is  not 
absolutely  necessary.  More  especially  is  this  the  case  with  the 
larger  animals.  Leconte  mentions  a  ]Mare  whose  career  he  traced  for 
five  years,  and  which,  notwithstanding  the  existence  of  this  condition, 
brought  forth  four  living  foals — three  without  assistance,  the  fourth 
being  in  a  wrong  position.  Cows  which  had  most  alarming  hernias 
have  even  brought  forth  twin  Calves  spontaneously. 

But,  as  a  rule,  with  these  larger  uniparous  animals  parturition  is 
always  more  protracted  and  dillicult  than  in  ordinary  circumstances, 
and  the  assistance  of  the  veterinary  obstetrist  is  needed  to  effect 
delivery;  and  this,  after  all,  is  in  some  instances  impossible,  and  the 
mother  and  offspring  are  lost.  This  is  more  particularly  the  case  with 
multiparous  animals,  and  especially  the  Bitch,  in  which  it  is  generally 
all  but  impossible  to  reduce  the  hernia  or  remove  the  foetuses  by  the 
natural  passage.  Roll  has,  nevertheless,  described  the  case  of  a  Bitch 
suffering  from  uterine  hernia,  which  brought  forth  its  progeny  in  a 
natural  manner  ;  and  Prange,  in  1844,  published  the  liistory  of  another 
Bitch  that,  unaided,  gave  birth  to  three  Puppies  which  liad  been  lodged 
in  a  hernia  of  this  kind.  A  case  occurred  in  my  own  experience  of  a  small 
terrier  Bitch,  which,  when  I  saw  her,  had  what  the  owner  and  others 
thought  was  a  very  large  mammary  tumour.  Soon  after  she  brought 
forth  two  Puppies — one  dead,  the  other,  the  largest,  alive — and  without 
help,  when  the  supposed  tumour  completely  disappeared.  Sheather^ 
describes  a  case  of  this  kind,  in  which  five  Puppies  were  expelled 
without  assistance. 

When  there  are  several  fcctuses,  some  of  them  may  be  contained  in 
a  non-hcrniaod  cornu,  and  so  can  readily  be  born  ;  while  tliose  in  the 
extruded  horn  may  experience  ditliculty,  and  if  the  hernial  sac  is  con- 
stricted at  its  neck  birth  may  be  impossible.  So  that  if  the  Bitch  lives 
and  no  operation  is  performed,  the  imprisoned  fretuses  may  be  ulti- 
mately expelled  by  a  process  of  ulceration  of  the  abdominal  walls. 

At  a  meeting;  of  the  Medicftl  Society  of  Strasburp,  M.  Kopp  {OazeUe  Midicale  dt 
Sfrwihourf),  1875)  exhibited  the  uterus  and  it«  apjHindages  bt'lunpinj,'  to  a  Ritch  upon 
which  he  had  operated  in  order  t<>  extract  .a  firtus  which  was  loflt'ed  in  onu  of  the  uterine 
cornua.  The  animal  had  been  restlesA  for  nome  twenty-four  hours,  when  Kopp  was 
called  in  to  examine  it.  He  found  every  indication  of  approaching  ))arturition  ;  but 
notwithstanding  this,  and  the  C"n»iderable  volume  of  the  abdomen,  the  oa  titeri  was 
almost  closed — a  circumstance  which  decided  him  to  wait.     During  the  night  the  Bitch 

>    Vthriiiary  Journal,  1887,  p.  234. 


304  MATERXAL  DYSTOKIA. 

gave  birth  to  a  dead  Puppy,  and  on  the  foUowinsf  day  the  dinsinished  distention  of  the 
abdomen  enabled  him  to  discover,  beneath  the  skin,  the  presence  of  three  fnetuses.  On 
inquiry,  he  ascertained  that  for  some  time  the  animal  had  been  sufiFering  from  an 
inguinal  hernia  on  the  left  side,  and  this  information  led  him  to  adopt  active  measures. 
The  skin  was  incised  over  the  isolated  hernial  sac,  as  far  as  the  inguinal  c^nal ;  then, 
after  largely  opening  the  tumour,  as  well  as  the  uterine  cornu  it  cuntained,  he  was  able 
to  remove  the  three  dead  foetuses  and  their  membranes.  The  prolapsed  uterine  portion, 
having  been  carefully  cleansed,  was  closed  by  suture  and  returned  to  the  abdominal 
cavity,  and  a  strong  ligature  placed  round  the  sac.  The  inguinal  canal  had  been  widely 
incised  ;  but  notwithstanding  this,  the  reduction  of  the  uterus  and  its  appendages  offered 
somo  difficulties,  in  consequence  of  the  great  mass  of  fat  in  and  upon  the  broad  ligaments 
surrounding  them.  Evei'ything  appeared  to  be  going  on  favourably  until  the  ninth  day, 
when  the  animal  suddenly  succumbed.  Death  was  attributed  to  purulent  absorption, 
produced  through  the  agency  of  a  small  abscess  on  the  broad  ligament,  which  had  been 
abraded  during  the  operation  of  reduction.  There  were  no  traces  of  metro-peritonitis,  and 
the  wound  in  the  uterus,  as  well  as  in  that  portion  of  the  sac  which  had  been  ligatured, 
was  cicatrising  most  satisfactorily.  According  to  Kopp,  this  was  an  instance  of  intra-  and 
extra-abdominal  pi'egnancy  at  the  same  time  ;  and  in  proof  of  this,  he  pointed  to  the 
narrowness  of  the  inguinal  canal,  aiid  the  presence  of  the  uterine  hernia  previous  to 
impregnation. 

Three  of  the  foetuses  were  developed  in  the  cornual  hernia,  and  the  fourth  in  the  bod)' 
of  the  uterus. 

Chanel  reports  that  a  Sow  brought  forth  young  after  a  portion  of  one 
of  the  uterine  cornua  containing  two  foetuses,  and  which  had  been 
hernied,  was  amputated. 

Notwithstanding  these  instances,  however,  the  assistance  of  the 
obstetrist  is  necessary  to  effect  dehvery,  for  which  a  careful  examina- 
tion, as  in  diagnosis,  will  indicate  the  means. 

Previous  to  parturition  the  hernia  should  be  supported,  when  pos- 
sible, by  a  truss  or  retaining  bandage,  and  care  should  be  taken  to 
prevent  over-exertion  or  straining. 

With  the  larger  animals,  delivery  by  the  natural  passage  is,  of  course, 
the  chief  object  to  be  attained.  In  certain  cases,  the  simplest  measure, 
and  which  is  sometimes  all  that  is  necessary,  is  to  elevate  the  hernia 
by  means  of  a  sheet  or  blanket  passed  under  it,  and  raised  by  an  assis- 
tant at  each  side  of  the  animal.  Manipulation  ^^er  vaginam  may 
supplement  this  support,  and  in  the  majority  of  such  cases  may  even  be 
absolutely  necessary  to  complete  delivery. 

In  other  instances,  however,  the  foetus  cannot  be  removed  from  the 
hernial  sac  without  placing  the  female  in  a  recumbent  posture.  Either 
lateral  or  dorsal  decubitus  may  be  resorted  to,  according  to  circum- 
stances, but  the  preference  is  usually  given  to  the  latter  position  ; 
though  when  lateral  decubitus  is  tried,  the  animal  should  be  placed  on 
the  side  opposite  to  that  in  w^hich  the  hernia  exists. 

In  the  dorsal  position,  the  weight  of  the  foetus  and  uterus  is  removed 
from  the  floor  of  the  abdomen  ;  consequently,  the  abdominal  muscles 
are  relaxed,  and  the  borders  of  the  hernial  opening  are  not  so  tense  ; 
while  the  uterus  and  its  contents,  by  their  own  weight,  have  a  tendency 
to  escape  from  the  hernia  and  fall  into  the  abdomen  ;  at  the  same  time 
the  foetus  is  more  accessible  to  the  hand  of  the  obstetrist. 

Should  the  os  be  contracted,  it  must  be  dilated  by  the  hand;  if  the 
membranes  are  intact,  they  are  to  be  ruptured  ;  should  the  foetus  make 
an  unfavourable  presentation,  which  is  not  very  frequent  in  these  cases, 
this  can  be  rectified  ;  and  if  the  creature  is  dead,  which  is  nearly  always 
the  case  when  assistance  has  not  been  rendered  sufficiently  early,  and 
the  membranes  are  ruptured,  it  can  be  all  the  more  easily  removed. 

When  the  foetus  presents  anteriorly  and  the  head  can  be  seized,  this 


DYHTUKLl  nv  DISPLACEMENT.  305 

should  be  brought  into  the  pelvic  inlet,  and  cords  attached  to  the  lower 
jaw,  or  Schaack's  head-collar  forceps  (to  bo  hereafter  described)  may  be 
employed  ;  then  having  secured  the  head,  the  fore  limbs  are  sought  for, 
and  brought  into  the  passage  one  after  the  other,  where  they  are  also 
secured  by  cords  around  the  pasterns.  Sometimes  these  limbs  cannot 
be  found,  owing  to  their  being  bent  back  against  the  body  of  the  foetus, 
and  this  will  certainly  render  delivery  more  ditlicult. 

Should  the  fn'tus  present  posteriorly,  the  case  is  more  unfavouraljle  ; 
though  if  the  hind  limbs  can  be  found  and  brought  into  the  vagina, 
delivery  may  soon  be  effected  if  there  are  no  other  complications. 

Cords  being  fastened  to  the  pasterns,  sulVicient  and  well-directed 
traction  should  be  employed  on  them,  the  hand  of  the  operator  remain- 
ing in  the  pelvis  if  necessary,  in  order  to  guide  the  passage  of  the  foetus. 
Saint-Cyr  suggests  that  an  intelligent  assistant  may  at  the  same  time 
bo  directed  to  make  methodical  pressure  on  the  hernia,  in  order  to  com- 
plete its  reduction,  which  is  effected  when  the  contents  of  the  sac  are 
returned  to  the  abdomen. 

At  times  this  reduction  is  easy,  and  at  other  times  it  is  extremely 
dirticult.  In  the  latter  instances,  all  the  more  care  is  necessary  that  the 
external  manipulations  are  not  too  forcible,  if  it  is  desired  to  have  a 
living  foetus.  Should  the  resistance  prove  greater  than  the  means  which 
may  safely  be  employed  to  overcome  it,  then  a  surgical  operation  must 
be  determined  on.  When  the  muscles  of  the  abdomen  prove  an  obstacle 
to  the  escape  of  the  fcetus  from  the  hernial  sac,  and  produce  a  kind  of 
strangulation,  an  incision  may  be  made  through  them  in  the  most  con- 
venient part,  as  in  the  operation  for  strangulated  hernia  of  the  intestine. 

In  other  cases  the  Cajsarian  operation  may  have  to  be  resorted  to, 
and  speedily,  if  the  mother  or  progeny,  or  even  both  are  to  be  saved. 
Recourse  to  this  formidable  measure  will  only  be  had  in  particular 
instances :  as  when  the  mother  or  fcetus  is  valuable,  and  other  means 
have  failed  or  are  not  likely  to  succeed. 

And  in  uterine  hernia  this  operation  is  undertaken  in  far  more 
favourable  conditions  than  in  some  other  circumstances  which  necessi- 
tate its  adoption.  In  this  accident  only  the  skin,  and  perhaps  also 
occasionally  the  tunica  abdominalis,  has  to  be  cut  through  to  expose 
the  uterus,  which  has  not  to  be  sought  for  among  the  mass  of  intestines 
and  laboriously  withdrawn  from  their  midst ;  indeed,  it  generally 
occupies  the  whole  of  the  hernial  tumour,  and  so  closely,  that  there  is 
no  danger  of  the  intestines  escaping  during  the  operation.  .\  simple 
incision — no  larger  than  is  necessary — through  the  organ,  a  larger  one 
through  the  fa'tal  membranes,  and  the  prompt  extraction  of  the  foetus 
therefrom,  pretty  nearly  complete  the  task. 

If  the  Ctcsarian  operation  is  timeously  resorted  to,  the  chances  are 
greatly  in  favour  of  delivering  a  living  ftetus  ;  with  the  Cow  a  living 
and  perfectly  viable  Calf  is  almost  certain  to  be  obtained,  even  a  long 
time  after  labour  has  commenced  and  the  "  water- bag "  has  rup- 
tured. And  even  with  the  Mare  it  is  not  at  all  impossible  to  rescue 
a  living  Foal,  if  the  operation  is  resorted  to  before  rupture  of  the  mem- 
branes. 

The  chances  in  favour  of  the  mother  are,  of  course,  fewer  than  with 
the  fcetus  ;  for  under  the  most  favourable  conditions,  after  removal  of 
the  progeny,  there  will  still  remain  the  great  hernial  sac,  which  it  will 
be  most  ditttcult  to  keep  the  intestines  from  occupying,  and  still  more 
difficult  to  cure  in  a  radical  manner — judicious  trussing  and  bandaging 

20 


306  MATERNAL  DYSTOKIA. 

being  nearly  all  that  can  be  done  to  palliate  the  effects  of  the  acci- 
dent. 

All  these  considerations  should,  of  course,  be  duly  estimated  by  the 
veterinary  surgeon  in  undertaking  the  treatment  of  such  a  case  ;  and 
it  is  scarcely  necessary  to  say  that,  with  the  Cow  more  especially,  the 
butcher  will  frequently  have  to  be  called  in  when  the  question  of  risk 
and  expense  has  been  fairly  discussed. 

It  need  hardly  be  pointed  out  that  it  is  generally  very  injudicious  to 
attempt  to  breed  from  an  animal  affected  with  hysterocele,  or  an  abdo- 
minal hernia  of  any  description,  notwithstanding  the  fact  that  this  con- 
dition may  not  militate  against  gestation  and  parturition  in  every  case. 

With  the  smaller  animals,  and  especially  the  Bitch,  the  Caesarian 
operation  has  usually  to  be  resorted  to  for  various  reasons,  if  birth 
cannot  take  place  ;  the  chief  of  these  are  the  small  size  of  the  creature, 
the  difficulty  in  reaching  the  foetus  or  foetuses  and  extracting  them  by 
the  natural  passage,  as  well  as  the  irreducible  nature  of  the  hernia, 
which  is  often  extremely  constricted  at  the  neck,  and  attempts  at 
reduction  are  often  followed  by  death.  Besides,  the  Bitch  withstands 
very  serious  operations  in  the  abdominal  region  better  almost  than  any 
other  animal,  the  entire  uterus  having  been  frequently  removed  by 
abdominal  section  without  a  fatal  termination.  In  this  animal  the 
operation  is  also  very  simple,  and  demands  only  ordinary  care  and 
manipulative  skill. 

Everything  is,  therefore,  in  favour  of  gastro-hysterotomy  in  uterine 
liernia  of  the  pregnant  Bitch  ;  but  in  order  to  ensure  whatever  success 
may  be  possible,  it  must  be  performed  early,  and  before  serious  injury 
has  been  done  by  attempts  at  reduction  or  delivery  in  other  ways.  It 
has  been  argued  that  it  might  be  preferable  to  open  the  sac,  divide  the 
constriction  w^hich  prevents  reduction,  and  return  the  gravid  uterus  to 
the  abdomen,  when  delivery  might  be  effected  in  a  natural  and  spon- 
taneous manner.  And  it  has  been  shown  that  this  mode  of  operating 
is  rational  and  possible,  and  may  be  followed  by  success  should  there 
be  no  adhesions  between  the  misplaced  uterine  cornu  and  the  hernial 
pouch.  The  experience  gained  in  such  cases,  however,  does  not  testify 
very  markedly  in  favour  of  this  procedure,  and  the  evidence  is  certainly  in 
favour  of  the  Ceesarian  operation,  and  particularly  when  adhesions  exist. 

The  dangers  to  be  apprehended  from  gastro-hysterotomy  are  inflam- 
mation and  strangulation  of  the  imprisoned  cornu  and  of  the  uterus, 
which  at  this  time  is  so  vascular,  impressionable,  and  particularly 
susceptible  to  the  influence  of  the  air  on  its  internal  surface.  To  avert 
these  dangers,  it  has  been  proposed  to  remove  the  uterine  horn 
altogether  ;  and  we  are  certainly  of  opinion  that,  in  certain  cases,  the 
proposal  is  worthy  of  a  trial. 

We  will  describe  the  Ceesarian  operation  in  another  place. 

Deviation  of  the  Utekus. 

By  the  term  deviation,  when  applied  to  the  uterus,  is  meant  a  change 
in  the  direction  of  the  organ,  by  which  the  cervix  and  os  no  longer 
correspond  to  the  axis  of  the  vagina.  This  change  of  direction  in  the 
vaginal  opening  of  the  uterus  may  be  productive  of  more  or  less 
difficulty  in  parturition. 

Changes  in  the  position  of  the  uterus  are  somewhat  common  in 
woman,  whose  vertical  uterus  may  easily  deviate  in  any  direction, 
producing  those  flexions    and  versions  which   not   infrequently   ofler 


DEVIATION  OF  THE  UTERUS.  ;J07 

serious  obstacles  to  delivery.  With  quadrupeds,  however,  in  which 
the  uterus  is  horizontal,  the  veterinary  obstetrist  has  but  to  deal  with 
one  kind  of  deviation  of  the  uterus,  the  only  one  possible — that  of 
inferior  obliquiti/,  which  appears  to  be  extremely  rare,  and  corresponds 
to  antevei'sion  in  the  human  female. 

Accordinj^  to  some  authorities,  who  have  more  particularly  studied  it, 
this  change  in  position  may,  in  certain  circumstances,  become  a  very 
serious  cause  of  dystokia. 

The  accident  has,  up  to  the  present  time,  only  been  observed  in  the 
Cow  ;  and  this  circumstance  is  believed  to  be  explained  by  an  interesting 
feature  in  the  anatomy  of  tliis  animal,  which  has  been  brought  under 
notice  by  Professor  Goubaux,  of  the  Alfort  Veterinax-y  School. 

It  would  appear  that  in  Bovines,  as  noted  at  p.  18,  the  abdominal 
nuiscles  are  not  attached  to  the  anterior  border  of  the  pubis  as  in 
Solipeds,  but  are  inserted  into  a  thick  ligament  found  at  the  external 
and  inferior  part  of  the  pubic  bones,  and  which  strengthens  the 
symphysis  pubis.  It  consequently  happens  that,  at  this  border  of  these 
bones,  the  floor  of  the  abdomen  is  on  a  lower  plane  than  that  of  the 
pelvic  cavity ;  so  that  there  is  a  kind  of  step  between  the  two  cavities, 
the  height  of  which  varies  in  different  animals,  but  has  been  found  to 
be  as  much  as  three,  four,  and  even  live  inches.  Dissection  has  demon- 
strated that  the  peritoneum  lining  the  lower  surface  of  the  abdominal 
cavity,  on  arriving  at  the  pubis  ascends  this  step,  in  covering  it  like  a 
carpet,  to  line  the  upper  surface  of  the  pubic  bones  and  tlie  anterior 
part  of  the  pelvic  cavity. 

From  this  anatomical  peculiarity,  it  may  happen  that  the  fundus  of 
the  gravid  uterus,  instead  of  being  directed  forward,  will  incline  directly 
downwards  and  lie  on  this  pelvic  step,  not  passing  beyond  the  umbilicus, 
behind  which  it  may  even  rest  sometimes.  At  the  same  time,  and  as 
a  consequence  of  this  arrangement,  the  other  end — the  cervix — is  tilted 
upwards  in  the  direction  of  the  sacro-vertebral  angle,  and  it  may  even 
compress  the  rectum  against  that  part.  It  will  be  obvious  that,  through 
this  great  deviation  in  the  direction  of  the  cervix,  the  os  no  longer  cor- 
responds to  the  axis  of  the  vagina,  the  canal  following,  of  course,  the 
same  oblique  ascending  line  as  the  cervix.  Such  an  alteration  in  the 
position  of  the  uterus  entails  a  similar  change  in  the  attitude  of  the 
f(rtu3,  which,  instead  of  being  placed  almost  horizontally,  is  now  more 
or  less  vertical — the  head  towards  the  sacrum,  and  the  buttocks  resting 
on  the  pubic  step. 

During  parturition  we  may  easily  understand  how  affairs  are 
changed  with  regard  to  the  performance  of  this  act.  The  uterine 
contractions  are  no  longer  directed  towards  the  cer\'ix  ;  the  os  only 
dilates  slowly  or  not  at  all,  according  to  the  degree  of  uterine  obliquity; 
the  animal  is  exhausted  with  ineffectual  attempts  to  expel  the  ftptus  ; 
and  if  assistance  is  not  rendered,  it  may  succumb  without  being 
delivered,  or  the  uterus  may  rupture.  If  the  position  of  the  ftrtus  is 
abnormal,  then  the  case  is  still  worse,  so  far  as  artificial  delivery  is 
concerned.  Garreau  has  observed  that  labour  may  be  suspended  alto- 
gether ;  the  foetus  dies,  becomes  mummified,  and  is  retained  for  perhaps 
a  very  long  time. 

Diagnosis. 

The  diagnosis  of  this  deviation  does  not  appear  to  be  attended  with 
much  difficulty.     The  long  duration  of  labour,  and  the  inutility  of  the 


308  MATERNAL  DYSTOKIA. 

expulsive  efforts,  prove  that  some  obstacle  to  delivery  must  be  present. 
Consequently,  vaginal  exploration  is  resorted  to,  and  when  the  hand  is 
passed  into  that  canal  it  reaches  a  kind  of  imperforate  cul-de-sac,  at  the 
bottom  of  which  is  a  large  round  tumour  into  which  no  opening  can  be 
found.  This  tumour  is  the  lower  face  of  the  uterus,  which,  pressed 
against  the  corresponding  wall  of  the  vagina,  projects  into  the  pelvic 
inlet.  Eaising  the  hand  towards  the  sacrum,  the  os  will  be  discovered 
much  removed  from  its  normal  position,  and  situated  above  and  in  front 
of  the  uterine  tumour  just  alluded  to. 

Sometimes  the  os  is  completely  closed,  in  other  cases  it  may  be  more 
or  less  dilated.  When  in  the  latter  condition,  there  is  frequently  formed 
at  this  point  a  kind  of  membraneous  transverse  fold,  raised  in  the  form 
of  a  valve,  which  has  been  compared  to  a  fleshy  band  analogous  to 
that  which  forms  the  sacculations  of  the  large  intestine  ;  this  band  is 
stretched  across  the  lower  part  of  the  os,  and  it  has  to  be  surmounted 
before  the  hand  can  touch  the  foetus.  The  latter  is  lodged  in  a  kind  of 
pouch  or  excavation  situated  beneath  the  band,  and  constitutes  the 
tumour  met  with  at  first  at  the  bottom  of  the  vagina. 

The  more  or  less  vertical  position  of  the  foetus  should  also  serve  as  a 
guide. 

Complications. 

To  Saint-Cyr,  Garreau,  and  Schaack,  we  are  indebted  for  our  descrip- 
tion of  the  condition  we  have  been  describing,  and  to  the  two  latter  are 
also  due  the  knowledge  we  possess  of  certain  complications  which  are 
worthy  of  notice. 

Garreau  has  found  the  cervix  in  this  uterine  deviation  thickened, 
indurated,  and  the  os  closed.  Delivery  was  impossible,  and  the  foetus 
remained  for  three  months  in  the  uterus  without  causing  any  great  in- 
convenience to  the  Cow.  At  the  end  of  this  period  the  Calf  was  ex- 
tracted by  Caesarian  section,  and  with  perfect  success  ;  as  the  Cow 
quite  recovered,  and  w^as  sold  at  a  good  price  eight  months  afterwards. 

In  one  of  the  cases  described  by  Schaack,  the  foetus  was  in  the 
vertebro-sacral  position,  and  the  limbs  and  head  having  been  secured 
by  cords,  delivery  was  accomplished  by  strong  traction.  In  a  quarter 
of  an  hour  afterwards,  however,  the  Cow  lay  down,  trembled  all  over, 
the  muscles  of  the  limbs  and  the  eyes  contracted  in  a  convulsive  manner, 
and  death  rapidly  ensued. 

At  the  autopsy,  which  was  made  six  hours  after  death,  a  quantity 
of  blood,  in  the  form  of  a  large  clot,  was  found  in  the  abdomen,  and  the 
textures  about  the  pubis  were  infiltrated  with  that  fluid.  The  uterus 
had  resumed  its  ordinary  form ,  and  its  mucous  membrane  was  intact ; 
but  at  the  inferior  part  of  the  organ  there  was  a  large  triangular  tear, 
about  six  inches  long  and  four  wide ;  and  it  was  noted  that  this  lacera- 
tion had  caused  the  rupture  of  two  good-sized  arteries,  which  of  course 
led  to  the  haemorrhage  that  caused  death  so  rapidly. 

Indications. 

The  indications  for  treatment  in  this  deviation  are  simple  ;  raise  the 
fundus  of  the  uterus,  lower  the  cervix,  and  bring  the  os  in  line  with 
the  vagina.  When  this  is  accomplished,  the  uterine  contractions  will 
act  directly  on  the  cervix,  and  if  this  is  healthy,  dilatation  of  the  os  will 
soon  take  place  ;  then  the  foetus,  pushed  towards  the  vagina,  instead  of 
against  the  sacrum,  will  enter  the  passage,  from  which  a  little  judicious 


TOIiSION  OF  THE  UTERUS.  30» 

manipulation  will  in  all  probability  remove  it,  and  thus  complete 
delivery. 

Several  modes  of  procedure  have  been  recommended  for  adoption  in 
carrying  out  these  indications.  Indeed,  Saint-Cyr  states  that  when  the 
deviation  is  inconsiderable,  and  the  band  mentioned  as  obstructing  the 
OS  is  not  present,  reduction  is  often  spontaneously  effected  by  luere 
decubitus.  This,  in  pushing  upwards  the  fundus  of  the  uterus,  brings 
down  the  cervix  to  its  normal  position  by  an  easily  understood  tilting 
movement.     Scliaack  has  noticed  tliis  to  happen  in  two  instances. 

In  such  cases,  says  Kainard,  if  the  animal  persists  in  standing,  it 
may  sutlice  to  raise  the  belly  by  means  of  a  folded  sheet  or  blanket, 
or  even  a  plank  held  by  an  assistant  on  each  side  of  the  Cow ;  or  the 
creature  may  be  gently  thrown  down  on  a  thick  bed  of  straw. 

In  diilicult  cases,  however,  these  measures  will  not  be  sutlicient,  and 
Garreau  recommends  the  following  procedure  to  be  adopted.  Intro- 
duce the  right  hand  into  the  rectum  and  the  left  into  the  vagina  ;  with 
the  first  press  on  the  head  of  the  fcctus,  and  push  back  its  body  (the 
vaginal  tumour),  with  the  second,  tilting,  as  it  were,  the  young  creature 
into  its  natural  position.  This  will  bring  the  uterus  into  its  normal 
situation,  and  consequently  place  the  os  opposite  the  vagina. 

Saint-Cyr,  nevertheless,  gives  the  preference  to  the  method  re- 
commended and  practised  by  Schaack  in  these  troublesome  cases, 
inasmuch  as  it  is  more  simple,  and  experience  has  demonstrated  its 
efficacy.  This  method  consists  merely  in  throwing  down  the  Cow 
most  carefully,  placing  the  animal  on  its  back,  and  keeping  it  in  that 
position  by  bundles  of  straw.  Tlie  weight  of  the  fa-tus  carries  the 
uterus  down  towards  the  spine  (inferior) ;  the  fundus  of  the  organ  is 
depressed,  and  the  cervix  raised  towards  the  pubis  (now  superior) ;  the 
obliquity  of  the  uterus  is  thus  got  rid  of. 

Schaack  has  on  two  occasions  resorted  to  this  mode  of  reduction, 
and  in  each  case  the  abnormal  valve  disappeared,  and  parturition  was 
rendered  easy. 

Professor  Peuch,  of  the  Lyons  Veterinary  School,  states  that  in  a 
case  of  this  description  he  employed  Schaak's  method ;  when  the  Cow 
was  placed  on  its  back  the  obliquity  disappeared  spontaneously,  and 
with  the  greatest  facility. 

TOHSION    OF    THE    UtERUS  :    CONTOKSIO    UtERI. 

Torsion,  or  "twisting"  of  the  gravid  uterus  on  itself — and  which 
often  involves  not  only  the  cervix  of  the  organ,  but  also  the  vagina — 
is  an  accident  unknown  in  the  pregnant  human  female,  but  for 
anatomical  reasons  may  occur  in  animals,  and  particularly  in  the  Cow, 
in  which  it  has  been  most  fre<juently  observed.  The  accident  is  rare 
in  the  Mare  ;  it  has  bet'ii  observed  in  the  Slieep  and  (loat,  as  well  as 
in  the  Cat ;  but  though  in  the  Sow  and  Hitch  the  uterine  cornua  may 
become  displaced  and  twisted  on  each  other,  and  even  become  hernied 
by  the  broad  ligaments,  yet  torsion  of  the  uterus  has  not  been  noted 
in  them,  so  far  as  can  be  ascertained. 

The  accident  will  be  first  studied  in  the  Cow,  and  afterwards  in  the 
Mare  and  other  animals. 

History. 
Though  torsion  of  the  uterus  is  now  recognised  as  a  serious,  but  not 
insurmountable  obstacle  to  parturition,  yet  its  existence  may  be  said 


310  MATERXAL  DYSTOKIA. 

to  be  of  recent  discovery  ;  for  though  it  was  clearly  and  explicitly  in- 
dicated in  the  last  century  by  Boutrolle  [Parfait  Boiivier,  second  edition, 
1766),  yet  it  was  not  until  after  much  observation  and  discussion  in 
this  century  that  such  a  condition  was  proved  to  be  possible.  Boutrolle 
wrote  :  "  If  it  is  possible  to  pass  two  or  three  fingers  into  the  os  {yelVere), 
the  hand  and  arm  may  be  forced  through  ;  but  if,  on  the  contrary,  a 
finger  cannot  be  passed  into  it,  and  the  opening  is  found  to  be  turning, 
it  is  a  sign  that  the  os  is  twisted — that  it  has  made  a  half-turn  on  itself 
— and  it  is  impossible  to  enter  it." 

Though  Veterinary  Science  had  gained  a  sound  footing  in  France 
soon  after  the  publication  of  Boutrolle's  "Perfect  Cowherd,"  yet  its 
students  do  not  appear  to  have  paid  any  heed  to  the  amateur's  descrip- 
tion of  the  spiral  twist  of  the  cervix  uteri,  the  difficulty  in  penetrating 
the  05,  and  the  impossibility  of  birth  taking  place  through  it.  In- 
difference or  incredulity  may  have  prevailed ;  and  it  was  not  until 
painful  experience  had  awakened  attention  to  the  existence  of  the 
accident,  that  the  veterinarians  of  this  century  began  to  notice  it. 

Nevertheless,  in  France,  Boutrolle's  "Cowherd"  appears  to  have 
been  carefully  read  and  usefully  studied  by  those  for  whom  it  was 
written — the  country-folks  or  cowmen,  or  he  may  have  gained  his 
knowledge  from  these;  for,  according  to  Saint -Cyr,  one  of  their 
great  problems  in  cases  of  difficult  parturition — a  problem  not  con- 
fined to  the  cowherds  of  France— was  to  discover  if  the  calving  Cow 
was  not  "  barree  "  (obstructed),  if  it  had  not  the  torche,  veliere,  or 
portiere  torse,  torle,  or  tordue  (cervix  twisted),  terms  employed  accord- 
ing to  the  localities  and  dialects,  and  which  signify  what  Boutrolle 
has  distinctly  described. 

At  the  commencement  of  this  century,  however,  we  are  informed  by 
Rainard  that  Maurin  of  Cantal,  and  Yieillard  of  Brioude,  two  of  his 
pupils,  had  witnessed  this  form  of  dystokia. 

In  France,  other  veterinary  observers  afterwards  published  similar 
cases,  the  first  in  order  being  Lecoq,  of  Bayeux,  w^ho  in  1837  had 
occasion  to  note  this  accident.  In  a  Memoire  sur  le  part  lahoricux,^ 
he  expresses  his  surprise  at  the  silence  prevailing  among  veter- 
inary authorities  with  regard  to  this  condition,  which  was  met  with 
from  time  to  time,  and  was  well  enough  known  to  breeders.  In 
describing  the  symptoms  he  had  noted,  Lecoq  says  :  "  The  hand 
having  been  introduced  into  the  vagina,  and  pushed  as  far  as  the  neck 
of  the  uterus,  encountered  a  kind  of  valve  obstructing  the  entrance  to 
the  latter.  I  was  beyond  the  part  I  had  taken  for  a  valve,  and  had 
got  into  a  narrow  canal  whicJi  Jiad  the  form  of  a  scrcic  [ayant  la  forme 
d'une  vis).  The  Cow  died  on  the  following  day  without  having  been 
delivered,  and  at  the  autopsy  it  was  found  that  the  uterus  was  com- 
pletely turned  upside-down  —  the  superior  face  having  become  the 
inferior — and  that  this  version  had  taken  place  from  right  to  left." 

The  first  Continental  veterinarian  who  observed — or  rather,  who 
described — a  complete  rotation  of  the  uterus  (the  previous  cases  recorded 
were  only  those  of  haK-rotation)  was  Eichner,  a  professor  at  the  Berne 
(Switzerland)  Veterinary  School,  who,  in  his  "  Systematic  Treatise  on 
the  Diseases  of  the  Bovine  Species  "  (published  in  1810),  mentions  it, 
and  advises  rolling  the  body  of  the  Cow  as  a  means  of  remedying  the 
accident.  In  1842,  Blickenstorfer,  professor  at  the  Zurich  Veterinary 
School,  also  wrote  a  memoir  on  it.     The  first  in  France  to  direct  special 

'  Comptes  Rtndus  de  la  Sociefe  Vittrhiairt  du  Calvudof<  tt  de  la  Mavche,  1838. 


TORSIOX  OF  THE  UTERUS.  811 

attention  to  it,  was  Mazure,  whose  description  is  one  of  the  best  we 
possess.  It  is  published  in  the  same  periodical  which  contains  Lecoq's 
account.  From  liis  narrative,  it  appears  that  he  was  consulted  by  one 
of  his  colleagues  with  regard  to  a  Cow,  the  cervix  of  whose  uterus  was 
so  twisted  that  a  linger  could  not  enter  the  os.  Ma/.ure  gave  an 
unfavourable  prognosis  ;  but,  notwithstanding,  it  was  attempted  to 
reduce  the  torsion  by  making  an  opening  in  the  right  Hank  in  order  to 
reach  the  uterus.  The  attempt  failed,  though  it  demonstrated  that 
there  was  a  quantity  of  fcetid  serosity  and  fibrinous  flakes  in  the  peri- 
toneal cavity ;  that  the  uterus  had  a  rupture  in  its  left  posterior  border, 
the  rent  being  rounded  in  form  and  having  a  diameter  of  from  twenty 
to  twenty-four  centimetres  ;  and  that  the  fcctus  was  dead,  as  had  been 
suspected. 

.\s  nothing  more  could  be  done  with  the  Cow,  it  was  destroyed,  and 
it  was  then  discovered  that  the  uterus  had  made  a  complete  revolution 
on  its  axis  ;  while  towards  the  part  adjoining  the  cervix,  there  were 
found  live  spiral  twists,  two  of  which,  more  voluminous  than  the  others, 
were  of  a  greyish  colour  and  hard  in  texture.  Throughout  the  whole 
extent  of  these  twists  in  the  uterus,  the  connective  tissue,  infiltrated 
with  serosity,  formed  a  swelling  which  rendered  the  dilatation  of  the 
posterior  part,  and  the  passage  of  the  Calf  through  it,  most  difficult. 
The  foetus  was  perfectly  developed  and  intact,  and  did  not  appear  to 
have  been  dead  more  than  two  or  three  days. 

Another  Norman  veterinax-ian,  Pouchy,  described  four  cases  about 
the  same  period.  These  Cows  merely  suffered  from  loss  of  appetite, 
great  distention  of  the  abdomen,  unhealthy-looking  coat,  a  foetid  and 
sanguinolent  vaginal  discharge,  and  suppression  of  milk,  for  six  to 
eight  weeks  ;  when  submitted  to  treatment,  and  turned  out  to  pasture, 
they  recovered  sufliciently  to  become  fit  for  the  butcher. 

In  Cerniany,  about  the  same  time,  according  to  Dieterich,  torsion  of 
the  uterus  had  been  the  subject  of  investigation  and  treatment  by 
Schmidt  of  Bavaria,  Vix  of  (iiessen,  Fricke  of  Hanover,  and  Irminger. 
Fricke  cured  a  case  by  fastening  the  feet  together,  two  by  two,  and  roll- 
ing the  animal  in  a  contrary  direction  to  that  in  which  the  uterus  was 
twisted. 

In  Britain,  in  the  same  year  that  Reichner  described  the  accident 
in  Switzerland  (1H40),  Mr.  Carlisle,  of  Wigton,  under  the  head  of 
"  ('asarian  Operation  "'  describes  an  undoubted  case  of  torsion.  The 
circumstance  which  rendered  the  operation  necessary,  was  a  severe 
injury  the  animal  had  received  two  days  previously,  since  when  it 
had  manifested  symptoms  of  parturition ;  but  though  several  attempts 
had  been  made  to  extract  the  fo-tus,  delivery  could  not  be  accomplished 
minnij  to  the  uterus  being  tu-isted  Caesarian  section  having  delivered 
the  Calf  and  its  membranes,  the  Cow  only  lived  a  short  time.  The 
uterus  was  found  to  be  "  completely  rotated,  even  to  the  termination  of 
tlie  vagina." 

After  this  period,  torsion  of  the  uterus  attracted  a  large  share  of 
attention  among  the  most  accomplished  Continental  veterinarians,  and 
particularly  after  the  observations  published  by  Denoc,  in  France,  in 
184j.  It  formed  the  subject  of  animated  and  interesting  discussions  at 
the  Belgian  Sociote  de  Medicine,  the  Societe  Central  de  Med.  Veterin- 
aire  of  Paris  in  1853  and  ISGO,  the  Veterinary  Society  of  Wurtemberg 
in  IH.54,  and  that  of  Denmark  in  1855  ;  and  memoirs  on  it  have  been 
'    I'tterinarian.  vol.  xiii.,  p.  407. 


312  MATERNAL  DYSTOKIA. 

published  by  Bordonnat,  Eossignol,  Gaven,  Bouley,  Canu,  Lemaire, 
Cliambon,  Goubaux,  Chauveau,  Weber,  Liautard,  Dagoureau,  Lessona, 
Ollivero,  Ercolani,  Lafosse,  Chuchu,  Goron,  Obig,  Heu,  Eocco,  ]\Iarlot, 
Gourcy,  Coquet,  and  many  other  foreign  veterinarians ;  while  it  is 
alluded  to  with  more  or  less  detail  in  the  treatises  of  Eainard,  Bau- 
meister  and  Eueff,  Ziirn,  Harms,  Lanzillotti-Buonsanti,  Cruzel,  Saint- 
Cyr,  etc. 

In  this  country  it  did  not  receive  much  attention  for  some  years,  if 
we  are  to  judge  from  the  paucity  of  allusions  to  it ;  though  there  can  be 
no  doubt  that  the  accident  frequently  occurred.  But  in  recent  years 
many  cases  have  been  described  by  "Cartwright  (^A^hitchurch),  Woods 
(Wigan),  Bennet,  Cox,  Eussell,  Macgilli\Tay,  Cunningham,  and  others. 
Their  observations  refer  to  torsion  of  the  uterus  in  the  Cow. 

With  the  Mare,  in  which  the  accident  is  nearly  always  fatal,  it  has 
been  witnessed  by  Belhomme,  Elsen,  Delwart,  Hamon,  Noll,  Devaux, 
Canu,  Leconte,  Schmidt,  Miinich,  Anderson,  and  Cox. 

It  has  been  observed  in  the  Ewe  by  Lewis,  in  the  Bitch  by  Macgilli- 
vray,  and  in  the  Cat  by  Yivier. 

Nature,  and  Frequency. 

Before  proceeding  to  describe  the  symptoms  and  other  features  of 
this  curious  accident,  it  may  be  well  to  inquire  into  its  nature  and 
frequency. 

As  the  designation  indicates,  the  accident  consists  in  a  rotation  of  the 
uterus  on  its  axis,  by  which  its  upper  surface  may  successively  become 
lateral  and  inferior  ;  and  lateral  on  the  opposite  side  and  superior,  when 
the  revolution  is  complete.  This  revolution  may  take  place  in  two 
opposite  directions  ;  the  upper  face  may  at  first  be  left  lateral  or  right 
lateral— -the  first  constituting  left  torsion,  the  second  right  torsion. 

Torsion  may  be  incomplete  or  complete.  There  may  be  quarter-torsion, 
half-torsion,  three-quarter  torsion,  or  complete  torsion,  according  to  the 
degi-ee  of  rotation  the  uterus  has  experienced.  In  those  instances  in 
■which  the  organ  has  made  two  complete  turns,  we  have  a  double 
torsion. 

The  consequences  of  this  rotation  are  easily  seen.  The  vagina  and 
its  prolongation — the  cervix  uteri  —  because  of  their  attachments, 
cannot  follow  the  uterus,  and  therefore  become  twisted  in  a  cord-like 
manner ;  whence  arises  stricture  of  the  os — the  constriction  being  all 
the  greater  as  the  rotation  is  comj)lete — and  utter  impossibihty  to 
effect  delivery  of  the  foetus  unless  the  uterus  is  replaced  in  its  normal 
position,  or  its  contents  are  removed  otherwise  than  through  the  os. 

Incomplete  torsion  is  by  far  the  most  frequent  form  encountered  in 
practice.  It  is  often  so  slight  that  it  might  rather  be  classed  among 
the  deviations  of  the  uterus  already  alluded  to.  For  instance,  very 
frequently  there  is  only  a  trifling  displacement  of  the  cornu  containing 
the  foetus,  and  this  may  carry  the  uterus  with  it,  giving  rise  to  a  condi- 
tion which  bears  a  certain  analogy  to  the  uterine  obliquity  met  with  in 
woman,  in  which  the  organ  is  inclined  laterally.  Schaack,  Eainard, 
Weiss,  and  Zundel  have  often  noted  these  cases  in  animals ;  and  the 
latter  states  that  they  occur  in  greatest  proportion  among  the  larger 
lymphatic  Cows.  In  other  instances,  the  torsion  consists  of  a  quarter 
or  half-turn,  the  upper  face  of  the  uterus  having  become  lateral  or 
inferior;  sometimes  the  gravid  cornu  occupies  the  inferior  region  of  the 


TORSIOX  OF  THE  UTKltUS.  313 

abdomen  ;  and  at  other  times,  making  a  wider  rotation,  it  is  lodged  in 
the  opposit*!  flank. 

There  are  scarcely  any  moans  in  practice  by  wiiich  we  can  estimate, 
with  mathematical  exactness,  tlie  degree  of  torsion  the  uterus  has 
undergone  ;  as  what  we  have  designated  a  quarter-turn  or  revolution 
only  signifies  that  the  organ  has  made  a  rotation  of  90°,  while  the 
half-turn  is  scarcely  ISO  .  Nevertheless,  an  approximation  is  all  that 
can  be  looked  for,  and,  indeed,  is  all  that  is  necessary. 

As  we  have  already  mentioned,  Mazure,  in  1H42,  had  a  case  of  com- 
plete rotation  of  the  uterus  on  its  axis ;  this  was  remedied  by  causing 
the  organ  to  turn  completely  round  in  the  opposite  direction.  Other 
writers  have  spoken  of  a  complete  rotation  in  some  cases,  but  it  may  be 
surmised  that  it  was  only  a  half-turn.  Double,  treble,  and  even  quad- 
ruple twists  have  been  described  ;  because  there  have  been  found  two, 
three,  or  more  spiral  ridges  or  doubles  close  together,  hard,  and  resisting. 


Fig.  .s.l. 

Incomilktk  ToHaiON  ok  thk  Utkuls. 

1,  Body  of  the   Uterus;  2,  3,  4,  Spiral  Twists  directed  from  left  to  right; 
5,  Cervix  Uteri  and  \'af{ina  ;  6,  Susin-nsory  Liffainent  ;  7,  Pelvis. 

and  usually  parallel  to  each  other.     But  these  multiple  plies  are  only 
what  a  somewhat  long  and  supple  cylinder  makes  when  it  is  twisted. 

To  account  for  these  multiple  plic<r,  which  have  erroneously  been 
taken  for  so  many  complete  turns  of  the  uterus,  we  have  only  to  accept 
the  illustration  offered  us  by  Delafond,  who,  comparing  that  organ  to  a 
long  stocking,  puts  a  weight  in  the  foot  of  the  latter,  and  gives  it  a  turn 
in  the  middle,  keeping  the  open  or  upper  end  fixed.  Or  a  small  body, 
to  represent  the  faHus,  may  be  enclosed  in  the  middle  of  a  handker- 
chief— the  utems — so  as  to  make  a  sac.  If  the  end  containing  the 
body  be  turned  or  twisted  on  itself,  the  neck  of  the  sack  will  have  a 
first  ply,  representing  one-fourth  of  a  complete  twist ;  a  second  ply  will 
represent  the  half  of  a  complete  twist  or  turn,  and  will  cross  the  other; 
so  that  when  a  complete  turn  has  been  made,  it  will  be  found  that  there 
are  at  least  four  plies  or  strands. 


314 


MA  TERN  A  L  D  YS  TOKIA . 


Notwithstanding  this  illusion,  however,  it  is  certain  that  double  and 
even  multiple  torsion  of  the  uterus  may  exist ;  but  then  the  body  of  the 
organ  and  the  vagina  are  close  twisted  like  a  cord.  This  multiple 
torsion  is  discovered  on  making  the  autopsy  of  an  animal  which  has 
died  or  been  killed  because  of  non-delivery.  In  such  a  case,  it  requires 
two  or  more  turns  of  the  uterus  to  bring  it  to  its  normal  position.  Such 
a  complicated  condition  would  appear,  however,  to  be  very  rare. 

An  important  question  is  that  relating  to  the  possibility  of  such  an 
accident  occurring  to  an  organ  like  this,  which  is  attached  to  the  pelvis 
by  its  continuation — the  vagina — suspended  to  the  vertebrae  in  the 
lumbar  region  by  broad  ligaments,  and  maintained  in  situ,  in  addition, 


Fig.  87. 

MvLTu^LE  Torsion  ov  thk  Uterus. 

1,  Body  of  the  Uterus  ;  2,  2,  2,  Torsion,  involving   the   Body  of   the  Organ 
3,  Rectum  ;  4,  Bladder  ;  5,  Vagina  ;  6,  Symphysis  Pubis. 


by  the  neighbouring  viscera,  and  more  especially  by  the  rumen  in  the 
Cow — the  animal  in  which  uterine  torsion  is  observed  by  far  the  most 
frequently. 

This  question  can  be  answered  by  a  reference  to  what  we  have  stated 
with  regard  to  the  anatomy  of  this  portion  of  the  generative  apparatus, 
at  pp.  39,  43,  and  46.  We  have  seen  that,  in  the  Cow,  the  concave 
curvatures  of  the  uterine  cornua  look  downwards,  and  that  it  is  to  these 
concavities  the  broad  ligaments  are  attached  ;  so  that  if  the  uterus  be 
considered  as  freely  suspended  in  the  abdomen,  the  extremity  of  each 
cornu  is  turned  outwards  and  upwards,  while  its  base,  near  the  body  of 
tlie  organ,  although  drawn  in  the  same  direction  by  the  ligaments,  yet 


TOnsmx  OF  TIIK  UTHnrr.^,  315 

retains  its  position,  being  firmly  maintained  in  it  by  tlio  body  of  tho 
uterus,  whicb  also  receives  the  insertion  of  the  broad  lij^aments  on  its 
lower  face.  This  insertion  causes  tlie  uterus  to  project  above  the 
lif^amonts,  which  are  very  broad,  particularly  at  their  anterior  border, 
and  widely  separated  from  one  another  in  front,  near  their  lumbar 
attachment.  The  li^'aments  suspend  the  uterus  loosely  in  the  abdomen, 
and  allow  it  to  become  fully  developed  during  pregnancy.  At  this 
period,  too,  they  become  greatly  increased  in  substance  and  length.  As 
gestation  advances,  nearly  the  whole  of  the  great  size  of  the  uterus  is 
due  to  the  development  of  the  one  horn  in  which  the  fd-tus  is  situated  ; 
and  as  the  other  horn  retains  its  normal  size,  the  twisting  of  this  around 
its  ligament,  and  consequent  torsion  of  the  cervix,  can  be  readily  under- 
stood. 

Such  is  the  explanation  of  the  accident  given  by  Chauveau  ;  but 
Goubaux  does  not  quite  assent  to  it.  According  to  him,  it  is  not 
because  one  horn  of  the  uterus  is  developed  more  than  another,  neither 
is  it  owing  to  one  of  the  broad  ligaments  being  longer  than  its  fellow  ; 
it  is  in  consequence  of  the  development  of  the  cornua  during  gestation, 
and  their  projecting  greatly  beyond  their  means  of  attachment  or  sus- 
pension, the  broad  ligaments  being  thrown  altogether  back.  During 
Sregnancy  the  cornua  are  considerably  lengthened,  while  the  ligaments 
o  not  increase  in  breadth,  their  points  of  attachment  to  the  inner  face 
of  the  tlank  or  the  ilium  reniaining  invariably  the  same.  This  projec- 
tion of  the  gravid  cornu  beyond  the  broad  ligament  supporting  it — and 
which  may  be  as  much  as  nearly  two  feet — must  render  the  production 
of  the  torsion  remarkably  easy.  We  have  shown  that  the  uterus  is  sus- 
pended in  its  ligaments  as  in  a  hammock,  and  if  these  ligaments  increased 
in  width  as  the  gravid  organ  is  developed  in  size,  so  as  not  to  bo  over- 
lapped by  the  cornua,  then  it  might  to  a  certain  extent  roll  about  in 
the  hammock,  but  could  not  twist  around  it.  pjven  if  the  uterus  were 
suspended  at  the  extremity  of  the  ligaments,  as  in  the  Mare,  it  would 
be  far  less  liable  to  torsion,  and  would  swing  in  the  abdomen  like  a  kind 
of  pendulum. 

As  it  is,  the  projection  of  the  gravid  uterus  beyond  its  means  of  sus- 
pension, the  peculiar  attachment  of  the  broad  ligaments  to  the  lower 
face  and  concave  border  of  the  cornua,  and  a  large  proportion  of  the 
weight  being  situated  high  above  and  in  front  of  tliese  ligaments — all 
this  makes  us  comprehend  how  a  shock  of  any  kind  may  throw  tho 
organ  otT  its  hanmiock,  and  produce  incomplete,  or  even  complete, 
torsion  in  the  pregnant  Cow  without  rupturing  the  hammock  itself. 

RuetY  and  Ercolani  have  witnessed  cases  in  whicli  the  torsion  was 
confined  to  the  gravid  cornu  ;  and  Stocktleth  mentions  its  occurrence  in 
the  body  of  the  uterus,  in  front  of  the  cervix.  Most  frequently,  how- 
ever, it  involves  tlie  vagina,  as  well  as  the  cervix  and  body  of  the 
organ. 

In  certain  cases  alluded  to  by  Zundel,  the  accident  has  been  accom- 
panied by  rupture  of  tlie  ligaments ;  and  instances  are  recorded  by 
Dense  and  Albrecht  in  which  the  rupture  has  extended  to  the  uterus 
itself.  Rueff  alludes  to  a  case  in  which  the  foetus  had  even  escaped  into 
the  abdominal  cavity  from  a  uterus  thus  ruptured,  and,  developing  in 
the  peritoneal  sac,  constituted  an  extra-uterine  pregnancy. 

With  regard  to  the  direction  of  the  torsion,  several  authorities  have 
maintained  that  it  takes  place  from  left  to  right.  Others,  however, 
have  found  it  to  be  in  the  contrary  direction,  and  there  appears  to  be  no 


316  MATERNAL  DYSTOKIA. 

reason  why  it  should  occur  in  one  way  more  than  another,  as  the  foetus 
is  developed  in  either  cornu  irrespectively.  Eeynal,  however,  believes 
that  the  obliquity  of  the  inner  face  of  the  rumen  might  dispose  the 
uterus  to  torsion  towards  the  right.  Chauveau  is,  we  think,  justified  in 
asserting  that  torsion  always  takes  place  inwards  and  upwards — the 
foetus  slipping  off  its  hammock  causes  this  to  swing  round  either  to  the 
right  or  left. 

The  relative  infrequency  of  this  occurrence  in  the  other  domesticated 
animals,  is  undoubtedly  owing  to  the  different  arrangement  of  the 
uterus  and  its  suspensory  ligaments. 

With  regard  to  the  frequency  of  the  accident,  this  depends  upon 
several  circumstances,  the  chief  of  which,  perhaps,  are  related  to  the 
nature  of  the  country  in  which  the  animals  are  reared,  as  well  as  to  the 
manner  of  rearing  them.  This  will  explain,  partly  or  wholly,  why 
veterinarians  in  one  locality  are  familiar  wdth  the  accident,  while  others 
with  as  extensive  experience  never  witness  it. 

Leconte  states  that  he  has  observed  it  about  a  dozen  times,  in 
between  three  and  four  hundred  cases  of  difficult  parturition.  Lemaire 
has  met  with  it  seven  times  in  four  years ;  and  Eocco  speaks  of  having 
witnessed  about  thirty  cases  of  uterine  torsion  during  forty  years' 
practice. 

Etiology. 

Torsion  of  the  uterus  ordinarily  occurs  towards  the  termination  of 
pregnancy — about  the  eighth  or  ninth  month,  and  its  causes  appear  to 
be  very  diverse,  if  we  are  to  accept  the  numerous  opinions  which  have 
been  offered  on  this  point. 

The  cause  which,  of  all  others,  appears  to  operate  most  frequently  in 
producing  this  condition,  is  a  slip  or  fall,  and  particularly  od  the  hind 
quarters — croup  or  hocks. 

For  this  reason,  uterine  torsion  is  oftenest  witnessed  among  Cows  at 
liberty  in  pastoral  countries  where  the  ground  is  broken,  intersected,  or 
hilly.  Therefore  it  is,  also,  that  the  accident  is  not  at  all  uncommon  in 
Switzerland  and  the  hilly  parts  of  South  Germany  ;  while  it  is  almost 
unknown  on  the  plains,  and  is  very  rare  indeed  among  Cows  kept  in 
sheds. 

Sometimes  the  Cow  has  slipped  upon  its  hind-quarters  and  tumbled 
over,  through  coming  in  contact  with  another.  Mai'lot  and  Liautard 
have  seen  it  arise  from  a  horn  thrust  in  the  flank  by  a  companion  Cow,  the 
blow  throwing  the  foetus  and  the  uterus  round  to  the  opposite  side.  It 
has  occurred  in  a  Cow  which  was  often  butting  with  others.  Chambon 
has  noted  it  in  a  Cow  w4iich  was  in  the  habit  of  rolling  like  a  horse  ; 
Dagoureau  reports  it  occurring  in  a  pregnant  Cow  which  leapt  on  others 
like  a  Bull,  and  Liautard  in  another  that  used  to  get  its  fore  feet  in  the 
manger.  Eocco  states  that  it  is  produced  in  shoeing  at  the  forge,  w^hen 
pregnant  Cows  are  either  thrown  down  or  put  in  the  travis  to  he  shod ; 
and  Eueff  mentions  a  case  in  which  it  happened  through  casting  a  Cow 
for  the  purpose  of  performing  an  operation  on  it.  In  other  instances  it 
has  been  ascribed  to  falling  when  jumping  a  ditch,  or  slipping  up  wben 
descending  a  steep  hill. 

Eeynal,  Mignon,  Chambon,  Weber,  and  others,  appear  to  consider 
meteorism  as  one  of  the  most  certain  and  most  frequent  causes  of 
uterine  torsion,  through  the  displacement  of  the  viscera  which  the  dis- 
tension occasions.      Either  the  expansion  of  the  rumen  induces  unusual 


TOKSIOy  OF  THE  UTKRUS.  .117 

and  inordinate  movements  on  the  part  of  tlae  fcutus  ;  or  it  acts  din-ctly 
on  the  uterus,  and  produces  displacement  of  the  or^an  tlu'ougb  tho 
changes  in  situation  and  relations  imposed  on  the  other  abdominal 
organs.  Mr.  Cartwriglit,  of  Whitchurch,  was  of  opinion  that  great  dis- 
tension of  the  stomach  may,  oitlier  of  itself,  or  especially  in  connection 
with  a  fall,  cause  the  uterus  to  be  forced  on  one  side,  or  twisted. 

Other  authorities,  among  whom  we  find  Ercolani,  attiibute  the  acci- 
dent to  severe  toil  when  Cows  are  worked — as  in  draught  ;  others,  to 
deformity  or  malposition  of  the  fu'tus ;  and  others,  again,  think  it  may 
be  mainly,  if  not  exclusively,  due  to  the  spontaneous  and  energetic 
movements  of  the  fuitus  in  utcro,  towards  the  termination  of  pregnancy. 
It  is  well  known  that  these  movements  are  sometimes  very  lively  and 
powerful,  and  especially  when  induced  by  sudden  jerks  or  blows 
intlicted  on  the  pregnant  animal,  or  when  the  abdomen  is  compressed, 
after  the  ingestion  of  cold  water,  etc.  There  can  be  no  doubt  that  the 
movements  which  the  fcetus  executes  in  order  to  get  rid  of  uncomfort- 
able sensations  or  avoid  unpleasant  positions,  gives  rise  to  those  various 
attitudes  and  mal-presentations  which  so  frecjuently  render  birth  dilVi- 
cult,  if  not  impossible  ;  and  their  occurrence  may  also  explain  how  the 
young  creature  may  be  the  means  of  causing  the  cornu  in  which  it  is 
contained,  to  roll  and  twist  around  the  vacant  cornu  on  the  opposite 
side.  In  this  way  Colin  endeavours  to  account  for  those  cases  in  which 
the  uterus  has  made  several  revolutions  on  itself  when  the  movements 
persist — a  very  rare  accident,  it  is  true ;  while  he  admits  that  the 
(juarter  or  half  revolutions — which  are,  after  all,  most  frequent — may 
occur  without  the  active  intervention  of  the  fcetus,  or  even  of  the  uterus, 
and  may  take  place  through  falls  or  slips. 

Torsion  from  the  above  cause  is  all  the  more  feasible,  as  at 
the  end  of  pregnancy  the  amniotic  and  allantoic  fluids  are  diminished 
in  quantity,  and  the  membranes  and  uterus  are  therefore  applied  closer 
to  the  foetus,  and  may  follow  its  movements  moru  readily. 

Chambon  and  other  veterinarians  are  of  opinion  that  the  irregular 
and  often  violent  movements  whicli  the  pregnant  animals,  and  especi- 
ally primipara',  manifest  when  the  labour  pains  commence — lying  down 
and  getting  up  again,  throwing  themselves  first  down  on  one  side,  then 
on  another,  and  sometimes  even  rolling — are  the  most  frequent  cause  of 
torsion,  which,  according  to  them,  only  takes  place  at  parturition.  The 
latter  opinion  is  supported  by  a  case  described  by  Landel,  in  which, 
when  he  made  a  first  exploration  of  the  genital  passage  at  the  com- 
mencement of  birth,  there  was  no  obstruction  ;  but  soon  after,  on  again 
exploring,  he  found  that  torsion  of  the  cervix  uteri  had  occurred  in  the 
inten-al. 

Other  authorities  have  supposed  the  accident  to  be  occasioned  by 
premature  straining  in  parturition,  before  the  os  is  sufliciently  dilated; 
while  others,  again,  have  attributed  it  to  pregnant  Cows  in  sheds  not 
having  enough  space  to  lie  down. 

Lessona  and  a  few  others  believe  that  the  accident  may  be  due  to  the 
habit  that  certain  Cows  have  of  roUing  themselves  alternately  from 
right  to  left  when  they  are  lying.  On  the  sternum  they  may  do  this  ; 
but  though  among  Solipeds  and  other  animals  rolling  on  the  back  is  a 
perfectly  natural  movement,  yet  it  is  rarely  if  ever  witnessed  in  the 
Bovine  species.  Sternal  or  abdominal  rolling  could  scarcely  produce 
displacement  of  the  uterus. 

Ruptme  of  one  or  both  of  the  broad  ligaments  has  been  indicated  by 


318  MATERNAL  UYSTOKIA. 

Leconte  as  always  present  in  torsion  ;  but  this  is  an  error,  as  such  a 
lesion  is  found  to  be  exceedingly  rare  after  death.  But  rupture  of 
either  or  both  of  these  important  suspensory  bands  may  take  place 
when  pregnancy  has  well  advanced,  and  there  is  a  severe  strain  upon 
them.  Then  it  can  be  readily  understood  how  the  uterus,  rolling  about 
among  the  digestive  viscera  and  mainly  retained  b)^  the  cervix  and 
vagina,  may  twist  and  twine  on  itself,  and  thus  effectually  occlude  the 

OS. 

Torsion  of  the  uterus  has  been  witnessed  by  Pouchy,  subsequent  to  a 
birth  in  \vhich  there  was  eversion  of  the  vagina  and  uterus. 

In  all  likehhood,  the  stretching  of  the  broad  hgaments,  through 
repeated  pregnancies,  predisposes  to  it ;  though  this  cannot  be  the  sole 
cause,  as  torsion  is  often  met  with  in  primiparae. 

Displacement  of  the  uterus  by  the  pressure  of  a  diseased  kidney  has 
been  recorded  by  Eueff.  The  kidney  was  of  great  size,  and  weighed 
more  than  thirty-three  pounds. 

Sijmptoms. 

"We  have  stated  that  this  accident  always  takes  place  towards  the 
termination  of  pregnancy- — from  the  eighth  to  the  ninth  month.  But 
Wegerer,  Benzie,  and  other  veterinarians,  assert  that  they  have 
witnessed  it  so  early  as  the  fifth  month.  Without  disputing  the 
correctness  of  their  observations,  it  must  be  admitted  that,  during  the 
early  periods  of  gestation,  the  means  by  which  the  uterus  is  retained  in 
its  situation  are  sufficiently  powerful  to  prevent  any  displacement  of 
this  kind  ;  and  that  it  can  only  be  at  a  late  period,  when  the  foetus  is 
fully  developed,  and,  with  its  membranes,  has  attained  its  maximum 
size  and  weight — so  far  as  uterine  life  is  concerned,  that  such  an  occur- 
rence is  likely.  And  the  existence  of  torsion  is  generally  only  dis- 
covered when  the  time  for  the  expulsion  of  the  foetus  has  arrived  ; 
though  it  has  been  said  that  parturition  takes  place  earlier  when  torsion 
is  present. 

As  a  rule  there  is  no  particular  indication  of  inconvenience  or  suffer- 
ing at  the  moment  when  torsion  of  the  uterus  has  taken  place,  if  it  has 
occurred  before  parturition  ;  and  it  would  appear  that  gestation  may  go 
on  to  its  termination  without  any  appreciable  symptoms  being  noted,  or 
anything  like  functional  disturbance  observed. 

JEven  in  the  initial  stage  of  parturition,  when  enlargement  of  the 
iidder,  sinking  of  the  croup,  swelling  and  dilatation  of  the  vulva,  etc., 
have  become  manifest,  there  is  no  sign  w^hich  can  be  relied  upon  to 
prove  the  existence  of  torsion.  Only  in  some  instances  it  has  been 
remarked  that  the  tumefaction  of  the  vulva  is  not  so  great  as  in  ordinary 
cases,  and  that  it  remains  dry,  and  appears  to  be  buried  more  deeply 
between  the  ischial  tuberosities. 

Occasionally  some  difficulty  in  micturition  is  observed  before  partu- 
rition, should  torsion  have  occurred — the  urine  escaping  only  in  small 
quantity  at  a  time  ;  or  there  may  be  total  suppression.  This  interfer- 
ence with  the  discharge  of  the  urine  is  due  to  the  compression  the 
bladder  experiences  from  one  of  the  twists  in  the  uterus. 

The  fii'st  labour  pains,  which  soon  appear,  are  usually  feeble,  and  are 
separated  by  a  comparatively  long  interval  of  quiet,  during  which  the 
animal  appears  to  be  nothing  amiss.  Nevertheless,  as  time  goes  on, 
symptoms  of  colic  are  evinced  now  and  again,  and  though  the  labour 


roiisiox  ay  the  i'tkrus.  .{19 

pains  succeed  each  other  more  rapiilly,  and  become  more  energetic,  yet 
birth  does  not  seem  to  advance  ;  the  "water-bag  "  does  not  show  itself, 
and  nothing  appears  externally.  This  condition  niay  persist  for  six, 
twelve,  twenty-four,  and  even  forty-eight  hours  ;  when,  if  not  before, 
the  veterinarian  is  perhaps  requested  to  attend. 

In  other  instances,  however,  the  symptoms  are  more  marked  and 
severe  during  this  lirst  period.  The  animal  ap[)ears  to  suffer  from  the 
pain  of  intense  uterine  and  abdominal  spasms,  marked  by  violent  strain- 
ing, which  comes  on  at  longer  or  shorter  intervals  ;  it  moves  about 
anxiously ;  paws  energetically  now  and  again  ;  attempts  to  lie  down  ; 
rests  on  its  chest  or  sits  like  a  dog  on  its  hind-quarters ;  springs  up 
suddenly,  and  often  with  a  bound.  The  pulse  is  quickened,  the  skin 
becomes  alternately  hot  and  cold,  moist  and  dry ;  and  the  expulsive 
efforts,  though  so  violent,  are  of  course  futile. 

In  many  instances,  after  a  period  varying  from  twelve  to  forty-eight 
hours,  these  symptoms  may  disappear,  and  the  animal  seems  to  have 
recovered,  for  the  time  at  least,  its  ordinary  health.  To  such  an  extent 
does  this  occur,  that  it  might  be  believed  the  period  of  ))irth  had  not 
arrived,  and  that  the  symptoms  were  only  those  of  "  false  pains." 

In  the  course  of  from  one  to  six  days,  howevei",  this  normal  quietude 
is  interrupted  by  the  recurrence  of  the  labour  pains,  and  in  so  urgent  a 
form  that  there  can  no  longer  be  any  doubt  as  to  real  attempts  at 
delivery.  But  still  the  efforts  are  not  succeeded  by  any  tangible 
evidence  that  birth  is  making  progress.  As  some  obstacle  to  the  expul- 
sion of  the  ftetus  now  evidently  intervenes,  a  manual  examination  will 
probably  be  made  by  the  veterinarian,  if  he  has  chanced  to  be  called  in, 
and  after  he  has  heard  the  history  of  the  case  and  noted  the  general 
symptoms. 

The  oiled  hand,  on  being  introduced  into  the  vagina,  meets  at  first 
with  no  obstacle  in  that  canal ;  but  on  advancing  into  it,  the  fingers 
soon  encounter  one  or  more  folds  or  ruga^  which  render  the  passage 
more  and  more  constricted  towards  the  cervix  uteri.  Towards  the 
termination  of  the  vagina,  the  fingers  reach  a  kind  of  citl-dc-sac,  formed 
by  the  mucous  folds,  which  at  this  part  converge  in  a  spiral  manner, 
their  direction  being  either  to  the  right  or  left.  .Mthough  at  first 
there  appears  to  be  no  passage,  yet  it  will  be  found  that  by  turning 
the  hand  in  the  same  spiral  direction  as  the  cavity  winds,  or  rather  the 
rugie  incline,  the  fingers  will  be  able  to  penetrate  to  a  certain  depth  ; 
and  if  one  of  the  most  prominent  ridges  be  followed  in  this  way,  it  will 
be  discovered  that  it  has  a  corkscrew-like  course. 

This  is  the  pathognomonic  or  distinctive  symptom  of  torsion  of  the 
uterus,  and  it  is  not  found  in  simple  deviation  or  obliquity  of  the  organ. 
In  the  latter  condition  there  is  no  spiral  twisting  or  rug;e,  but  merely  a 
fold  of  mucous  membrane  passing  from  behind  forward,  in  an  oblique 
manner ;  while  tiie  hand  can  be  i)assed  with  little  ditliculty  to  the 
cervix,  the  os  of  which  is  usually  found  dilated.  It  is  only  this 
fold  of  membrane,  in  uterine  deviation,  which  prevents  the  passage 
of  the  fcEtus  througli  the  os,  by  hindering  uniform  pressure  on  the 
cervix. 

The  kind  of  spiral  infundibulum  into  which  the  hand  penetrates  in 
torsion  of  the  uterus,  varies  in  dimensions  according  to  the  amount  of 
torsion.  In  the  quarter-turn  or  revolution,  it  may  be  possible  to  get 
the  hand  into  the  constriction,  though  with  difficulty,  and  to  reach  so 
far  as  to  touch  the  neck  of  the  uterus,  which  may  be  more  or  less 


320  MATERNAL  DYSTOKIA. 

dilated,  and  allow  the  position  of  the  fcetus  to  be  ascertained.  In 
accomplishing  this  manoeuvre,  the  fingers  can  feel  a  large  salient  spiral 
ring  which  becomes  wider  as  the  hand  enters  deeper  into  the  organ, 
and  which  terminates  in  the  cavity  of  the  latter  in  a  wide  membranous, 
fan-like  manner.  If  the  torsion  is  to  the  left,  this  ring  inclines  to  the 
right,  and  the  membranous  expansion  in  the  uterus  is  directed  obliquely 
from  right  to  left  towards  the  fundus  of  the  organ.  The  spiral  twist 
is  in  the  direction  of  the  torsion,  and  the  uterus  is  carried  towards 
the  left  iiank.  In  torsion  to  the  right,  the  arrangement  is  the  reverse 
of  this. 

In  the  half-turn  or  revolution,  occlusion  is  so  marked  that  the  fingers 
can  scarcely  be  made  to  enter  the  obstacle,  and  the  cervix  cannot  be 
reached  unless  the  torsion  is  beyond  it.  There  are  always  two 
prominent  rings — two  mucous  folds  which  cross  each  other,  but  which, 
as  they  recede  from  the  torsion,  become  wider  apart  and  spread  like  a 
fan.     We  shall  investigate  the  character  of  this  twist  hereafter. 

In  the  complete  turn,  the  occlusion  is  such  that  only  one  finger  can 
penetrate  to  a  very  slight  depth  in  the  spiral  stricture,  and  the  direction 
of  the  rugae  is  very  baffling,  as  they  seem  to  intersect  each  other,  and  to 
run  in  opposite  directions. 

In  some  instances,  when  the  mucous  membrane  of  the  vagina  is 
involved,  the  spiral  ridge  may  be  distinguished  in  the  roof  of  that  canal, 
and  even  near  to  its  commencement. 

When  the  hand  can  be  introduced  into  the  uterus,  it  is  generally 
found  that  the  foetal  membranes,  as  well  as  the  footus,  are  intact,  and 
particularly  in  the  half  and  complete  degrees  of  torsion.  In  the  quarter 
revolution,  the  membranes  are  sometimes  ruptured  and  the  waters 
discharged  for  a  considerable  period. 

The  foetus  is  usually  alive  soon  after  the  first  labour  pains ;  but  it 
quickly  perishes,  and  its  death  is  almost  certain  to  have  taken  place 
within  forty-eight  hours  after  parturition  has  commenced.  The  period 
of  its  decease,  however,  will  greatly  depend  on  the  intensity  of  the 
"  pains." 

The  position  of  the  foetus  varies  according  to  circumstances.  It  is 
most  frequently  in  the  dorso-  or  lumbo-ilial  position,  rarely  in  the  lumbo- 
sacral, as  it  follows  the  movements  of  the  uterus  ;  so  that  in  reducing 
the  torsion  the  foetus  should  be  brought  into  its  normal  position.  Some- 
times when  the  twist  is  slight  and  the  passage  sufficiently  large,  the 
foetus  partly  enters  the  pelvis,  where  it  may  not  only  be  felt,  but  seized 
by  the  parts  first  presenting.  At  other  times  it  is  entirely  lodged  in  the 
abdomen  ;  and  at  others,  again,  it  may  be  felt  towards  the  pubis,  in  a 
kind  of  pouch  or  sub-vaginal  tumour,  formed  by  a  duplicature  of  the 
uterus  beneath  the  inner  opening  of  the  os.  In  the  latter  case,  torsion 
is  complicated  with  obliquity  of  the  organ,  and  the  tumour  not  un- 
frequently  considerably  elevates  the  bladder  and  meatus  urinarius. 

The  form  of  the  abdomen  is  sometimes  characteristic.  The  foetus 
can  generally  be  found  higher  in  it,  towards  the  flank,  on  the  right  or  left 
side.  This  change  in  the  position  of  the  foetus  may  also  be  recognised 
by  exploration  ])er  rectum,  which  may  also  possibly  allow  the  torsion  of 
the  uterus  to  be  distinguished,  as  well  as  its  direction.  The  uterus  can  be 
felt  through  the  wall  of  the  rectum  as  a  tense  hard  mass,  while  the  broad 
ligaments  may  be  discovered  as  hard  funicular  bands.  The  Fallopian 
ligaments,  which  have  encircled  the  cervix  uteri  and  strangle  it,  can 
often  be  felt ;  and  in  recent  cases  the  pulsation  of  the  uterine  artery 


TOIiSWX  OF  THE  L'TEIIUS.  -Vn 

can  be  perceived.     It  may  be  noted,  also,  that  occasionally  the  rectum 
itself  is  displaced  ami  drawn  towards  the  entangled  uterus. 

If  tlie  animal  is  not  relieved,  the  symptoms  above  indicated  persist 
with  variable  intensity,  according  to  circumstances.  The  straining  and 
attempts  at  spontaneous  delivery  continue  either  feebly,  and  with  long 
intervals  between,  or  they  are  violent  and  almost  incessant.  The  animal 
soon  ceases  to  eat  and  ruminate  ;  it  becomes  dull  and  dispirited ;  fever 
sets  in,  and  the  pulse  and  respiration  are  hurried  ;  rigors  and  grinding 
of  the  teeth  are  remarked  from  time  to  time  ;  the  lacteal  secretion  which 
had  commenced  is  now  suspended ;  the  mammai  become  soft  and 
small ;  the  eyes  sink  in  their  orbit ;  and  extreme  prostration  ensues. 
The  creature,  unable  to  get  up,  constantly  lies  ;  the  pulse  becomes  im- 
perceptible, while  the  heart's  beats  are  loud  and  tumultuous  ;  and  death 
generally  occurs  from  the  tliird  to  the  tenth  day  after  the  eai-liest  symp 
toms  were  exhibited. 

Many  authorities  are  of  opinion  that  death  is  the  only  result  that  can 
he  looked  for  when  assistance  is  not  rendered,  and  the  animal  is  accord- 
ingly left  to  its  fate  ;  and,  contrary  to  what  Kainard  has  stated,  they  do 
not  admit  that  the  fa>tus  may  become  mummified  in  the  uterus  and  the 
Cow  live  and  thrive.  But  we  have  the  evidence  of  the  old  French 
authority,  Boutrelle,  as  \vell  as  that  of  Ercolani,  Lessona,  Rocco,  (iurlt, 
Liautard,  Pouchy  (already  quoted),  and  others,  that  this  happy  termina- 
tion is  quite  possible  ;  and  indisputable  cases  are  recorded  of  Cows  with 
unreduced  uterine  torsions,  which  have  perfectly  recovered  and  fattened, 
and  in  the  uterus  of  which,  after  slaughter,  the  desiccated  or  mummified 
fcEtus  has  been  found. 

But  yet  these  must  be  looked  upon  as  exceptional  cases  ;  and  while 
they  only  prove  that  spontaneous  recovery  is  possible,  it  must  be 
admitted  that,  in  the  great  majority  of  instances,  death  is  not  long  in 
appearing  in  torsion  of  the  uterus,  if  the  organ  is  not  restored  to  its 
normal  position. 

Diagnosis. 
The  diagnosis  of  this  accident,  and  the  direction  and  extent  of  the 
torsion,  are  of  great  importance  from  an  obstetrical  point  of  view.     We 
will  therefore  consider  (1)  The  presence  of  torsion  ;  (2)  The  direction  of 
the  torsion  ;  and  (3)  The  degree  of  torsion. 

1.  The  Presence  of  Torsion. — To  recognise  the  existence  of  torsion  of 
the  uterus  is  not  attended  with  much  difficulty ;  and  in  describing  the 
symptoms  we  have,  to  a  certain  extent,  shown  the  manner  in  which  the 
accident  manifests  itself  to  tiie  obstetrist. 

It  has  been  stated  that,  when  the  hand  is  introduced  into  the  vagina 
of  an  animal  the  subject  of  this  displacement,  it  is  soon  discovered  that 
there  is  something  in  the  way,  and  this  appears  to  be  a  narrowing  of 
the  passage.  Passing  on,  the  constriction  seems  to  be  increasing,  until 
at  the  end  of  the  canal  there  is  only  a  very  small  opening,  into  which 
the  lingers  may  pass  with  difliculty  ;  when  inserted  there,  it  is  found 
that  they  cannot  be  pushed  straight  forward,  but  have  a  tendency  to 
deviate  to  the  right  or  left,  and  finally  to  assume  a  spiral  course. 

We  have  also  stated  that  this  peculiarity  in  the  constriction  is 
markedly  characteristic  and  distinctive  of  uterine  torsion,  and  this 
statement  holds  good  in  the  large  majority  of  cases;  so  that  it  is  scarcely 
possible  to  make  a  mistake. 

21 


322 


3IATERNAL  DYSTOKIA. 


In  very  exceptional  instances,  however,  the  torsion  may  have  occurred 
in  front  of  the  cervix — in  the  body  of  the  uterus ;  and  then  the  cervix 
may  be  easily  reached,  while  the  os  may  even  be  penetrated,  without 
discovering  any  indications  of  the  accident.  Such  occurrences  have 
been  recorded  by  Stockfleth,  Ercolani,  and  Eueff ;  and  these  excellent 
authorities  have  also  witnessed  the  torsion  limited  to  the  cornu  contain- 
ing the  foetus.  Here  we  have  neither  the  constriction  of  the  vagina, 
nor  the  spiral  involutions  of  its  lining  membrane,  to  guide  us  to  a  con- 
clusion, and  we  must  mainly  rely  on  rectal  exploration. 

Fortunately,  such  cases  are  all  but  unknown  in  practice,  and  prob- 
ably in  ninety-nine  per  cent,  it  will  be  found  that  the  twisting  has  taken 
place  at  the  cervix,  when  we  have  the  infallible  distinctive  sign — the 
spiral  rugae  in  the  vagina. 

2.  The  Direction  of  the  Torsion. — It  has  been  demonstrated  that  the 
uterus  may  revolve  on  itself  in  two  different  directions,  and  that  in 

A  B 


Fig.  88. 
A,  Cord  twisted  to  the  Right  ;  B,  Cord  twisted  to  the  Left. 


order  to  make  a  complete  revolution,  its  upper  face  may  become  right 
lateral,  then  inferior,  then  left  lateral,  and  again  superior;  or  if  it  re- 
volves in  the  opposite  direction,  it  will  become  successively  left  lateral, 
inferior,  right  lateral,  and  once  more  superior. 

We  have  casually  indicated  how  the  direction  of  the  twist  may  be 
discovered  when  it  has  not  made  a  complete  revolution.  But  the 
manner  of  discovering  to  which  side  the  gravid  uterus  has  inclined, 
has  been  one  of  the  most  debatable  in  the  history  of  this  accident, 
and  has  occasioned  much  controversy  and  the  most  contradictory  in- 
terpretations ;  up  to  the  present  time,  in  fact,  the  problem  has  not 
met  with  a  satisfactory  solution.  The  confusion  prevailing  with  re- 
gard to  what  appears  such  a  simple  matter,  is  well  exemplified  in  the 
discussion  which  took  place  in  1860,  at  a  meeting  of  the  Central  Veter- 
inary Medical  Society  of  Paris,  at  which  the  most  opposite  notions  were 
promulgated.  And  yet,  next  to  assuring  one's  self  that  torsion  does 
exist,  the  ascertaining  of  the  direction  it  follows  is  of  supreme  impor- 


TORSION  OF  THE  f'TEKUS. 


321? 


tance,  as  on  this  alone  depends  our  bein^'  able  to  rectify  the  malposition 
of  the  or^'an  without  delay.  The  disputation  appears  to  have  arisen 
solely  from  a  confusion  of  terms — from  neglecting  to  define  what  was 
meant  by  torsion  from  left  to  riglit,  or  right  to  left ;  and  Haint-Cyr 
praiseworthily  endeavours,  and  with  success,  to  settle  the  question  by 
repairing  the  omission. 

"  When,"  ho  says,  "in  its  revolution  the  left  cornu  of  the  uterus 
passes  above  the  riijht  cornu,  the  upper  face  of  the  organ  becomes 
successively  riijht  lateral,  then  inferior,  then  left  lateral,  and  again 
superior — thus  constituting  a  complete  revolution  ;  tiio  torsion  is  tlien 
from  left  to  rujht,  or  simply  right  torsion." 


LEfT  Utekise  TOBSIOS. 

1 ,  Body  of  the  Uterus  ;  2,  Cervix 
Uteri  twiate*!  to  the  left ;  3, 
Rectum  ;  4,  Bladder  ;  5,  Sym- 
physis. 


yig.  90. 

Right  Uterine  Torsion. 

1,  Body  of  the  Uterus  ;  2,  2,  2,  Torsion 
of  the  Cervix  Uteri  to  the  right,  iii- 
volvinv;  the  Body  of  the  Organ  ;  ."'>, 
Rectum  ;  4,  Bladder  ;  5,  Vagina  ;  (>, 
Symphysis. 


The  reverse  movement  constitutes  torsion /rom  right  to  left,  or,  better, 
left  torsion. 

In  other  words,  the  passing  of  the  left  cornu  over  the  right  produces 
right  torsion;  that  of  the  right  over  the  left  cornu,  left  torsion. 

Hence  we  have  the  simple  and  easily  remembered  and  understood 
terms  of  right  torsion  and  left  torsion,  which  are  synonymous  with 
torsion  from  left  to  right  and  torsion  from  right  to  left. 

This  being  decided  upon,  the  next  question  is  how  to  distinguish, 
from  a  purely  objective  point  of  view,  a  right  from  a  left  torsion;  and 


S24 


MATERNAL  DYSTOKIA. 


this  also,  it  appears,  has  been  a  source  of  difficulty  and  debate,  from 
neglecting  to  define  terms.  Saint-Cyr  again  has  come  to  the  rescue, 
and  his  efforts  to  put  the  matter  in  a  clear  light  must  be  looked  on  as 
eminently  satisfactory. 

Glancing  at  Fig.  88,  we  see  two  pieces  of  cord,  the  strands  of  which 
exactly,  but  more  clearly,  represent  the  spiral  plicaB  of  the  twisted 
vagina  or  cervix  uteri.  It  will  be  observed  from  the  course  of  the 
strands,  that  the  pieces  are  twined  in  opposite  directions  :  cord  A  being 


Fig.  91. 

Right  Uterine  Torsion  : 
Manipulation. 


Fig.  92. 

Left  Uterine  Torsion 
Manipulation. 


twined  to  the  right,  and  cord  B  to  the  left.  This  disposition  of  the 
strands  of  a  rope  being  generally  recognised  as  exact  in  the  technical 
language  of  mechanics,  as  well  as  in  speaking  of  the  spiral  inclination 
of  the  thread  of  a  screw,  the  same  application  of  the  terms  should  hold 
good  in  such  a  mechanical  deviation  of  the  uterus  as  that  now  under 
consideration. 

These  different  torsions  can  be  imitated  by  the  handkerchief,  as  has 
just  been  pointed  out ;  and  they  are  well  represented  in  Figs.  86  (left 
torsion),  89  (left  torsion),  90  (right  multiple  torsion),  and  93  (left  tor- 
sion), which  illustrate  simple  and  multiple,  as  well  as  right  and  left 
torsion. 


TORSIOy  OF  THE  UTERUS.  325 

This  being  fully  uudorstooj,  it  now  remains  to  demonstrate  how  tlie 
different  torsions  may  be  distinguislied  in  the  living  animal,  by  vaginal 
exploration.  In  doing  so,  we  will  follow  the  remarkably  lucid  directions 
furnished  by  Saint-Cyr,  to  guide  practitioners  in  forming  a  diagnosis. 

Supposing  the  riijht  hand  introduced  in  a  state  of  pronation  (palm 
downwards)  into  the  vagina  of  a  Cow  supposed  to  be  suffering  from 
uterine  torsion,  it  is  evident  that,  in  order  to  follow  the  direction  of  the 
spiral  folds  met  with,  it  must  execute  a  kind  of  rotary  or  screw-like 
movement  on  the  wrist.  If  this  movement  is  such  that  the  cubital 
border  of  the  hand,  to  the  rirjlit  at  first  (Fig.  91,  position  A),  becomes 
inferior  (little  linger  downwards — position  13),  then  internal,  so  as  to 
arrive  at  a  state  of  supination  (palm  upwards — position  C),  then  the 
torsion  is  to  the  riijht. 

On  the  contrary,  if  the  hand,  in  following  the  spiral  folds  in  the 
vaginal  canal,  rotates  in  the  opposite  direction,  of  course  tJie  torsion  is 
to  the  left.  For  instance,  as  in  the  other  case,  the  hand  is  introduced 
in  a  state  of  pronation  (Fig.  92,  position  A),  but  instead  of  the  thumb 
turning  upwards  and  round  to  the  right,  it  inclines  downward  to  the 
left  ^position  B),  the  little  finger  ascending  until  it  is  uppermost,  and 
the  palm  of  the  hand  is  turned  outwards  (position  C). 

This  is  a  very  simple  matter,  apparently ;  and  yet  in  practice  it  may 
be  very  important.  It  may  be  sufficient,  then,  if  the  fact  is  impressed 
upon  the  young  obstetrist,  that  when  the  palm  of  the  hand  turns  to  the 
left,  or  inwards,  the  torsion  is  to  the  right ;  and  when  it  inclines  out- 
wards, or  to  the  right,  then  the  twist  is  to  the  left. 

■i.  The  Degree  of  TorsioJi. — To  ascertain  the  degree  of  torsion  is  more 
diflicult  than  to  discover  its  existence  or  direction ;  though  every 
endeavour  should  be  made  to  satisfy  one's  self  in  this  respect,  as  the 
"  detorsion  "  will  be  easy  as  the  torsion  is  slight,  and  vice  versd. 

It  has  been  stated  that  it  may  exist  as  a  quarter,  half,  throe-quarter, 
or  a  complete  revolution  ;  and  that  it  may  even  extend  to  a  double, 
treble,  or  quadruple  twist.  But  it  must  be  always  doubtful  whether  we 
can  diagnose  with  certainty  these  different  degrees  of  torsion  which  may 
be  met  with  in  obstetrical  practice. 

It  is  evident,  however,  that  the  greater  the  amount  of  torsion,  so  the 
more  will  the  vagina  be  constricted,  and  penetration  by  the  hand 
rendered  difficult.  We  have  already,  in  treating  of  the  symptoms, 
drawn  attention  to  the  condition  of  the  vagina  and  cervix  uteri  in  the 
more  simple  cases.  When,  for  instance,  the  hand  can  be  passed 
without  very  much  trouble  as  far  as  tlie  cervix,  and  the  os  can  be 
penetrated  to  such  a  depth  that  some  parts  of  the  fcctus  are  felt,  then 
it  may  be  presumed  that  the  organ  has  only  made  about  one-fourth  of  a 
revolution  on  itself.  If  the  passage  is  more  constricted,  the  spiral  folds 
closer  together,  and  the  cervix  can  be  reached  with  much  difficulty — 
perhaps  only  one  or  two  fingers  entering  the  os — we  may  expect  that 
the  uterus  has  made  a  half  or  three-quarter  revolution. 

But  if  the  vagina  is  completely  occluded  not  far  from  the  vulva,  the 
fingers  being  only  able  to  pass  into  the  funnel-shaped  infundibulum  for 
a  very  short  distance,  and  cannot  reach  the  cervix,  then  there  may  be 
one  or  more  complete  twists.  The  spiral  folds  will  also  be  close  and 
numerous,  and  for  this  reason  their  direction  will  be  all  the  more  diffi- 
cult to  ascertain. 


326  MATEEXAL  DYSTOKIA. 

Prognosis. 

With  the  Cow,  torsion  of  the  uterus  must  be  looked  upon  as  a  serious 
accident ;  for  except  in  a  few  exceptional  cases,  when  assistance  is  not 
rendered  the  foetus  and  mother  have  always  perished.  Nevertheless, 
notwithstanding  its  grave  character,  modern  veterinary  science  does 
not  consider  it  beyond  remedy ;  and  its  records  show  that,  by  judicious 
intervention,  mother  and  offspring  may  often  be  saved. 

But  in  order  to  attain  this  happy  result,  a  careful  diagnosis  must  not 
only  be  made,  and  the  direction  and  extent  (if  possible)  of  the  torsion 
clearly  ascertained,  but  the  proper  mode  of  restoring  the  uterus  to  its 
normal  position  must  also  be  observed  and  skilfully  carried  out. 

A  cautious  opinion  must  always  be  given,  but  its  favourableness  will 
of  course  depend  upon  the  brief  duration  of  the  parturient  symptoms, 
the  degree  of  torsion,  the  condition  of  the  animal,  and  whether  it  has 
been  subjected  to  unskilful  manipulation  before  the  veterinarian  has 
been  called  in. 

Pathological  Anatomy. 

When  the  animal  has  been  subjected  to  manipulatory  manoeuvres  to 
effect  delivery,  or  when  it  has  been  permitted  to  live  many  hours  after 
signs  of  parturition  have  appeared,  the  first  important  alteration  noted 
on  opening  the  abdomen  is  that  due  to  peritonitis.  There  is  a  quan- 
tity of  blood-tinted  serum  effused  into  the  peritoneal  sac,  in  which  float 
shreds  of  fibrin  ;  and  the  lining  membrane  is  reddened,  deeply  injected 
with  blood  in  parts,  and  particularly  those  which  have  been  in  contact 
with  the  uterus  ;  not  uufrequently  there  is  a  fibrinous  exudate  on  its 
surface,  and  this  may  cause  adhesion  between  it  and  different  organs. 

On  removing  the  intestines  and  the  floor  of  the  pelvis,  the  uterus  and 
vagina  are  exposed,  and  the  torsion  is  visible.  This  appears  as  a  large, 
hard  cord,  composed  apparently  of  a  number  of  spiral  strands  of  unequal 
size,  the  closest  twined  of  w^hich  are  in  the  middle  of  the  strangulation  ; 
this  cord — formed  by  the  termination  of  the  vagina  and  the  cervix  and 
body  of  the  uterus — opens  out  its  strands  as  it  recedes  from  the  densely- 
twined  portion  towards  the  fundus  of  the  uterus  on  one  side,  and  to  the 
vagina  on  the  other  (Fig.  93). 

The  broad  ligaments  are  sometimes  compressed  between  the  spiral 
folds,  which  they  concur  to  form,  and  with  which  they  are  so  intimately 
connected  that  very  often  they  cannot  be  recognised  until  the  uterus 
has  been  untwisted.  In  other  instances,  they  merely  envelop  the  twist 
in  crossing  it ;  so  that  the  extent  of  the  torsion  cannot  be  seen  until 
the  ligaments  are  detached  from  the  ilium  on  each  side. 

Earely,  as  we  have  remarked,  are  these  ligaments  ruptured  ;  and 
though  some  veterinary  authorities  have  maintained  that  torsion  is 
impossible  w^ithout  one  or  both  being  torn,  yet  this  lesion  is  seldom 
witnessed.  In  the  large  majority  of  cases,  they  are  tense  and  greatly 
stretched,  tightly  compressing  the  cervix  and  rendering  occlusion  of  the 
OS  all  the  more  rigid  ;  but  when  the  uterus  is  reinstated  in  its  natural 
relations,  they  are  found  to  be  intact. 

If  the  uterus  be  seized  at  its  fundus  and  turned  in  a  direction  con- 
trary to  that  of  the  torsion,  the  strands  of  tbe  latter  gradually  open, 
widen,  and  are  effaced  ;  while  the  strangulation  disappears,  the  cervix 
comes  into  view,  and  the  vagina  assumes  its  normal  length  and  w^idth, 
as  well  as  its  almost  cylindrical  form. 

So  that  the  hand  introduced  into  the  vagina,  ^;cr  vulvam,  no  longer 


TORSION  OF  THE  UTERUS. 


327 


encountei-s  the  spiral  plicaj  met  with  in  the  animal  wliilo  alive  ;  hut 
passes  through  the  canal,  and  even  into  the  uterus,  without  hindrance. 
The  numher  of  turns  necessary  to  accomplish  this  will  indicate  the 
amount  of  torsion  which  had  taken  place.  Most  frequently  only  half  a 
turn  is  necessary,  showing  that  the  uterus  had  made  half  a  revolution 
on  its  axis — the  upper  surface  having  become  the  lower.  Sometimes 
the  quarter  of  a  turn  will  sutlice  to  adjust  it ;  while  in  other  instances 
a  complete  turn,  or  even  two,  three,  or  four  turns  in  the  opposite  dix-ec- 
tion  to  the  torsion,  may  be  needed  before  the  obstruction  disappears  ; 
though  it  is  very  doubtful  if  more  than  two  complete  twists  or  turns  are 
ever  really  made. 


Fig.  93. 

Left  Uterine  Tor.sion  in  ■<itit. 

1,  Body  of  the  Uterus  ;  2,  Twisted  crnlx  iiteri ;  .'!,  Vagin.a  ;    I,  L<  ft  K.'\lloi)ian 

Ligament. 


At  times  the  uterus  and  vagina  exhibit  signs  of  inflammation,  par- 
ticularly towards  the  strangulation,  and  the  indications  of  acute  metro- 
peritonitis are  frequently  most  marked.  In  exceptional  instances  we 
may  have  gangrene  of  the  uterus,  probably  due  to  obstruction  of  the 
bloodvessels  implicated  in  the  torsion. 

As  a  complication,  a  more  or  less  extensive  rupture,  complete  or 
incomplete,  of  the  uterus  may  exist — possibly  having  been  ])roduced  by 
the  severe  uterine  contractions  during  the  life  of  the  animal.  This 
rupture,  implicating  the  walls  of  the  organ,  is  most  frequently  met  with 
in  its  body,  in  the  vicinity  of  the  twisted  portion,  or  at  the  junction  of 
the  gravid  cornu  with  the  uterus.  The  foetus  has  been  at  times  found 
partly  fixed  in  the  fissure. 


328  MATERNAL  DYSTOKIA. 

"With  regard  to  the  foetus  itself,  its  condition  varies  with  the  length 
of  time  %Yhich  has  elapsed  since  it  perished,  and  also  whether  or  not 
the  external  air  has  had  access  to  it.  In  some  instances,  even  when  it 
has  been  dead  for  a  long  time,  it  will  be  fomid  in  a  state  of  perfect  pre- 
servation ;  in  others  it  is  in  an  advanced  stage  of  putrefaction,  the  hair 
and  hoofs  coming  off  readily,  and  the  body  swollen  and  emphysematous, 
while  the  odour  emitted  is  disgustingly  powerful  and  foetid. 

In  rare  cases  the  foetus  is  mummified,  and  this  may  even  occur  when 
it  has  attained  its  full  development. 

Such  is  an  outline  of  the  pathological  anatomy  of  this  accident. 
Numerous  illustrations  of  the  various  lesions  met  with  after  death 
might  be  furnished,  but  the  above  description  applies  to  all. 

Treatment. 

The  successful  treatment  of  torsion  of  the  uterus  had,  to  the  great 
majority — indeed,  to  all — of  the  veterinary  obstetrists  of  not  long  ago, 
evidently  appeared  hopeless  ;  consequently,  the  animal  suffering  from 
this  accident  was  either  left  to  die  without  succour,  or  was  consigned 
to  the  butcher  if  its  carcase  could  be  utilised  for  food.  In  some  few 
instances,  the  animal  has  recovered  from  the  effects  of  the  torsion,  and 
without  reposition  of  the  organ  having  been  effected.  After  fruitless 
efforts,  the  labour  pains  subside,  the  foetus  dies  and  becomes  mummified; 
the  Cow  is  in  an  ailing  condition,  perhaps,  for  some  time,  but  rallies, 
and  may  even  regain  its  former  condition,  not  unfrequently  even  yielding 
a  certain  quantity  of  milk. 

In  other  cases  the  Cow  becomes  emaciated  and  miserable-looking, 
gives  no  milk,  and  generally  succumbs,  after  a  variable  period,  to  chronic 
peritonitis.  But  in  far  more  instances  serious  illness  ensues  at  the  very 
commencement,  and  we  have  metritis  and  peritonitis,  gangrene  of  the 
uterus,  putrefaction  of  the  foetus,  septicaemia,  paraplegia,  or  other  grave 
conditions  which  quickly  terminate  life. 

In  British  veterinary  literature  successful  attempts  at  delivery  have 
been  recorded. 

On  the  Continent,  although  many  cures  have  been  published,  yet  they 
only  date  from  a  comparatively  recent  day.  Nevertheless,  according  to 
Eainard,!  Vieillard  long  ago  (1823)  succeeded  in  one  instance  in  saving  a 
Cow  and  Calf,  through  having  recourse  to  vaginal  hysterotomy.  In  this 
case  there  was  inversion  of  the  uterus,  the  cervix  of  which  w^as  extruded 
beyond  the  vagina,  and  showed  three  markedly-salient  spiral  rings.  He 
experienced  much  difliculty  in  making  convenient  openings  ;  the  exten- 
sive incisions  he  was  compelled  to  make,  in  order  to  remove  the  foetus, 
became  lacerations,  and  there  was  serious  hiemorrhage.  Yet  the  animal 
made  a  good  recovery.  This  formidable  operation  has  not  found  an  imi- 
tator, and  should  not  require  one — except,  perhaps,  in  a  similar  case,  when 
there  is  eversion  of  the  vagina,  so  that  the  parts  to  be  incised  are  visible. 

The  principal — indeed,  the  sole — indication  for  the  relief  of  this 
accident  is  to  untioist  the  uterus ;  in  doing  this  the  cervix  and  os  are 
restored  to  their  normal  condition,  and  the  vagina  rendered  patent, 
while  the  uterus  itself  assumes  its  ordinary  relations. 

Various  methods — all  of  which  have  been  attended  with  more  or  less 
success  in  practice — have  been  devised  to  accomphsh  this  object. 

They  are  (1)  Abdominal  taxis  ;  (2)  Vagi^ial  hysterotomy  ;  (3)  Vaginal 

1  Op.  cit.,  vol.  i.,  p.  240. 


TORSION  OF  THE  UTKRi'S.  329 

taxis;  {^)  Denoc  s  procedure  ;  (5)  Darrcau's  procedure;  {G)  liOtatioii  uf 
the  Coiv's  body:    and  (7)  Gastro-hysterotomy,  or  Ccesarian  section. 

1.  Abdominal  Taxis. — The  idea  of  opening  the  abdomen  and  thrust- 
in^'  the  hands  and  arms  into  its  cavity,  in  order  to  search  for  the  twisted 
uterus,  then  to  untwist  it  directly  by  turning  it  on  its  axis  in  a  contrary 
direction  to  the  torsion,  in  order  to  dehver  the  animal  by  the  natural 
passages,  is  at  tirst  sight  an  eminently  rational  and  practical  procedure, 
and  one  which,  occurring  independently  to  several  minds,  has  been 
resorted  to  by  a  number  of  veterinary  obstetrists.  But,  however  simple 
and  feasible  it  may  appear,  yet  it  is  very  far  from  being  an  easy  or 
always  successful  method,  and  this  for  several  reasons.  Among  these 
may  be  cited  the  great  weight  of  the  gravid  uterus — from  112  to  180 
pounds — its  immense  size,  its  convex,  smooth,  and  slippery  surface  ; 
the  limited  space  there  is  in  the  abdominal  cavity  for  manipulation  ; 
and  the  obstacles  the  other  viscera  otl'er  to  version  manceuvres. 

"  Nothing,"  says  ^lazure,  after  repeatedly  trying  this  method, 
"  appears  more  simple  to  the  mind  than  to  seize  with  the  hand  one  of 
the  sides  of  the  uterus,  and  to  swing  it  round,  and  especially  as  it  is 
restoring  the  organ  to  its  natural  position.  Yet  no  one  whom  I  know 
is  competent  to  perform  this  simple  movement." 

"  My  confrere  and  I  tried  to  swing  round  the  uterus,"  writes  Gosselin, 
"  but  it  was  in  vain  ;  all  our  efforts  could  not  even  cause  it  to  change 
its  place." 

Bouley  attempted  this  method  in  1853,  but  did  not  succeed.  After 
failing  in  other  manceuvres  to  effect  the  detorsion  of  the  uterus,  in 
despair  he  made  a  large  incision  in  the  right  flank,  in  order  to  try  if  he 
could  not,  by  direct  taxis  on  the  organ  itself,  restore  it  to  its  ordinary 
condition.  But  he  was  disappointed  :  for  the  uterus,  enormously  dis- 
tended, so  completely  tilled  the  abdominal  cavity  that  the  hand  could 
scarcely  be  introduced  between  it  and  the  walls  of  the  abdomen  ;  while 
the  surface  of  the  uterus  was  so  smooth  that  the  operator's  fingers  could 
not  cling  to  it. 

Notwithstanding,  this  operation — which,  from  having  been  performed 
in  the  region  of  the  flank,  has  received  the  designation  of  "laparotomy" 
(from  \a-dpa,  flank  or  /o/;is,  and  TijLruv,  to  cut) — has  been  practised 
with  variable  success  in  Germany  by  Fausel  (1849),'  Epple  (1852), 
Kohler  (1853),  Diccas  (1867),  Lechleuthner  (1868),  Obich  (1869), 
Heichlinger  (1869),  etc.  ;  in  France  by  Darreau,  Garreau,  and  others  ; 
in  Italy  by  Santoni  and  Rocco  ;  and  in  Denmark  by  Stockfleth. 

We  have  said  that  the  success  attending  laparotomy  has  been  variable. 
This  is  exemplified  in  Obich's  experience.-'    This  veterinarian  had  three 

'  It  is  worthy  of  note  that  the  idea  of  resorting  to  laparotomy  occurred  t<j  an  excellent 
veterinary  practitioner  in  Scotland,  perhaps  lonir  befort-  it  did  to  Fansel,  though  for  lack 
of  Mpjxirtunity  it  waa  not  carried  into  effect.  Mr.  Cartwright,  of  Whitchurch,  writing  in 
1s.jO,  "  On  Torsion  of  the  irterus  in  the  Cow"  (  I'f.lerinartHii,  vol.  xxiii.,  p.  248),  and  it» 
treatment,  and  proposing  to  try  rolling  th>  .ininial,  adds  :  "HI  did  not  succeed  in  this 
way,  I  should  proceed  according  to  a  suggestion  given  nie  by  Mr.  .lohn  Steel,  of  Biggar, 
Lanarkshire — viz.,  to  make  an  incision  between  the  ilium  and  the  ribs  on  the  right  side, 
»nd  try  to  untwist  it  (the  uterus).  If  I  succeeded,  I  shoidd  sew  up  the  wound  and  allow 
the  labour  to  take  its  natural  course  ;  but  if  not,  I  am  not  aware  that  there  is  any  other 
means  but  that  of  performing  the  Ctesarian  oj>»ration.  Mr.  Steel,  .ilthough  he  ha.s  not 
yet  h!»d  an  opportunity  of  testing  its  practicability,  deserves  the  thanks  of  the  profession 
for  such  a  suggestion,  and  it  is  one  which  I  think  verj-  likely  to  succeed.  At  any  rate, 
if  it  does  not,  we  can  but  perform  the  Cssarian  operation." 

'   Woe  fume  h  rij't  Jiir  ThierhtUkunde,  1869. 


330  MATERNAL  DYSTOKIA. 

cases  of  uterine  torsion,  in  which  he  resorted  to  this  operation  to  replace 
the  organ.  Two  of  the  cases  were  attended  with  complete  success  ;  but 
in  the  third  the  uterus  was  of  such  an  extraordinary  size  and  weight,  that 
he  failed  to  restore  it  to  its  natural  position.  He  proposed  in  future  to 
facilitate  the  operation  by  using  a  looped  cord  with  which  to  raise  the 
organ. 

Heichlinger  operated  successfully  on  a  Cow  in  the  same  manner,  but 
the  animal  afterwards  perished  through  gangrene  of  the  uterus. 

It  must  be  admitted  that  the  operation  has  not  been  performed 
sufiiciently  often,  and  then  sometimes  in  very  unfavourable  circum- 
stances, to  enable  us  to  draw  any  satisfactory  conclusions  as  to  its 
value.  Darreau,  who  has  been  fortunate  in  some  of  his  attempts, 
writes:  "Direct  taxis  by  an  opening  made  in  the  flank  has  had  some 
advantages  ;  I  have  even  thought  for  a  moment  after  my  first  success 
that  it  would  be  the  only  means  I  should  resort  to  for  the  future.  But 
unfortunately,  new  cases  upset  my  predictions,  and  compelled  me  to 
seek  for  more  efficacious  means."  And  Fausel  admits  that  the  con- 
siderable weight  of  the  uterus  may  sometimes  prove  an  insurmountable 
obstacle. 

The  dangers  attending  the  operation,  even  if  reposition  of  the  uterus 
be  effected,  are  as  great  as  its  difficulties.  Several  good  authorities  have 
therefore  recommended  its  abandonment,  or  at  least  its  being  adopted 
only  in  very  exceptional  circumstances.  Franck,  however,  shows  that 
it  is  far  from  being  unsuccessful — the  uterus  having  been  untwisted  in 
thirteen  out  of  fifteen  cases,  nine  of  the  thirteen  animals  recovering,  the 
other  four  being  operated  upon  too  late. 

Oj^eration. — Different  operators  have  different  modes  of  operating. 
Some  prefer  the  animal  in  a  standing  position  ;  others  throw  it  down. 
One  selects  the  left  flank  ;  another,  and  perhaps  with  more  reason,  in- 
cises the  right  flank.  Saint-Cyr  recommends  the  standing  position, 
with  the  hind  quarters  slightly  raised.  The  right  hind  leg  is  pulled  back 
by  a  rope  held  by  an  assistant,  to  prevent  the  operator  being  kicked  ; 
while  the  head  is  tied  short.  An  intelligent  assistant  introduces  his 
arm  into  the  vagina,  in  order  to  follow  and  announce  the  results  of  the 
untwisting.  The  operator  then  makes  an  incision  in  the  right  flank, 
not  too  high,  and  from  six  to  eight  inches  long,  which  should  be  sufficient 
to  allow  the  arm  to  be  easily  introduced.  This  incision  should  be 
oblique— downwards  and  forwards — and  skin,  muscles  (following  the 
fibres)  and  peritoneum  are  to  be  carefully  cut  through.  The  hand, 
damped  with  warm  water,  is  passed  into  the  abdomen,  above  the  uterus 
if  the  tzvist  is  to  the  left,  but  below  it  if  it  is  to  the  right ;  then  attempts 
are  made  to  put  the  organ  in  place  by  pressing  and  pushing  it  ;  if  any 
part  of  the  foetus  can  be  seized,  the  labour  is  lessened,  and  wearing  a 
cloth  glove,  or  wrapping  the  hand  in  a  piece  of  thin  cloth,  will  facilitate 
holding.  The  task  is  also  lessened  in  having  the  abdomen  raised  by  a 
sheet  placed  under  it,  and  held  by  men  on  each  side  ;  or  a  man  on  hands 
and  knees  under  the  abdomen  is  even  more  advantageous,  as  he  can  raise 
any  part  required  by  means  of  his  back  or  loins. 

Having  effected  detorsion,  the  wound  is  closed  by  suture,  and  anti- 
septic dressings  are  placed  over  it,  these  being  retained  by  a  wide  band- 
age round  the  body.  The  wound  quickly  heals  if  peritonitis  had  not 
set  in  before  the  operation  was  begun. 

According  to  Obich,  within  eight  days  the  wound  will  have  healed  by 
first  intention. 


TORSION  OF  THE  CTEKCS.  3M 

2.  Vaginal  Hystekotomy. — Vieillard,  so  long  ago  as  1823,  removed 
the  fu'tus  from  a  twisted  uterus  by  means  of  vaginal  section.  In  INOO 
Ercolani  proposed  riKjiiuil  lii/sterotomif,  the  opening  being  made  through 
the  upper  wall  of  the  vagina,  for  the  reposition  of  the  twisted  uterus. 
The  operation  is  of  the  same  kind,  and  is  conducted  in  a  similar  manner, 
as  that  for  the  castration  of  Cows,  introduced  by  Charlier ;  except  that, 
instead  of  the  ovaries  being  seized,  the  uterus  is  grasped  through  tlie 
wound,  and  attempts  iiuide  to  untwist  it.  Huetf  speaks  in  favour  of  the 
proceeding ;  but  we  cannot  find  that  it  has  ever  been  carried  into 
practice,  and  serious  doubts  may  be  entertained  as  to  the  likelihood  of 
its  being  successful,  owing  to  the  weight  and  size  of  the  gravid  uterus, 
and  only  one  hand  being  employed  to  turn  the  displaced  mass,  unless 
the  torsion  be  very  trifling ;  in  which  case  a  simpler  operation  might 

'succeed. 

If  attempted,  not  much  risk  nu\y  be  apprehended  from  incising  the 
vagina,  as  it  has  generally  been  found  to  be  attended  with  little  danger, 
and  cicatrisation  soon  takes  place. 

3.  Vaginal  Taxis. — All  sanguinary  and  serious  operations  for  the  cure 
of  uterine  torsion — like  the  two  preceding — should  be  avoided,  if 
possible,  until  the  simpler  means  which  modern  veterinary  science  has 
indicated  are  tried.  We  allude  more  particularly  to  version,  which 
rarely  fails  to  ])ring  the  case  to  a  satisfactory  termination.  That  is,  of 
course,  on  the  assumption  that  this  is  resorted  to  sufliciently  early  ;  for 
it  must  be  i-emembered  tliat  nothing  is  gained  by  delay  in  this  accident, 
and  if  relief  is  to  be  afforded  it  must  be  rendered  promptly,  and  as  soon 
as  the  existence  of  displacement  is  fairly  established.  When  delay  has 
been  allowed  to  take  place,  more  or  less  serious  consequences  must 
ensue  to  either  the  fcetus  or  the  maternal  organs,  or  to  both. 

In  certain  cases  of  very  incomplete  torsion — quarter  rotation  of  the 
uterus,  for  instance — and  when  there  is  sufficient  space  in  the  vagina 
for  the  hand  to  pass  through  the  obstacle  and  into  the  os  or  uterus, 
detorsion  has  been  accomplished  by  seizing  the  most  suitable  parts  of 
the  fcetus  and  exercising  direct  traction  on  it.  Instances  of  success  by 
adopting  this  course  have  been  furnished  by  Chambon,  Cann,  Gaven, 
Darreau,  and  others. 

The  mode  of  procedure  maybe  as  follows: — After  ascertaining  the 
direction  of  the  torsion,  the  arm  is  to  be  introduced  into  tlie  uterus  as 
deeply  as  possible  ;  if  the  fastal  membranes  are  yet  intact,  they  must  be 
largely  ruptured,  and  the  most  convenient  parts  of  the  fcjctus  sought  for. 
In  this  respect  it  will  be  found  that  every  part  of  the  young  animal  does 
not  offer  the  same  advantages  to  the  operator,  for  reposition  of  the 
uterus.  The  head  is  too  large,  and  does  not  afford  sufficient  hold  for 
the  hand  ;  the  pasterns  and  knees  are  too  much  removed  from  the 
body  and  too  round  ;  but  the  hocks  and  elbows  are,  of  all  parts  perhaps, 
those  best  adapted  for  this  kind  of  manipulation.  If  one  of  them  can 
be  reached,  it  should  be  firmly  grasped,  and  endeavours  made  by  it  to 
raise  the  body  of  the  fa?tus,  at  tlie  same  time  giving  it  a  turning  move- 
ment contraiy  to  that  which  would  be  given  to  the  uterus  in  order  to 
untwist  it. 

Supposing,  for  example,  that  the  torsion  is  to  the  right,  and  that  the 
fcetus,  offering  an  interior  presentation,  is,  from  the  fact  of  the  quarter 
revolution  of  the  organ,  in  the  right  dorso-ilial  position ;  then  the  object 
must  be  to  place  it  in  the  dorso-sacral  position. 


332  MATERXAL  DYSTOKIA. 

To  effect  this,  the  right  hand,  in  a  state  of  supination  (knuckles  down- 
wards, palm  upwards),  must  be  introduced  beneath  the  foetus,  and,  if 
possible,  the  left  fore  limb  seized  by  the  elbow  ;  then  the  operator, 
turning  his  arm  round,  raises  the  body  of  the  creature,  at  the  same  time 
turning  it  so  that  the  withers  describe  the  arc  of  a  circle  from  right  to 
left — from  the  right  flank  of  the  Cow  towards  the  sacrum. 

Sometimes  when  the  foetus  is  alive,  at  the  moment  this  manoeuvre  is 
being  executed  it  makes  a  movement  which  greatly  assists  the  efforts  of 
the  operator. 

If  the  dimensions  of  the  vagina  admit  of  it,  the  limbs  of  the  foetus  may 
be  drawn  into  the  pelvis,  and  even  as  far  as  the  vulva ;  and  while  the 
operator  is  acting  as  described  on  the  upper  part  of  one  of  the  legs,  an 
assistant  presses  on  the  free  portion,  and  by  thus  aiding  in  the  version 
considerably  facilitates  the  task. 

By  this  procedure  several  obstetrists  have  been  successful  in  readjust- 
ing the  uterus,  through  the  medium  of  the  foetus — the  adjustment  being 
ascertained  by  the  disappearance  of  the  spiral  mucous  folds  from  the 
vagina,  and  the  patency  of  the  canal. 

Nevertheless,  it  has  been  remarked  that  this  operation  is  not  so  easy 
as  one  would  be  inclined  to  imagine  without  testing  it  in  practice.  It 
requires  much  force  to  raise  and  turn  the  foetus  in  this  way ;  and  the 
constricted  vagina  and  powerful  uterine  contractions  are  formidable 
obstacles  to  the  exercise  of  that  force. 

Some  veterinarians,  as  Meyer  and  Losner,  have  succeeded  in  adjust- 
ing a  slightly  twisted  uterus  by  introducing  the  hands  into  the  vagina, 
and  aided  by  assistants,  who  manipulated  either  with  their  hands  or  by 
means  of  boards  or  sheets  applied  underneath  the  abdomen,  so  as  to 
set  the  organ  straight.  Of  course,  such  attempts  must  be  greatly  pro- 
moted if  the  foetus  can  be  reached  and  used  as  an  instrument  in  the 
manner  just  alluded  to. 

4.  Dexoc's  Procedure. — Denoc  appears  to  have  been  the  first 
veterinarian  who  attempted  reduction  of  this  torsion  by  the  simple 
means  stated  above,  but  applied  in  such  a  manner  as  to  merit  the 
designation  of  "original."  His  procedure  marked  a  great  step  in 
advance,  so  far  as  veterinary  obstetrics  are  concerned. 

In  1845  he  describes  the  case  of  a  Cow^  unable  to  calve,  but  whose  os 
uteri  was  sufficiently  dilated  to  allow  him  to  pass  his  hand  into  the 
uterus,  where  the  foetus  lay  in  a  good  position,  but  from  which  it  could 
not  be  expelled,  owing  to  a  wide  membranous  fold  extending  from  the 
cervix  to  the  fundus  of  the  organ. 

His  manner  of  getting  rid  of  the  torsion  consisted  in  suspending  the 
animal  by  a  very  narrow  sack  passed  under  its  chest ;  and  two  pulleys 
having  been  fixed  in  the  wall  on  the  right  side — one  corresponding  to 
the  fore  limbs,  the  other  to  the  hind  ones — the  fore  legs  were  tied  by  a 
cord  which  passed  through  the  corresponding  pulley,  while  the  hind 
ones  were  also  secured  by  another  cord  running  through  the  posterior 
pulley.  Five  men  were  posted  to  the  distal  end  of  each  of  these  cords, 
and  directed  to  pull.  When  this  was  done,  the  suspended  Cow  was 
swung  into  a  dorsal  position.  Then  two  strong  men,  placed  on  the  left 
side,  were  directed  to  push  the  animal's  body  to  the  right — a  movement 
which  caused  it  suddenly  to  rotate. 

An  exploration  with  the  hand  led  to  the  discovery  that  the  uterus 
^  Recueil  de  Mt'decine  Velerinaire,  1845,  p.  69. 


TOUSluX  OF  THE  UTERUS. 


333 


liad  changed  its  place,  but  that  tliere  was  either  a  double  torsion,  or 
the  inversion  of  the  animal  had  only  incompletely  turned  the  uterus,  as 
the  duplicaturo  was  still  present  at  the  cervix. 

<  Another  pull  was  given  at  the  cords,  and  the  previous  manoeuvre 
repeated,  and  this  time  with  good  elYect,  as  it  was  found  that  the 
nl)structing  fold  had  now  vanished,  and  the  uterus  was  in  its  ordinary 
position. 

•  The  Cow  was  then  left  alone,  to  await  the  result  of  its  own  expulsive 
t  tTorts;  but  nothing  having  transpired  after  about  an  hour,  a  dose  of 
( igot  of  rye  was  administered.  Another  hour  had  not  elapsed  when 
parturition  was  accomplished  without  the  slightest  dilliculty,  two 
Calves  being  born. 


(j  (j  u 


a^   4k 


,-  J 


Fig.  94. 
Darreau's  Retroversor. 


5.  D.\RREAu's  Procedure. — Denoc's  method  does  not  appear  to  have 
been  much  practised,  either  because  it  was  lost  sight  of,  or  was  only 
adapted  for  cases  of  very  slight  torsion  ;  and  in  view  of  the  great  dilli- 
culty generally  experienced  in  vaginal  taxis — which  is,  after  all,  the 
most  reasonable,  least  dangerous,  and  perhaps  the  most  convenient  of 
all  methods — several  devices  have  been  brought  forward  to  render  it 
more  easy  and  effective.  Of  these  none  deserves  more  notice  than  that 
of  Darreau,  which  was  brought  before  the  Central  Veterinary  Medical 
Society  of  Paris  in  1852.  The  improvement  in  vaginal  taxis  for  tliis 
accident  mainly  consists  in  the  employment  of  what  has  been  desig- 
nated a  "  uterine  retroversor  "  {utcrin  ritrovcrseur) — an  appliance  which 
would  appear  to  be  very  ingenious,  if  complicated.  And,  besides,  it  is 
only  of  service  in  those  cases  in  which  the  hand  can  be  introduced  in 
the  uterus  and  the  feet  of  the  fa'tus  seized — a  state  of  affairs,  unfor- 


•3U  MATERNAL  DYSTOKIA. 

tunately,  not  always — nor  indeed  very  often — present  in  torsion  of  this 
viscus.  Liautard  and  some  others,  however,  while  admitting  that  the 
apparatus  is  not  very  easily  applied,  yet  testify  to  its  utility. 

The  apparatus  is  composed  of  three  rods  (x\,  A',  A" ;  Fig.  94)  ;  of  a 
winch  (B) ;  of  a  screw,  with  a  movable  screw-nut  (D),  pierced  by  three 
holes  ;  and,  finally,  three  cords  (E,  E',  E")  with  a  loop  (F).  The  end 
of  each  rod  (G),  a  little  thickened,  has  a  longitudinal  hole  (H) ;  the 
other  extremity  (I)  has  a  hole  punched  through  it,  and  a  shoulder  (K). 
This  end  of  the  thi'ee  rods  is  inserted  into  the  three  holes  of  the  winch. 

The  apparatus  is  put  together  for  use  in  the  following  manner  : — The 
cords  are  fastened  by  their  loop  (F)  to  the  tw^o  pasterns  and  the  lower 
jaw  of  the  foetus,  and  serve  as  points  of  attachment  as  well  as  con- 
ductors to  the  rods.  With  this  object  the  obstetrist  passes  them,  one 
by  one,  through  the  hole  (H)  in  each  rod  ;  then,  by  one  hand,  he  seizes 
the  extremity  (I),  and  with  the  second  hand  the  other  end  (G)  ;  direct- 
ing the  latter  towards  the  part  of  the  foetus  to  be  pulled  at,  an  assistant 
who  keeps  the  cord  tense  passes  this  through  the  hole  (I).  This  done, 
each  rod  is  inserted  in  one  of  the  openings  of  the  winch,  the  screw  (C) 
is  pushed  through  the  middle  hole,  and  the  cords  are  passed  through 
the  holes  in  the  nut  (D)  of  the  screw  (C),  by  means  of  which  they  are 
made  as  tight  as  may  be  necessary. 

The  apparatus  may  be  used  either  while  the  Cow  is  standing  or  lying 
on  its  back.  By  turning  the  handle  of  the  winch  in  a  contrary  direction 
to  the  torsion,  counter- torsion  is  at  once  effected  without  difficulty,  and 
without  causing  the  animal  any  fatigue.  If  the  resistance  is  at  all 
great,  the  operator  entrusts  the  instrument  to  the  assistant,  passes  his 
hand  into  the  uterus,  presses  on  the  head  of  the  Calf,  and  in  this  way  aids 
the  action  of  the  retroversor.     Parturition  then  takes  place  naturally. 

6.  EoTATioN  OF  THE  Cow's  BoDY. — The  methods  of  Denoc  and 
Darreau  are  likely  to  be  useful  only  in  cases  in  which  the  uterus  is 
slightly  twisted ;  and  in  these  instances,  and  others  in  which  the 
torsion  is  much  greater,  the  method  about  to  be  considered  is  so  simple, 
attended  with  so  little  danger,  and  hitherto  has  yielded  such  favourable 
results,  that  it  is  certainly  to  be  preferred,  unless  vaginal  taxis  can  be 
resorted  to  with  every  chance  of  speedy  success.  This  method  consists 
in  rolling  the  animal  affected  with  uterine  torsion,  in  such  a  manner 
that  the  twist  which  forms  an  obstacle  to  parturition  is  effaced,  and 
the  genital  passages  are  open  for  the  passage  of  the  foetus. 

This  method  has  been  in  vogue  for  a  long  time,  and  its  introduction 
is  due,  according  to  Dieterichs,  of  the  Berlin  Veterinary  School,  to 
Fricke,  a  Hanoverian  veterinary  surgeon.  At  least  this  would  appear 
to  be  the  fact  from  what  Dieterichs  has  stated  with  regard  to  Denoc's 
procedure  in  1845,^  when  he  says  that  not  only  had  Schmidt,  Vix, 
Irminger,  and  Schenker — all  German  veterinarians  — mentioned  the 
occurrence  of  torsion  of  the  uterus ;  but  that  Fricke,  in  addition,  cured 
a  Cow  of  the  accident  by  tying  its  feet,  two  and  two,  then  rolling  it, 
taking  care  to  move  it  in  a  contrary  direction  to  that  in  which  the 
torsion  had  been  produced. 

Strebel,    howevei%    asserts    that    Eichner    of    Berne    recommended 

rolling  before  either  German  or  French  veterinary  surgeons  did — the 

move  to  be  made  in  a  direction  the  opposite  of  the  uterine  twist,  the 

Cow's  body  to  be  higher  behind  than  before.     However  this  may  be, 

^-  Becueil  de  Mcdecine  Veterinaire,  1845. 


TOnSIOX  OF  TIIK  UTERUS.  335 

German,  French,  Belgian,  Swiss,  and  Italian  veterinary  obstetrists  have 
practised  this  method  of  reduction  in  a  very  large  number  of  instances, 
and  altogether  with  most  gratifying  results.  And  veterinary  surgeons 
in  this  country  have  also  found  the  method  very  satisfactory.  As  with 
Denoc's  rotation  method,  this  is  a  version  of  the  uterus,  and  not  of  the 
fa'tus. 

Tlie  manner  of  rolling  the  animal  varies  somewhat  with  difl'erent 
authorities,  but  in  principle  all  are  agreed.  The  first  step,  after  ascer- 
taining the  existence  and  the  direction  of  the  displacement,  is  to  empty 
the  udder  of  its  milk  as  completely  as  possible,  so  as  to  prevent  the 
gland  being  injured  during  the  operation. 

\Vlnle  this  is  being  done,  a  sutViciently  roomy  place  should  be  got 
ready,  and  the  floor  covered  with  a  thick  layer  of  straw  or  moss  litter  ; 
on  this  the  Cow  is  thrown  on  the  proper  side,  and  witli  all  possible 
care,  the  feet  being  fastened  together.  The  hand  and  arm  are  then  to 
be  introduced  as  far  into  the  vagina  as  its  condition  will  permit. 
Should  the  os  be  accessible,  and  dilated,  some  part  of  the  fa?tus  must  be 
secured,  and  more  especially  a  limb  ;  this  must  be  firmly  maintained  in 
one  position.  If  the  fa?tU3  cannot  be  reached,  then  nothing  remains 
but  to  make  the  wall  of  the  vagina  the  point  of  resistance  until  a  better 
can  be  made  available. 

The  assistants  are  then  to  pull  at  the  ropes  which  secure  the  feet  of 
the  Cow,  so  as  to  bring  the  animal  on  its  back  ;  then  gently,  and  with- 
out jerking,  allow  it  to  fall  on  the  opposite  side.  This  being  done,  the 
animal  is  raised  on  its  chest,  by  the  shoulder  and  quarter,  and  turned 
over  on  the  side  on  which  it  was  thrown.  In  this  way  it  will  have 
made  a  complete  rotation. 

While  the  assistants  are  rolling  the  Cow,  the  operator,  with  his  hand 
in  the  vagina  or  uterus,  as  the  case  may  be,  endeavours,  by  pressing  in 
the  opposite  direction,  to  keep  the  organ  fixed  aud  to  prevent  its  follow- 
ing the  movement  the  body  is  undergoing. 

If  the  operation  is  well  conducted,  and  the  body  of  the  Cow  moved  in 
the  proper  direction,  the  obstetrist  will  lind,  as  rotation  is  carried  on, 
that  the  genital  passage  is  becoming  wider  and  the  obstacle  disappear- 
ing, until,  the  spiral  rings  having  become  efi'aced,  the  hand  can  reach 
the  cenix  and  penetrate  the  uterus  if  the  os  is  relaxed.  Generally  a 
gush  of  the  liquor  amnii  from  the  organ  announces  the  termination  of 
the  operation. 

If,  however,  the  hand  is  more  strongly  compressed  by  the  spiral  folds 
as  the  animal  is  turned  on  its  axis,  and  the  vaginal  canal  is  diminishing 
in  length,  it  is  a  proof  that  rotation  is  elTected  in  the  wrong  direction. 
This  is  remedied,  of  course,  by  reversing  the  movement. 

Sometimes  it  is  sufficient  to  make  the  animal  execute  a  complete  turn 
to  bring  the  uterus  into  its  usual  position.  More  fretjuently,  however, 
this  rotation  only  relaxes  the  constriction  and  does  not  entirely  efface 
the  rings  ;  so  that  it  is  necessary  to  continue  the  turning— always  in 
the  same  direction — until  the  desired  result  has  been  obtained.  Then 
parturition  can  be  completed  in  the  ordinary  way. 

It  will  be  seen  from  this  description  that  the  method  consists  simply 
in  rolling  the  Cow  as  one  would  roll  a  barrel  ;  and  the  only  point  now 
to  be  discussed  is  the  direction  in  which  it  should  be  rolled. 

This  point,  strange  to  say,  has  given  rise  to  as  warm  and  unsatis- 
factory discussions  as  some  of  the  other  points  to  which  reference  has 
already  been  made.     Some  authorities  have  declared  that,  to  achieve 


336  MATERNAL  LYSIOKIA. 

the  reduction  of  the  torsion,  the  Cow  must  be  rolled  in  the  same  direc- 
tion as  it ;  others  assert  that  the  rolling  should  be  contrary  to  the 
torsion  ;  while  others,  again,  pretend  that  both  procedures  are  correct, 
according  as  in  one  the  uterus  is  maintained  fixed,  while  in  the  other  it 
remains  free  in  the  abdominal  cavity. 

The  confusion  imported  into  the  discussion  was  probably  largely  due 
to  the  manner  in  which  each  disputant  looked  at  the  question — or, 
rather,  to  the  position  in  which  he  mentally  placed  himself  during  the 
supposed  operation.  For  instance,  one  may  have  fancied  an  animal  in 
a  standing  attitude  placed  before  him  ;  another,  with  a  Cow  lying  on 
its  back  ;  another  stood  in  front  of  the  beast ;  another  imagined  he  was 
behind  it ;  and  another  stood  at  its  right  side,  while  a  seventh  viewed 
it  from  the  left.  Consequently,  each  discussed  the  torsion,  and  the 
mode  of  remedying  it  by  rolling,  from  his  own  particular  point  of  view ; 
so  that  the  terms  they  employed  in  the  discussion  could  not  fail  to  be 
contradictory. 

Fortunately,  in  practice  no  great  harm  could  result ;  as  in  whatever 
direction  the  torsion  may  have  existed,  and  however  baftiing  the  spiral 
curving  of  the  vaginal  rugae  may  have  appeared  in  bad  cases,  the  grand 
test  and  guide  was  the  effect  produced  by  rolling.  If,  when  the  Cow 
was  turned  to  the  right,  the  vagina  became  shorter  and  more  firmly 
constricted,  then  it  was  evident  that  the  animal  was  being  rolled  in  the 
wrong  direction,  and  rolling  to  the  left  was  indicated,  when  the  con- 
striction would  be  diminished  and  the  vagina  lengthened.  The  pro- 
cedure might  be  empirical  ;  nevertheless  it  was  invaluable. 

But  there  can  be  no  reason  why  the  remedy  should  be  empirical,  or 
why  the  confusion  in  terms  which  has,  unfortunately,  existed  should  be 
allowed  to  hinder  the  progress  of  science,  and  even  throw  obscurity  on 
the  practice  of  such  an  important  operation  in  obstetrical  surgery. 

Saint-Cyr  had  already  explained  as  succinctly  and  clearly  as  possible 
the  exact  meaning  to  be  attached  to  the  terms  "right  torsion"  and 
"left  torsion";  and  he  has  set  himself  as  diligently  to  demonstrate 
what  should  be  understood  by  "  rolling  an  animal  to  the  right,"  and 
"  rolling  it  to  the  left."  He  supposes  an  animal  laid  on  its  riglit  side ; 
if  it  is  desired  to  turn  it  on  its  left  side,  it  is  evident  that  this  may  be 
accomplished  in  two  different  ways  :  first,  by  rolling  it  on  its  hack  and 
allowing  it  to  fall  on  the  left  side  ;  and,  second,  placing  it  on  its  sternum 
and  pushing  it  over  on  its  left  side.  In  both  cases  the  result  is  the 
same  :  the  animal  lying  at  first  on  the  right  side,  finds  itself  at  last  ou 
the  left  side.  And  yet  it  is  perfectly  obvious  that  the  second  movement 
is  exactly  the  reverse  of  the  first ;  while  it  is  not  less  evident  that  the 
creature  in  both  movements  has  been  turned  from  right  to  left :  for  this 
expression  in  its  real  sense  simply  means  that  the  animal  has  been 
moved  from  its  right  to  its  left  side. 

But  in  order  to  give  to  this  expression  a  precise  signification,  a  con- 
ventional interpretation  is  necessary.  This,  Saint-Cyr  proposes,  should 
be  as  follows : — "  It  ought  to  be  thoroughly  understood  that,  in  the 
movement  of  rotation  impressed  on  the  body  of  an  animal,  we  should 
always  commence  by  placing  it  on  its  back  before  bringing  it  on  the 
side  opposite  to  that  on  which  it  first  lay." 

In  this  sense,  "  to  turn  or  roll  a  Cow  from  right  to  left,"  means  that 
the  animal,  "  laid  at  first  on  its  right  side,  was  placed  on  its  back,  then 
on  its  left  side,  then  on  the  sternum,  and  finally  on  the  side  from  which 
it  commenced — the  right." 


TORSIOX  OF  THE  VrEUrs.  337 

The  contrary  expression  of  course  means  a  precisely  contrary  move- 
ment :  left  side,  back,  right  side,  sternum,  left  side. 

From  all  this  it  must  be  admitted  that,  in  order  to  effect  detorsion 
of  the  uterus,  the  Cow  should  be  rolled  in  the  same  direction  the  uterus 
followed  during  torsion ;  and  it  is  also  clear  that  the  uterus  does  not 
participate  to  the  same  extent  as  the  body  of  the  animal  in  the  rotatory 
movement  to  which  the  latter  has  been  subjected. 

Supposing,  as  Saint-Cyr  has  done,  that  the  torsion  has  been  recog- 
nised as  left,  and  as  is  depicted  in  Fig.  93  (p.  327). 

In  such  a  case  the  animal  would  be  cast  on  its  left  side,  and  turned 
successively  on  its  back,  right  side,  sternum,  and  left  side — it  icould  he 
rolled,  in  fact,  from  left  to  right. 

If  one  complete  rotation  does  not  sufBce,  then  the  movement  must 
be  continued  in  the  same  direction  until  the  hand  can  freely  pass  to 
the  cervix  and  into  the  uterus. 

The  soundness  of  these  views  of  our  estimable  colleague  is  amply 
verified  in  the  very  numerous  cases  of  torsion  of  the  uterus  which  have 
been  published  during  the  last  thirty  years  on  the  Continent,  and  par- 
ticularly in  France,  of  which  he  gives  a  few  examples.  All  the  facts 
collected  by  him  are  unanimous  in  justifying  the  acceptance  of  the 
precept  which  he  has  formulated  in  the  following  brief  and  distinct 
manner,  for  application  in  these  often-times  diHicult  cases  :  Torsion  to 
the  left — lay  the  animal  on  the  left  side  and  roll  it  to  the  left.  Torsion 
to  the  right — lay  the  animal  on  the  right  side  and  roll  it  to  the  right.  Or 
the  same  precept  might  be  formulated  in  this  way:  In  torsion  from  rigJit 
to  left  roll  the  Coic  from  left  to  right ;  and  vice  versd. 

Though  this  precept  appears  contradictory  to  what  has  been  recom- 
mended above — in  order  to  reduce  the  torsion,  make  the  body  of  the 
animal  execute  an  equal  degree  of  movement,  and  in  the  same  direc- 
tion, as  that  executed  by  the  uterus  ;  yet  the  contradiction  is  only 
apparent,  not  real.  In  fact,  in  this  manoeuvre  the  movement  of  rotation 
does  not  really  commence  at  the  moment  when  the  Cow,  lying  on  its 
side,  is  turned  on  its  back;  but  rather  at  the  time  when  it  is  thrown  on 
its  side  from  the  standing  posture.  If  it  is  thrown  on  the  left  side  for  a 
left  torsion,  it  really  falls  from  right  to  left — or  in  the  same  direction  as 
the  uterine  twist. 

Since  the  publication  of  these  valuable  remarks,  further  confirmation 
of  their  exactness  has  been  afforded  by  various  papers  published  in 
different  veterinary-  periodicals. 

There  is  not  much  to  add  with  regard  to  this  "  rotation  "  treatment 
of  torsion.  We  have  recommended  that  if  the  animal  can  be  moved 
from  its  stall,  and  time  permit,  it  should  be  thrown  down  on  litter  in  a 
roomy  place ;  all  the  limbs  may  be  tied  together  at  once  ;  or  first  the 
two  fore  and  then  the  two  hind  legs,  these  being  fastened  together 
afterwards,  but  not  allowed  to  cross.  For  an  ordinary-sized  Cow  five 
assistants  are  necessary  ;  one  of  these  is  to  be  placed  at  the  animal's 
head  to  hold  it,  and  make  it  follow  the  movements  of  the  body  ;  the 
second  should  keep  the  limbs  as  close  to  the  belly  as  possible,  when  the 
Cow  is  rolled  over  on  them.  It  is  verj-  important  during  the  operation 
that  the  hocks  be  kept  flexed  as  much  as  possible,  in  order  to  prevent 
the  udder  being  damaged,  and  also  to  avoid  muscular  injuries  to  the 
upper  part  of  the  hind  limbs.  The  other  three  assistants  should  lift 
and  roll  the  Cow,  and  aid  the  second  in  pulling  at  the  hind  legs  when 
the  animal  is  being  placed  on  its  back.     We  have  already  described 

22 


338  MATERNAL  DYSTOKIA. 

how,  and  explained  why,  rotation  should  be  made  either  in  one  direction 
or  the  other. 

The  operator  need  not  endeavour  to  render  the  uterus  perfectly  im- 
movable during  the  rolling,  as  it  turns  a  good  deal  with  the  body  of  the 
animal,  and  particularly  when  the  mass  of  the  rumen  presses  with  all 
its  weight  on  the  organ.  This  is  also  the  reason  why,  according  to 
Zundel,  a  half  or  even  quarter  torsion  requires  for  its  reduction  at 
least  a  complete  revolution  of  the  body.  It  often  needs  a  number 
of  turns  to  reduce  the  torsion,  but  generally  two,  three,  or  four  are 
sufficient. 

There  is,  therefore,  no  pressing  necessity  for  maintaining  the  uterus 
absolutely  fixed  while  the  Cow  is  being  rolled  ;  indeed,  as  a  rule  it  is 
no  easy  matter  to  keep  it  at  all  near  the  desired  position,  there  being  a 
great  difficulty  to  find  a  part  to  cling  to.  The  hand  should  rather  be 
employed  in  discovering  the  effects  of  the  version,  and  finding  when  the 
genital  passage  is  patent. 

Violet  attributed  his  insuccess  in  some  instances  to  the  want  of 
resistance  he  could  oppose  to  the  turning  round  of  the  uterus  as  the 
Cow  was  rolled,  when  he  held  the  feet  of  the  foetus.  He  therefore  tied 
the  two  pasterns  of  the  latter  together,  after  he  had  brought  them  out  of 
the  vagina,  giving  the  cords  to  assistants  wherewith  to  exercise  gentle 
traction.  A  thin  piece  of  wood  was  passed  between  the  legs  of  the 
foetus,  which  served  as  a  lever  by  which  the  creature  was  made  to  aid 
in  reducing  the  torsion,  the  Cow  being  rolled  half  round,  rarely 
altogether  round,  whenever  moderate  resistance  was  experienced.  In 
this  way  the  spiral  constriction  was  made  to  disappear  and  the  genital 
canal  opened,  without  injury  to  Cow  or  Calf. 

It  is  always  a  very  great  advantage  in  an  incomplete  twist  to  pull  the 
foetus  into  it  as  much  as  possible,  as  its  body  can  then  be  made  a  lever 
in  the  way  suggested  by  Violet. 

An  important  precaution  in  this  operation  has  been  notified  by  some 
practitioners  ;  and  that  is  to  roll  the  Cow  on  a  slightly  inclined  floor, 
if  possible.  It  may  be  observed,  however,  that  while  Wegerer  and 
others  recommend  that  the  hind  quarters  of  the  animal  should  be  the 
highest,  Chambon  and  Liaufcard  maintain  that  they  ought  to  be  lower 
than  the  rest  of  the  body.  And  we  can  scarcely  be  in  doubt  as  to  the 
correctness  of  the  latter  opinion  ;  for  in  the  position  indicated,  the 
uterus  falls  towards  the  pelvic  cavity,  and  this  favours  relaxation  of 
the  torsion,  and  the  more  easy  introduction  of  the  hand  through  the 
obstacle  in  the  vagina,  if  it  is  desired  to  attempt  to  fix  the  organ  by 
the  hand  while  rolling  is  taking  place. 

Wegerer 's  position  —  the  hind  quarters  raised — is  nevertheless  to 
be  preferred  if  it  is  sought  to  fix  the  uterus  by  its  own  weight,  when 
the  hand  cannot  be  passed  into  the  vagina,  or  cannot  act  advantageously 
there. 

As  in  the  majority  of  cases  there  is  only  incomplete  torsion,  and  all 
that  has  to  be  done  is  simply  to  replace  the  foetus,  or  rather  the  uterus, 
on  its  bed  or  hammock,  reposition  can  sometimes  be  effected  by  merely 
I'olling  the  animal  on  its  back. 

In  some  instances,  when  slow  steady  rolling  will  not  suffice,  a  quick 
or  jerking  roll  may  be  successful ;  in  other  instances  it  has  been 
found  advantageous  to  place  the  animal  on  its  back,  and  roll  it  from 
side  to  side. 

Wegerer,  Sacchero,  Eueff,  and  some  others  have   combined  rolling 


TO  n^  I  ox  OF  THE  UTElirs.  339 

with  abcloininal  manipulation  and  compression,  so  as  to  fix  the  fcetua 
and  uterus,  or  to  push  them  in  the  desired  direction  for  effecting 
detorsion  ;  at  the  same  time  rotation  is  practised  according  to  the 
directions  laid  down. 

Numerous  practitioners  are  content  to  roll  the  Cow  without  attempt- 
ing to  fix  or  manipulate  the  vagina  or  uterus,  and  many  successful 
cases  are  recorded  by  them. 

But  tliis  success  appears  to  have  been  obtained  at  the  expense  of  the 
Cow  or  its  ftctus,  as  the  rotation  had  to  be  carried  on  for  a  longer  time 
than  if  the  organ  had  been  fixed  ;  several  turns  may  be  necessary  where 
one  would  suffice  with  the  hand  in  the  vagina. 

If  detorsion  does  not  take  place  so  soon  as  anticipated,  there  is  no 
reason  to  despair.  If  the  direction  of  the  twist  has  been  exactly  made 
out,  the  rotation  may  be  continued.  Weber,  Wannovius,  and  Fischer 
mention  instances  in  which  the  Cow  has  been  rolled  from  fifteen  to 
twenty  turns  before  success  crowned  their  efforts.  It  is  even  men- 
tioned that  the  rolling  in  some  cases  has  occupied  an  hour  or  more. 
Weber  writes  : — "  The  Cow  is  often  rolled  for  more  than  an  hour. 
The  operation  is  laborious,  sometimes  painful,  to  the  operator ;  it 
demands  an  expenditure  of  strength  which  the  most  vigorous  can 
scarcely  boast  of,  and  requires  much  amour-propre  to  undertake  it. 
The  efforts  required  to  complete  it  are  so  great,  that  often  when  a 
successful  result  has  been  obtained  the  operator  is  out  of  breath  and 
exhausted." 

Happily,  these  extreme  and  baffling  cases  are  rare,  and  they  have 
generally  been  observed  with  Cows  in  which  the  foetus  was  dead.  It  is 
a  common  remark  that  reposition  is  easier  when  the  fujtus  is  alive  than 
when  it  is  dead. 

Unfortunately,  cases  will  be  met  with  in  which  replacement  of  the 
uterus,  and,  consequently,  delivery  of  the  foetus,  is  impossible  by  this 
method  of  rotation,  and  these  are  more  particularly  cases  of  multiple 
torsion.  Rueff  says  that  they  are  sometimes  accompanied  by  decom- 
position of  the  foetus,  when  the  gases  which  are  developed  in  the  uterus 
inflate  the  organ,  and  prevent  its  being  untwi-sted.  In  other  instances 
there  is  plastic  adhesion  Ijetween  the  spiral  folds,  or  between  the  uterus 
and  other  abdominal  viscera,  or  even  the  parietes  of  the  abdomen. 

When  the  uterus,  by  its  exaggerated  volume,  appears  to  offer  an  in- 
surmountable obstacle  to  reposition,  it  has  been  recommended  to 
puncture  it  through  the  vagina,  and  allow  a  quantity  of  its  contained 
fluid  to  escape,  so  as  to  reduce  it  to  manageable  dimensions,  when  the 
other  measures  can  be  resumed. 

It  is  also  advisable,  in  all  cases  of  torsion,  to  empty  the  digestive 
organs  as  much  as  possible,  by  an  active  purgative. 

It  has  often  been  predicted  that  the  rotation  procedure  may  give  rise 
to  serious  accidents — such  as  volvulus  of  the  intestines,  hernitc,  etc. 
But  we  cannot  find  any  notice  of  such  accidents  having  occurred. 

If  the  diagnosis  is  correct,  the  nature  and  direction  of  the  torsion  well 
ascertained,  the  animal  not  too  much  exhausted,  and  the  parts  in- 
volved not  seriously  injured,  a  successful  result  may  be  anticipated  in 
the  large  majority  of  cases,  when  the  treatment  above  indicated  is 
carried  out. 

When  the  uterus  is  placed  in  its  normal  position,  the  genital  passages 
patent  and  in  a  proper  state  for  delivery,  the  Cow  not  much  exhausted, 
and  the  fcetus  in  a  good  attitude  for  birth,  time  may  be  allowed  for 


340  MATEIIXAL  DYSTOKIA. 

Nature  to  effect  the  expulsion  of  the  young  creature.  Bh^th  is  generally 
not  long  delayed  under  such  circumstances,  and  the  operator  has  the 
satisfaction  of  knowing  that  he  has  been  the  means  of  saving  the  Cow, 
and  very  often  its  progeny,  with  but  trifling  inconvenience  to  both. 
The  after-consequences,  so  far  as  the  Cow  is  concerned,  are  of  no  more 
importance  than  those  of  ordinary  parturition. 

But  not  infrequently,  deceived  by  the  slight  symptoms  of  indisposi- 
tion the  Cow  at  first  exhibits,  the  owner  does  not  send  for  the  veterin- 
arian until  too  late  to  save  the  fcetus,  and  even  the  Cow. 

In  some  cases  it  will  be  found  that  birth  cannot  take  place  after  re- 
position of  the  organ,  from  inertia  or  paralysis  of  its  muscles  ;  this 
is  due  either  to  the  great  extension  the  fibres  have  experienced,  the  inter- 
rupted circulation  of  blood  in  the  organ,  or  injury  to  its  nerves. 

In  such  cases  stimulants  should  be  given,  and  friction  applied  to  the 
abdomen  and  loins.  Ergot  of  rye  is  recommended  by  Continental 
veterinarians.  Should  uterine  action  not  speedily  ensue,  and  particu- 
larly if  the  OS  is  dilated  and  the  membranes  are  ruptured,  the  foetus 
must  be  removed  by  traction.  If  the  os  is  impervious,  and  atony 
of  the  uterus  continues,  then  steps  must  be  adopted  to  deliver  artifi- 
cially. 

When  the  torsion  has  been  in  existence  for  some  time,  the  liquor 
amnii  expelled,  and  the  uterus  closely  applied  round  the  foetus,  then 
extraction  is  difficult  and  laborious,  and  prolapsus  uteri  is  not  unlikely 
to  follow.  The  genital  canal  should  be  lubricated  with  glycerine,  and 
injections  of  tepid  water  may  be  thrown  into  the  uterus  ;  when  the 
secundines  are  removed,  it  may  be  necessary  to  inject  some  anti- 
putrescent  substance,  if  there  are  foul-smelling  discharges  or  any 
apprehension  of  septicaemia. 

In  serious  cases,  after  reposition  of  the  uterus  and  delivery  of  the 
foetus,  grave  complications  may  ensue — such  as  metritis,  metro-perito- 
nitis, etc.  It  may  also  then  be  discovered  that  a  rupture  of  the  viscus 
exists. 

These  compHcations  must  be  treated  according  to  their  indications. 

7.  Gastko-hysterotojiy,  oe  C^saeian  Section. — This  operation  has 
been  recommended  when  the  other  measures  described  above  have 
failed,  with  the  object  of  saving  the  foetus,  if  it  be  alive,  or  to  preserve 
the  life  of  the  Cow.  Laparotomy  may  be  resorted  to  sometimes,  instead 
of  abdominal  section  towards  the  linea  alba. 

Eocco^  has  twice  successfully  performed  the  Caesarian  section  in 
torsion  of  the  uterus,  and  delivered  living  Calves.  Lemaire-  relates  a 
case  of  torsion  and  rupture  of  the  uterus,  in  which  recovery  was  hopeless. 
The  Cow  was  killed,  the  abdomen  immediately  and  widely  opened,  and 
the  foetus  extracted  from  the  uterus  with  all  haste.  The  Calf  was  alive, 
and  did  well.  Violet  has  also  had  recourse  to  this  operation  for  the 
same  reason  ;  the  Calf  livecl,  but  the  Cow  died  two  days  afterwards. 

We  shall  describe  the  operation  hereafter. 

Torsion  of  the  Uteeus  in  the  Maee. 

Torsion  of  the  uterus  in  the  Mare  is  a  rare  accident.  This  is  doubt- 
less owing  to  the  direction  of  the  uterine  cornua,  and  the  manner  in 

^  II  Medico  Veterinaria,  1863. 

-  Becueil  de  Medecine  Veterinaire,  ISoS. 


TORSIOX  OF  THE  UTEin'S.  841 

which  the  broad  ligaments  are  attached  to  them,  which  renders  rotation 
of  the  organ  very  dilVicult,  unless  there  is  some  anatomical  anomaly  in 
the  parts. 

The  possibility  of  such  an  accident  in  this  animal  has  been  experi- 
mentally demonstrated  by  Goubaux,  in  1864,  while  instances  of  its 
occurrence  have  been  published  by  Tisserant^  in  181G,  Belhomme-  in 
1850,  Elson  and  Dehvart-'  in  1852,  Hamon^  in  18G0,  Anderson-'  in  1860, 
Canu''  in  1861,  Schmidt'  in  1863,  Gierer'^  in  1863,  Jansen»  in  186(5, 
Coxi«  in  1875  and  1877,  Rollsi'  in  1878,  Deneubourg'-  in  1880,  Oreste'^ 
in  1881,  and  Miinich^^  in  1892.  There  can  scarcely  be  a  doubt  that  it 
is  much  more  frequent  than  is  suspected,  through  its  not  being  recog- 
nised, and  Saiut-Cyr  has  given  some  instances  which  go  to  prove  the 
truth  of  this  statement. 

Causes. 

The  causes  of  uterine  torsion  in  the  Mare  are  not  well  ascertained.  It 
is  not  improbable  that  some  of  the  causes  which  produce  it  in  the  Cow 
will  also  be  effective,  in  certain  cii'cumstances,  in  the  Mare. 

Wolff  mentions  that  he  has  witnessed  it  in  a  Mare  which  had 
suffered  from  attacks  of  colic  four  days  previously,  and  when  so  affected 
had  thrown  itself  down  and  rolled  violently.  In  Cox's  case,  a  few  weeks 
before  parturition  the  Mare  had  an  attack  of  colic,  and  rolled  over 
several  times. 

The  accident  has  only  been  seen  in  Mares  whose  period  of  pregnancy 
had  nearly  terminated.  In  Elsen's  case  the  Mare  had  been  ten  months 
pregnant  ;  in  Ilamon's  case  the  ordinary  period  had  expired  ;  and  the 
Mare  which  was  attended  by  Schmidt  was  within  a  few  days  of  foaling. 

Sympto7ns. 

The  general  symptoms  appear  to  be  similar  to  those  observed  in  the 
Cow.  In  the  majority  of  instances  the  animals  appeared  to  be  affected 
with  severe  colic,  and  attempts  at  micturition  were  frequent.  The  local 
symptoms,  however,  differ  somewhat,  the  torsion  being  generally  more 
forward  in  the  body  of  the  uterus  ;  so  that  the  spiral  vaginal  folds  are 
often  not  so  distinct,  and,  from  Goubaux's  experiments,  may  even  not 
be  felt  at  all. 

Rectal  exploration  is  recommended  by  Saint-Cyr  in  these  cases,  the 
torsion  being  felt  as  a  thick,  short  and  hard  cord.  Schmidt  easily  intro- 
duced his  hand  into  the  rectum  as  far  as  the  abdominal  margin  of  the 
pubis,  and  there  he  felt  under  his  hand  an  obstacle  which  prevented 
further  progress,  as  only  three  fingers  could  be  introduced  beyond  this. 
The  body  under  his  hand  was  hard,  resisting,  and  immovable  ;  whereas 
the  contents  of  the  colon  were  soft  and  easily  indented  by  the  fingers. 

'  Journal  flfs  Vehriiiairpn  <lu  Mi<li,  1846,  pp.  337,  343. 
-  Proce^-  Verbaiix  de  la  Soc.   l'tt<riji(i.ircj<  de  I'  Yoinf,  1850. 
^  Annak'*  <lc  Mt'il.   I'tft'rinairv  dt  Bruuelleit,  1852,  p.  452. 

*  Rfcueil  de  Mai.  V.l.rinaire,  1860,  p.  612. 

*  Veterinarian,  l><«iO,  p.  317. 

"  Rt-rutilde  Med.  Viiirinaire,  1861,  p.  186, 

"  Ibid.,  1864,  pp.  290,  714. 

"  Magazin  Von  Gurlt  uiul  liertwuj,  p.  322. 

»  Ibid. 

'*    Veterinary  Journal,  vol.  i.,  p.  264  ;  vol.  iv.,  p.  28. 

"  Ibid.,  vol.  vii.,  p.  11. 

'-   Traite  Pratique  d'tJbxtelrique  V^t^rinaire. 

"  Berue  V^t'rinaire,  1881,  p.  43. 

"   Wochenschri/t/iir  ThitrhtUkunde,  1892. 


342  3TATERXAL  DYSTOKIA. 

The  posterior  portion  of  the  floating  colon,  as  in  this  instance,  may 
be  obstructed  in  the  Mare  by  the  twist  formed  by  the  uterus  and  the 
broad  ligaments,  and  this  obstruction  will,  of  course,  prevent  expulsion 
of  the  fteces. 

Prognosis  and  Treatment. 

This  accident  must  be  considered  much  more  serious  in  the  Mare  than 
in  the  Cow,  for  some  of  the  reasons  already  alluded  to  as  influencing 
parturition  and  its  results  in  these  animals.  A  large  majority  of  the 
cases  terminate  fatally ;  of  seven  alluded  to  by  Franck  five  perished, 
and  a  similar  mortality  attended  those  I  have  investigated.  The  fcetus 
is  nearly  always  dead. 

The  treatment  must,  of  course,  be  similar.  Belhomme  succeeded,  by 
powerful  traction,  and  without  previous  reduction  of  the  twisted  uterus, 
in  extracting  a  dead  Foal  in  what  he  describes  as  a  case  of  "  demi- 
torsion."  It  is  probable  that  the  torsion  could  not  have  been  so 
great,  for  when  it  exists  to  this  degree  delivery  by  traction  is  impos- 
sible. 

Elsen  and  Delwart  succeeded  in  reducing  the  torsion  in  their  case, 
by  rolling  the  Mare  in  the  manner  we  have  recommended  to  be  adopted 
with  the  Cow.  In  this  instance,  however,  everything  was  against  the 
success  of  the  operation,  for  the  foetus  had  already  been  two  months 
beyond  its  time  in  the  uterus;  it  was  dead  and  in  a  state  of  putrefaction, 
and  had  to  be  removed  piecemeal.  The  Mare  died  from  septic  infection 
eleven  days  after  the  operation. 

In  Canu's  interesting  case  the  result  was  favourable.  The  mare  had 
been  endeavouring  to  foal,  it  would  appear,  for  ten  days,  and  was 
evidently  about  to  succumb.  Canu,  recognising  torsion  of  the  uterus, 
was  proceeding  to  open  it  by  force,  when  the  animal  fell  with  great 
violence,  and  the  shock  her  body  received  had  the  unlooked-for  result 
of  completely  untwisting  the  organ;  so  that  parturition,  though  difficult, 
became  possible.  The  Foal  was  dead,  as  might  have  been  predicted  ; 
but  the  Mare  was  saved,  and  continued  to  recover  sufficiently  to  be  put 
to  light  work,  when,  on  the  thirtieth  day  after  the  operation,  it  was 
attacked  with  metrorrhagia  which  nearly  proved  fatal.  It  eventually 
got  well. 

Deneubourg's  case  was  similar  to  Canu's,  and  a  living  Foal  was 
eventually  extracted,  but  it  died  in  a  few  hours  ;  the  Mare  recovered. 

In  Oreste's  case  the  foetus  was  putrefied,  and  the  Mare  succumbed  to 
septic  metritis  before  reposition  of  the  uterus  could  be  attempted. 

Hamon,  in  France,  and  Schmidt,  in  Germany,  endeavoured  to  effect 
reduction  of  the  torsion  in  their  cases  by  rolling  the  Mares  first  in  one 
direction,  then  in  the  other  ;  but  without  success,  as  both  animals  died 
without  being  delivered. 

Gierer  observed  two  cases  of  complete  torsion  in  Mares,  in  both  of 
which  the  accident  was  complicated  by  a  large  rupture  at  the  base  of 
the  uterus,  through  which  the  foetus  had  escaped  into  the  abdominal 
cavity. 

Cox  found  the  head  and  fore  legs  of  the  foetus  protruding  through 
the  inferior  wall  of  the  uterus.  Exploration  discovered  the  vaginal 
passage  beyond  these  parts,  but  it  suddenly  terminated  ;  though  a 
small  rugose  opening,  barely  admitting  two  fingers,  was  found.  The 
Mare  died  in  two  hours  ;  and  on  examination  there  was  noted  a  double 
twist  of  the  cervix  uteri,  with  rupture  of  the  uterus  and  vagina. 


Toiisiox  OF  THE  riKiirs.  343 

The  most  recent  cases  recorded  are  two  by  Munich. '  In  the  first 
the  Mare  had  been  showing  symptoms  of  cohc  for  some  days,  and  a 
vaginal  exploration  discovered  left-sided  torsion  of  the  uterus ;  there 
was  a  very  foul  odour.  As  the  Mare  was  dying  nothing  was  attempted. 
Death  was  due  to  septic  metro-peritonitis.  In  the  second  case  the 
Mare  was  lying  down  and  straining  violently.  An  examination  proved 
it  to  be  another  instance  of  complete  left-sided  torsion,  which  required 
eight  turns-over  of  the  Mare  to  adjust ;  a  very  small  Foal  was  extracted, 
but  the  straining  continuing,  the  presence  of  another  fo'tus  was  sus- 
pected, and  Miinich  was  making  another  exploration  of  the  uterus, 
when  suddenly  a  mass  of  the  small  intestine  escaped  i)cr  vulvavi, 
through  a  tear  in  the  upper  portion  of  the  uterus,  near  the  pelvic  inlet, 
and  at  the  point  where  he  had  felt  the  strongest  tension  before  com- 
mencing to  untwist  the  organ.  The  Mare  was  destroyed,  and  the  Toal 
died  in  twelve  hours. 

Torsion  of  the  Uterus  in  other  Animals. 

We  need  scarcely  allude  to  this  accident  in  the  other  animals  men- 
tioned as  liable  to  the  accident,  as  it  is  almost  impossible  to  diagnose 
its  existence,  owing  to  their  small  size.  Besides,  it  appears  to  be 
extremely  rare  in  them. 

In  multiparous  animals  the  foetuses  develop  simultaneously  in  both 
cornua,  which,  increasing  in  volume,  yet  remain  independent  ;  so  that 
torsion  may  occur  at  or  near  the  cervix  and  occlude  both  cornua,  or 
it  may  take  place  at  any  part  of  one  cornu.  In  such  a  case,  when  partu- 
rition occurs,  none  of  the  fcctuses  can  be  expelled,  or  those  in  the  non- 
twisted  cornu  may  be  born  with  difficulty,  and  even  one  or  more  of  those 
in  the  twisted  horn  if  the  twist  happened  some  distance  from  its  base  ; 
the  foetuses  beyond  the  stricture  are,  of  course,  retained  and  soon  perish, 
as  does  the  parent  in  the  majority  of  cases — and  generally  rapidly, 
from  strangulation  of  the  viscus.  Sometimes  the  severe  straining 
causes  extrusion  of  the  unconstricted  cornu. 

When  the  practitioner  is  called  in  time,  detorsion  may  be  attempted 
by  external  manipulation  through  the  abdominal  walls,  or  even  through 
the  vagina,  if  the  animal  be  sufficiently  large.  By  rolling  it  quickly 
several  turns  and  suddenly  stopping,  Saint-Cyr  thinks  detorsion  might 
be  effected  ;  he  also  recommends  trying  brief  suspension  by  the  hind 
legs  and  tlien  rolling.  But  the  difTiculty  is  to  know  in  which  direction 
to  roll  the  body.  As  a  last  resource  gastrotomy  or  laparotomy  may  be 
resorted  to. 

One  instance  in  the  Eice  is  recorded  by  Lewis,-  which  he  put  right 
by  rolling  the  animal  over  five  times  without  withdrawing  his  hand 
from  the  vagina,  and  exercising  slight  pressure  with  the  point  of  one 
finger  against  the  os  uteri ;  with  each  turn  of  the  animal  the  canal 
perceptibly  dilated. 

Saint-Cyr^  records  an  instance  in  a  four-year-old  Sore,  which,  arrived 
at  the  full  period  of  gestation,  began  to  strain  very  violently ;  this  con- 
tinued for  four  hours,  when  suddenly  a  large  mass  protruded  from  the 
vulva,  and  the  animal  soon  died.  The  mass  was  found  to  be  one  of  the 
uterine  cornua,  having  an  extensive  tear  with  lacerated  and  ecchymosed 

>    Wochenttchri/t  fur  ThierhtUhmde,  1892. 
'    Veterinary  Journal,  1886,  p.  319. 
3  Op.  cit.,  p.  496. 


344  MATERXAL  DYSTOKIA. 

borders.  The  other  cornu  was  in  the  abdomen,  and  contained  two 
voluminous  foetuses,  the  expulsion  of  which  was  hindered  by  a  half- 
twist  at  its  base  near  the  pelvic  inlet — the  torsion  being  from  left  to 
right. 

Macgillivrayi  alludes  to  a  case  in  a  small  terrier  Bitch,  which  he  put 
under  chloroform  and  secured  the  Puppies  one  by  one  by  means 
of  Breulet's  apparatus  ;  one  of  these  and  the  parent  survived. 

Guillebeau-  had  also  a  case  of  a  Bitch  which  expelled  two  decom- 
posed Puppies  after  a  dose  of  ergotine,  but  after  suffering  for  ten  days 
she  died.  The  left  cornu  was  found  to  be  strangulated  by  having 
become  twisted  completely  round,  involving  the  broad  ligament  as  well. 
Beyond  this  twist  were  two  emphysematous  foetuses ;  and  behind  it 
the  uterus  was  much  atrophied  and  its  canal  entirely  obliterated ;  so 
that  it  would  have  been  impossible  to  extract  the  foetuses  by  this 
way.  .  ^. 

Vivier^  and  Violet'*  each  give  an  instance  of  this  accident  in  the 
pregnant  Cat,  death  resulting  in  both  cases. 


CHAPTEE  III. 
Dystokia  from  Morbid  Alterations  in  the  Generative  Organs. 

roLLOwiNG  the  arrangement  adopted  by  Saint-Cyr,  we  will  in  this 
chapter  study  the  obstacles  to  parturition  which  are  due  to  (1)  Tumours 
developed  in,  or  in  the  vicinity  of,  the  genital  organs  of  the  female  ;  (2) 
Hernia  of  the  bladder ;  (3)  Bigidity  of  the  cervix  uteri  ;  (4)  Morbid  de- 
generations of  the  cervix  uteri ;  and  (5)  Obliteration  of  the  os  uteri. 

1.  Utero-Vaginal  Tumours. 

The  tumours  met  with  in  the  vagina  and  uterus  differ  much  with 
regard  to  their  nature,  origin,  structure,  and  influence  on  the  act  of 
parturition.  Sometimes  they  are  contained  in  the  interior  of  the  genital 
organs — in  the  uterus  or  its  cornua  or  cervix,  and  on  the  walls  of  the 
vagina,  as  well  as  on  the  labia  of  the  vulva ;  at  other  times  they  have 
their  seat  in  the  neighbouring  parts  or  organs — in  the  bladder,  rectum, 
or  pelvic  connective  tissue.  They  may  be  constituted  by  degeneration 
or  displacement  of  these  parts,  or  by  heteroplastic  products  developed 
there. 

Their  volume,  form,  and  consistence  are  very  diverse  ;  and  they  may 
either  adhere  closely  or  loosely  to  the  adjacent  parts,  being  fixed  in  the 
one  case  and  movable  in  the  other.  Some  are  attached  or  implanted 
by  wide  bases,  others  are  pediculated  or  retained  by  a  more  or  less 
narrow  pedicle. 

Tumours  of  the  soft  parturient  passages  are  rather  rare  in  the 
domesticated  animals,  and  their  occurrence  has  been  frequently  brought 
under  observation.  The  first  instance  is  probably  that  recorded  by 
Jeani'oy,  in  1828.^     Since  that  period  a  number  of  cases  have  been 

^   Veterinary  Journal,  1888,  p.  153. 

"  Archives  Viterinai^-e,  1882,  p.  361. 

3  Had.,  1876,  p.  424. 

*  Saint-Cyr's  Traite  Obstetrique  V4teri7iaire,  p.  497. 

•'  Becneil  de  Med.   Veterinaire,  1828,  p.  639. 


Mnlilllli  ALTEnATIoXS  IX  THE  HKXKHATII'H  nRtiJXS.  345 

recorded  by  veterinarians  in  this  and  other  countries,  and  some  of  these 
are  very  interesting. 

With  regard  to  parturition,  these  tumours  may  be  considered  in  a 
general  mamier  according  to  their  (I)  Scat  ;  (2)  Mode  of  attachment  ; 
and  (3)  Consistence. 

1.  Seat. — Tlie  situation  of  genital  tumours — whether  in  the  vagina, 
on  the  cervix  uteri,  in  the  os  uteri,  body  of  the  uterus,  or  cornua — will 
make  a  very  great  difference  in  the  act  of  parturition. 

Those  tumours  which  are  developed  in  the  uterine  cornua  may,  by 
altering  the  structure  of  the  walls  of  the  uterus,  hinder  the  amplilica- 
tion  of  the  organ,  impair  the  nutrition  of  the  foetus,  and  even  cause  it 
to  be  expelled  prematurely.  If,  however,  they  do  not  interfere  with 
the  regular  course  of  gestation,  birth  may  take  place  in  a  natural 
manner  and  without  interruption.  If  the  foetus  is  situated  behind  the 
tumour,  towards  the  body  of  the  uterus,  of  course  it  meets  with  no 
obstruction  in  its  passage  outwards  ;  and  if  it  should  happen  that 
labour  is  longer  and  more  dillicult  than  usual,  this  can  only  be  attri- 
buted to  the  alteration  the  pathological  production  has  effected  in  the 
muscular  structure  of  the  uterus,  and  which  may  produce  a  diminution 
in  its  contractile  or  expelling  power. 

When,  however,  the  tumour  is  between  the  ftotus  and  the  genital 
passages,  the  case  is  much  more  serious.  If  it  is  fixed  directly  on  the 
cen'ix,  it  may  prevent  dilatation  of  the  os  to  the  necessary  extent,  or 
perhaps  altogether.  W^hen  it  is  situated  in  front  of  the  cervix,  towards 
the  body  of  the  uterus,  but  in  the  immediate  vicinity  of  the  former, 
and  is  movable  to  a  certain  degree,  it  may  be  carried  into  the  dilated 
o-^,  occupy  it  to  a  greater  or  less  extent,  and  render  the  exit  of  the 
1  tus  impossible,  unless  the  tumour  is  moved  out  of  the  way.  If  the 
lumour  occupies  the  vagina,  it  will  prove  a  more  or  less  formidable 
obstacle,  according  as  it  is  large  or  small,  hard  or  soft,  and  consequently 
diminishes  the  lumen  of  this  outlet  for  the  fa'tus. 

2.  Mode  of  Attachment . — The  manner  in  which  tlie  tumours  are 
attached  to  the  membranes  from  which  they  arise,  has  some  influence 
on  their  action  as  obstacles  to  birth.  They  have  either  a  wide  base  of 
attachment,  or  they  are  sessile  or  pediculated. 

Those  tumours  which  have  a  very  wide  base  are  generally  of  a  malig- 
nant character ;  and  though  they  may  prove  very  serious,  so  far  as  the 
female  is  concerned,  yet  they  do  not  often  prove  a  cause  of  dillicult 
parturition,  provided  they  are  not  situated  in  the  vagina  or  on  the 
cervix.  Animals  so  affected  do  not  generally  breed,  though  they  may 
regularly  exhibit  a'Strum  ;  if,  however,  they  should  ciiance  to  conceive, 
and  pregnancy  has  terminated,  with  these  exceptions  parturition  may 
not  be  delayed  in  its  course. 

The  circumscribed  sessile  tumours  are  generally  more  serious  than 
those  which  are  pediculated ;  as  the  latter  may  be  more  or  less 
easily  displaced  when  they  are  in  the  way,  and  delivery  rendered  as 
easy  as  usual.  Or  if  the  pediculated  tumours  cannot  be  temporarily 
removed  from  the  path  of  the  fcetus,  they  may  easily  be  altogether 
got  rid  of  by  a  simple  operation,  particularly  if  their  base  is  very 
attenuated. 

3.  Consistence. — The  hardness  or  softness  of  the  tumours  has  an 
important  bearing  on  their  obstructiveness.  Such  tumours  as  the 
fibroids  are  so  dense  and  inelastic,  that  the  strongest  compression  will 
-oarcely  diminish  their  volume  or  alter  their  shape,;i^vl^le  othe^Sc:- 

/9^^    OF  -h;      ■  r  \ 

i   UNIVEr.3ITY    ) 


346  MATERXAL  DYSTOKIA. 

such  as  the  condylomata  or  papillomata — readily  change  their  form 
and  dimensions  when  submitted  to  pressure. 

We  will  allude  to  each  of  these  morbid  productions  more  fully 
hereafter. 

Diagnosis. 

The  diagnosis  of  these  tumours  is  not  always  so  easy  in  the  domesti- 
cated animals  as  in  woman.  In  the  latter,  the  surgeon  may  sometimes 
have  to  discover  the  existence  and  determine  the  nature  of  such  growths 
during  pregnancy ;  and  he  may,  consequently,  be  prepared  beforehand 
to  overcome  the  difficulties  which  will  present  themselves  at  a  later 
period.  But  w^ith  the  veterinary  obstetrist's  patients  this  is  not  so ;  and 
it  is  only  and  always  during  parturition,  in  the  midst  of  the  trouble 
which  inevitably  accompanies  a  difficult  birth,  that  he  is  called  upon  to 
give  an  opinion. 

But  as  some  compensation  for  this  disadvantage,  in  animals  direct 
exploration  is  easier  than  in  w^oman  ;  while  the  entire  hand  can  be 
introduced  into  the  genital  passages  of  the  larger  creatures  with  facility, 
and  every  part  be  explored ;  so  that  if  the  period  is  late  for  acquiring  in- 
formation with  regard  to  the  existence  of  tumours,  yet  these  facilities 
enable  the  obstetrist  to  obtain  most  valuable  notions  with  regard  to 
diagnosis,  prognosis,  and  treatment. 

But  this  exploration  should  be  complete  and  intelligent ;  as  errors  in 
diagnosis  are  easily  committed,  and  may  lead  to  serious  consequences. 
Here  the  hand,  not  the  eye,  must  be  the  guide,  and  just  as  the  sense  of 
touch  is  well  developed  in  it,  so  it  will  all  the  more  readily  distinguish 
between  a  tumour,  the  "  water-bag,"  or  some  part  of  the  fcetus  which 
is  covered  by  or  denuded  of  its  membranes  ;  as  well  as  discover  the 
exact  seat,  volume,  consistence,  and  mode  of  attachment,  besides  some- 
thing of  the  nature,  of  such  pathological  productions  as  are  now  being 
considered. 

Treatment. 

The  indications  for  the  treatment  of  these  obstacles  to  birth  will,  of 
course,  depend  upon  a  variety  of  circumstances,  the  majority  of  which 
have  been  referred  to.  Sometimes  we  may  be  able  to  act  directly  on 
the  tumour,  and  remove  it ;  in  other  cases,  from  its  situation  and  nature, 
it  may  be  beyond  the  reach  of  direct  action. 

When  in  the  vagina  and  not  far  from  the  vulva,  and  particularly 
when  pediculated,  it  is  occasionally  extruded  as  the  foetus  is  expelled 
from  the  uterus,  and  may  then  be  readily  seized  by  the  hand  or  forceps, 
and  taken  out  of  the  way.  In  such  a  case  the  tumour  may  be  either 
drawn  outside  the  vulva,  pushed  to  one  side  so  as  to  clear  the  passage, 
or  extirpated. 

If  it  is  situated  beyond  the  os,  and  is  sufficiently  movable,  it  may  be 
pushed  in  front  of  the  pelvic  inlet,  and  the  parts  of  the  foetus  which 
present  be  immediately  brought  therein  so  that  the  tumour  may  be  kept 
out  of  the  track  of  the  latter. 

Should  the  growth  be  of  the  nature  of  a  cyst  or  abscess,  merely 
puncturing  it  by  means  of  a  bistoury,  scalpel,  or  trocar,  will  evacuate 
its  fluid  contents,  when  it  will  collapse  and  birth  be  rendered  possible. 

When  it  is  a  pediculated  tumour  like  a  polypus,  it  may  be  got  rid  of 
at  once  by  extirpation,  if  the  pedicle  is  easily  accessible.  To  this  end 
the  pedicle  may  be  simply  cut  through;  but  this  measure,  though  the 


MonniD  ALTER ATIOXH  IX  THE  GEXERATIVE  ORGAXS.  347 

most  expeditious,  is  not  always  the  best ;  as  there  may  ensue  internal 
lucmorrliage,  ^vhich  will  be  all  tlie  more  troublesome  as  htemostatic 
agents  are  diOicult  of  application  to  the  wound. 

The  pedicle  may  certainly  be  ligatured,  either  in  mass  or  partially, 
previous  to  extirpation,  in  order  to  obviate  the  disadvantages  attending 
simple  excision.  This  means  has  been  successfully  employed,  and 
though  perhaps  a  longer  and  more  difficult  operation,  it  is  to  be  preferred 
when  possible. 

Kemoval  by  means  of  the  ocraseur  is  preferable  to  all  others  when 
possible.  It  is  no  more  difficult  than  simple  excision,  and  so  far  as 
htcmorrhage  is  concerned,  it  is  as  safe  as  the  ligature,  while  the  conse- 
([uences  are  much  more  trifling. 

When  the  base  of  the  tumour  is  very  small,  and  has  but  a  slender 
attachment  to  the  textures  from  which  it  springs,  and  when,  in  addi- 
tion, it  is  beyond  the  application  of  a  ligature  or  the  ucraseur,  it  may  be 
torn  off  or  removed  by  the  finger-nail. 

The  most  difficult  tumours  for  treatment  are  those  wliich  are  hard 
:'.nd  sessile,  and  to  which  the  foregoing  measures  are  not  applicable.  It 
-sometimes  happens,  however,  that  these  formations  have  only  a  very 
loose  connection  with  the  subjacent  tissues,  and  it  is  often  possible  to 
remove  them  either  wholly  or  in  part,  by  making  incisions  through 
them,  and  enucleating  the  divided  portions  by  means  of  the  fingers. 

It  is  rare  that  neoplasms  developed  in  the  labia  of  the  vulva  offer  any 
obstacle  to  birth ;  should  they  chance  to  do  so,  however,  it  is  easy  to 
remove  them  by  means  of  the  scalpel  or  bistoury.  If  the  subsequent 
(L'dema  of  the  labia  has  not  disappeared  when  parturition  commences, 
and  if  it  hinders  exploration  by  the  hand,  or  the  expulsion  of  thefcctus, 
it  may  be  combated  ])y  scarifications.  These,  however,  should  only  be 
Miade  during  parturition. 

There  may  occur  cases,  nevertheless,  in  which,  either  from  the  nature, 
mode  of  attachment,  or  situation  of  these  tumours,  their  removal  is  not 
possible,  and  birth  cannot  be  effected.  In  such  cases  it  will  be  for  the 
obstetrist  to  decide  whether  he  will  have  recourse  to  embryotomy  or 
Cffisarian  section — this  decision  being  arrived  at  after  duly  weighing  all 
the  circumstances  and  facts  relating  to  them. 

Having  completed  these  general  considerations  on  utero-vaginal 
tumours  as  a  cause  of  dystokia,  and  offered  the  above  indications  in  the 
way  of  treatment,  we  will  now  proceed  to  notice  each  class  of  these 
formations,  in  so  far  as  they  have  been  recognised  as  obstacles  to  par- 
turition in  animals. 

CANCEROUS,    CARCINOMATOUS,    OR   SARCOMATOUS   TUMOURS. 

Cancer  of  the  uterus  and  other  organs  of  generation  would  appear  to 
be  rare  in  animals,  and  very  few  veterinary  writers  allude  to  it.  Even 
those  observations  which  have  been  published  have  but  little  interest 
for  the  obstetrist,  as  nearly  all  of  them  have  no  relation  to  difficult 
parturition.  Some  cases,  however,  have  been  recorded  in  which  cancer 
of  the  cervix  uteri  has  produced  contraction  of  the  os,  and  necessitated 
'perative  interference  in  order  to  effect  delivery ;  and  one  or  two  instances 
are  noted  in  which  cancerous  tumours  have  elsewhere  proved  an  obstacle 
to  parturition,  and  even  when  that  act  has  been  accomplished  have 
proved  dangerous  from  the  hccmorrhage  they  occasioned. 

When  the  cancer  is  situated  at  the  cervix,  and  the  os  cannot  be 


348  MATERNAL  DYSTOKIA. 

dilated  by  the  foetus,  then  treatment  must  be  directed  to  effect  sufficient 
dilatation  for  its  passage  through  the  canal.  In  nearly  every  instance 
this  must  be  accomplished  by  free  incision  of  the  cervix. 

CONDYLOMATOUS,    PAPILLOilATOUS,    AND    LIPOMATOUS    TUMOURS. 

These  tumours  are  met  with  most  frequently  in  the  generative  organs 
of  the  Cow  and  Bitch,  and  particularly  in  the  vagiiaa.  They  seldom 
prove  a  serious  obstacle  to  the  passage  of  the  fcetus. 

They  first  appear  as  soft,  fungoid,  cauliflower-like  vegetations,  which 
bleed  from  the  slightest  contact,  and  are  readily  crushed  or  deformed. 
In  the  Bitch  they  sometimes  completely  fill  the  vagina,  and  give  rise  to 
a  constant  sanious,  and  most  offensive,  discharge  from  the  vulva. 

Lipomatous  tumours  are  also  most  frequently  noticed  in  the  vagina 
of  the  Bitch ;  and  in  two  instances  observed  by  Oreste  and  Falconio, 
one  tumour  was  the  size  of  a  filbert,  the  other  of  a  large  walnut. 

The  general  indications  for  treatment  are  applicable  to  these  growths, 
though  they  seldom,  if  ever,  prove  an  obstacle  to  birth. 

FIBKOID   AND    MYOMATOUS    TUMOUES. 

Fibroids  are  not  at  all  uncommon  in  the  generative  organs,  and  are 
frequently  the  cause  of  difficult  parturition.  They  have  been  observed 
in  the  uterus  and  vagina  of  the  Mare,  Cow,  Sow,  Goat  and  Bitch. 

In  structure,  it  would  appear  that  the  fundamental  portion  of  these 
tumours  is  composed  of  connective  tissue,  which  may  present  the  histo- 
logical characters  of  areolar,  mucous,  or  tendinous  tissue,  the  fibres  of 
which,  more  or  less  closely  interlaced,  have  connective  tissue  corpuscles 
or  cells  lying  between  them,  and  are  cemented  into  a  solid  mass  by  an 
inter-elementary,  more  or  less  abundant,  amorphous  substance  that 
greatly  contributes  to  increase  the  consistency  of  the  neoplasm,  giving 
it  a  dull  white  or  nacrous  appearance,  as  if  composed  of  cartilaginous 
tissue.  The  connective  tissue  corpuscles  composing  these  tumours  are 
sometimes  considerably  enlarged  and  hypertrophied,  and  this  is  more 
particularly  observed  in  the  fibroids  of  the  uterus.  This  arrangement 
has  been  found  to  exist  in  the  uterine  fibroma  of  a  Cow  examined  by 
Ercolani  in  1855 ;  cartilaginous  transformation  of  the  structure  has 
even  been  detected. 

The  fibroids  are  developed  from  the  submucous  or  subserous  connec- 
tive tissue,  or  from  the  muscular  texture  of  the  uterine  parietes.  When 
the  latter,  the  tumour  is  rarely  pediculated,  but  nearly  always  remains 
sessile.  The  uterine  fibroma  of  submucous  origin  is  certainly  at  first 
sessile,  and  is  covered  by  the  mucous  membrane  ;  but  as  it  grows  it 
becomes  pediculated. 

The  fibroids  of  the  uterus,  as  well  as  those  of  the  vagina,  are  some- 
times covered  by  the  mucous  membrane,  and  at  other  times  grow 
beyond  it.  They  are  sessile  or  pediculated,  and  are  of  variable  volume 
and  consistency ;  their  surface  is  either  smooth  or  irregular,  as  if  com- 
posed of  a  number  of  smaller  tumours. 

Franck  mentions  that  the  pathological  museum  of  the  Munich  Veter- 
inary School  contains  the  uterus  of  a  Cow,  one  of  the  cornua  of  which 
is  occupied  by  a  myomatous  tumour  springing  from  the  muscular  layer 
of  the  part,  and  as  large  as  a  man's  head. 

Sometimes  the  pediculated  fibroids  of  the  uterus,  in  consequence  of 


MUllBIl)  ALTKllATinXS  IX  THE  CEXERATIVE  OUHAXS.  319 

the  elongation  of  their  pedicle,  extend  beyond  the  os  into  the  va^'ina, 
and  even  in  some  instances  pass  through  the  latter  and  the  vulva,  and 
remain  suspended  between  the  thighs.  A  case  of  this  kind  has  been 
observed  by  Granaveri  and  studied  by  Ercolani.^ 

As  we  have  observed,  tlie  presence  of  fibroids  has  a  variable  influence 
on  the  process  of  parturition,  according  to  their  situation.  Of  course, 
the  larger,  and  particularly  the  submucous  interstitial  fibroids,  only 
very  exceptionally  allow  successful  fecundation  to  take  ])lace  ;  though 
in  some  instances,  when  this  occurs,  absorption  follows.  During  labour 
they  may  predispose  to  ruptui-e  of  the  uterus,  from  the  alteration  they 
have  produced  in  the  texture  of  the  organ. 

Submucous  or  subperitoneal  fibroids,  when  situated  towards  the 
fundus  of  the  uterus,  or  when  only  of  a  moderate  size,  very  frequently 
offer  no  particular  obstacle  to  birth,  and  interfere  but  little  with  labour. 
It  is  only  when  they  are  very  large,  and  situated  towards  the  cervix  or 
vaginal  canal,  that  they  may  become  a  serious  impediment  to  delivery. 
Those  with  short  pedicles,  and  which  are  designated  "  polypi,"  may  be 
rejected  backwards  before  the  advancing  foetus,  and  be  mistaken  for 
^ome  part  of  the  latter  by  the  unobservant  obstetrist. 

Sometimes  the  tumours  soften  towards  the  termination  of  gesta- 
tion, so  that  during  parturition  they  may  be  sufficiently  compressed 
iud  flattened  for  the  fcetus  to  pass  over  them.  If  they  have  an 
I  longated  pedicle  attached  to  some  part  which  is  easily  displaced,  they 
may  be  pushed  beyond  the  vulva  by  the  foetus,  or  the  pedicle  may  be 
ruptured  by  the  latter,  and  the  parturient  passage  thus  left  un- 
obstructed. 

The  recognition  of  these  tumours  is  not  very  diflicult  when  they  are 
within  reach  of  the  hand.  To  prevent  their  being  mistaken,  during 
manual  exploration,  for  some  part  of  an  ordinary  or  deformed  fcetus, 
their  nature  and  mode  of  attachment  must  be  attended  to.  With  this 
object,  the  hand  should  be  carefully  passed  between  them  and  the 
uterus  and  vagina  in  every  direction,  so  as  to  find  their  pedicle,  and 
thus  be  assured  that  they  do  not  belong  to  a  fa^tus. 

With  regard  to  the  treatment,  we  must  refer  to  the  general  indica- 
tions already  given.  We  may  only  add  that  when  the  tumours  are  not 
very  large,  it  is  better  not  to  interfere  until  Nature  has  done  what  it  can 
in  overcoming  the  obstacle;  for  in  these  instances,  as  in  so  many  others, 
it  sometimes  effects  surprising  results.  If  they  are  pediculated  and  can 
be  reached,  they  may  be  incised,  ligatured,  or  removed  by  the  ocraseur  ; 
should  the  base  not  be  attainable,  or  very  extensive,  they  may  be 
partially  extirpated. 

If,  after  parturition,  there  appears  anything  like  serious  hemorrhage 
due  to  this  extirpation,  this  may  be  suppressed  by  plugging  with  lint  or 
line  tow,  which  may  be  steeped  in  perchloride  of  iron. 

THROMBI    OR    H^MATOMATA. 

Thrombus  or  ha-matoma  of  the  vagina  or  \ailva,  usually  appears  most 
frequently  after  delivery.  Pfirter,  however,  has  recorded  the  case  of  a 
Mare  in  which  a  large  blood  tumour,  or  hoematoma,  was  caused  by  the 
rupture  of  bloodvessels  and  the  escape  of  blood  into  the  connective 
tissue  around  the  vagina.     It  formed  a  great  swelling  on  the  sides  of  the 

*  OrtMc  and  Falconio.  Studii  suUe  Xeoplasie  a  Massa  distinta  degli  Animali  Domestici, 
p.  58. 


350  MATERNAL  DYSTOKIA. 

vagina  and  vulva,  the  infiltration  of  blood  extending  to  the  perinoeum. 
This  tumefaction  proved  an  obstacle  to  parturition ;  so  that  it  was 
necessary  to  open  it  freely,  and  take  away  the  clots  of  blood  which  had 
formed.  The  htemorrhage  which  ensued  was  checked  by  the  injection 
of  a  solution  of  perchloride  of  iron. 

Saake  has  observed  these  blood-cysts  most  frequently  in  Swine  ;  death 
from  ha3morrhage  has  sometimes  resulted  from  their  rupture. 

The  application  of  ice  or  cold  water,  or  perchloride  ofiron,  or  even  the 
actual  cautery,  and  plugging  the  vaginal  canal,  will  generally  arrest  the 
bleeding. 

SEROUS    CYSTS. 

Kopp,  Hering,  Ayrault,  Lafosse,  Liautard,  Miiller,  and  others,  have 
observed  serous  cysts  on  the  vaginal  mucous  membrane,  and  even  in  the 
uterus,  of  the  Mare  and  Cow. 

The  vaginal  cysts  are  of  variable  size,  but  most  frequently  as  large  as 
a  pear,  which  they  are  generally  not  unlike  in  shape.  They  are  attached 
to  the  mucous  membrane  by  a  very  narrow  pedicle,  and  in  some  in- 
stances appear  between  the  labia  of  the  vulva  when  the  animal  is  re- 
clining, but  disappear  again  into  the  vagina  when  the  standing  posture 
is  assumed ;  though  occasionally  they  are  so  large  that  they  cannot 
return  without  assistance. 

The  cyst  is  smooth  and  transparent,  and  contains  a  clear  limpid 
serosity,  in  which  albuminous  flakes  are  often  observed. 

Not  infrequently  the  glands  of  Bartholin  in  the  vagina  of  the  Cow 
are  greatly  distended  with  mucus,  serum,  or  even  pus,  as  a  result  of 
inflammation. 

Such  cysts  are  not  likely  to  retard  parturition,  and  if  they  should, 
their  treatment  is  very  simple ;  as  a  lancet  puncture  sufiices  to 
evacuate  the  fluid  they  contain,  and  the  walls  readily  adhere  and 
cicatrise. 

Hering  has  seen  them  occupy  the  vagina  and  extend  into  the  uterus ; 
and  in  the  latter  organ  their  presence  may  be  more  serious  than  when 
they  are  limited  to  the  vagina.  They  may  prove  troublesome  obstacles 
to  delivery,  as  well  as  dangerous  to  the  animal  in  whose  uterus  they  have 
formed. 

When  the  cyst  is  attached  to  the  cervix  or  its  neighbourhood,  it  may 
pass  into  the  os  and  obstruct  it,  and  thus  prevent  the  foetus  passing 
through.  "When  very  large  it  may  so  closely  simulate  the  "  water-bag," 
as  to  be  mistaken  for  it— though  the  mistake  need  not  lead  to  grave 
results  ;  indeed,  if  ruptured  the  cyst  immediately  collapses,  and  can  no 
longer  prove  a  iDarrier  to  the  expulsion  of  the  foetus.  If  the  cyst  is 
situated  towards  the  os,  and  if  puncturing  it  be  deemed  inadvisable, 
pushing  it  beyond  the  pelvic  inlet  out  of  the  track  of  the  foetus  will  be 
sufficient  to  overcome  the  obstacle. 

Vaginal  cysts  may  be  mistaken  for  an  everted  bladder :  a  mistake 
which  we  are  assured  is  often  committed,  from  the  external  aspect  of 
the  tumour,  its  oval  shape,  and  its  colour.  Of  course,  this  mistake 
would  prove  most  unfortunate,  if  the  treatment  we  have  recom- 
mended be  adopted  ;  but  a  careful  examination  should  always  be  made 
before  any  active  interference  is  attempted,  and  this  examination  will 
obviate  such  an  error. 

Hernia  of  the  bladder  through  the  ruptured  walls  of  the  vagina,  may 
also  simulate  a  vaginal  cyst ;  and  if  it  be  punctured  in  this  position  it 


MonniD  ALTKnATIOX.'i  IX  rilK  h'KXKILlTll'E  OWIJXS.  351 

will   lead    to   the  same  lamentable  results,   in   all  probability,   as   in 
inversion. 

HEHNIA    OF    THE    HLADDER    INTO    THE    VAGINA  :    VAGINAL    CYSTOCELE. 

Dystokia  from  the  existence  of  a  va<^inal  cystocele  is  a  somewhat 
rare  accident,  and  only  a  few  instances  are  recorded  as  having  been 
observed  in  the  Mare  and  Cow  during  parturition. 

Inversion  of  this  viscus  may  occur  in  two  ways : — 1.  When  empty,  it 
may,  by  spasmodic  contraction  of  its  walls,  evert  itself — the  mucous 
membrane  becoming  external  and  the  peritoneal  coat  internal — and  thus 
turned  outside-in,  it  may  pass  through  the  meatus  urinarius  into  the 
vagina ;  2.  It  may,  without  being  everted,  escape  into  the  vagina  by  an 
c>ld  or  recent  fissure  in  the  floor  of  the  passage.  Most  of  the  cases 
occur  during  parturition,  and  when  the  animal  is  straining  violently, 
whereby  a  portion  of  the  contents  of  the  abdomen  and  uterus  are  pressed 
against  the  bladder,  and  may  thus  produce  its  inversion.  It  is  not  at 
all  improbable  that  the  viscus  may,  in  consequence  of  the  pressure  it 
ccasionally  receives,  be  in  a  spasmodic  state,  or  the  cervix  may  be 
lilated  and  relaxed  at  times  (Cartwright). 

In  the  Mare  and  Cow  the  urethra  is  short,  straight,  and  wide ;  and 
this  no  doubt  renders  the  bladder  liable  to  inversion.  Zundel  states 
that  it  may,  during  parturition,  acquire  such  dimensions  from  retention 
of  urine  that  it  will  entirely  fill  the  vagina,  and  protrude  externally 
during  the  expulsive  efforts  of  the  animal. 

However  this  may  be,  it  is  certain  that  the  cystocele  will  present  a 
different  appearance  in  the  vagina  according  as  its  peritoneal  or  mucous 
membrane  is  visible  :  i.e.,  everted  or  non-everted. 

In  the  first  case  we  find  a  somewhat  hard,  red  tumour  with  a  corru- 
gated surface,  and  attached  to  the  floor  of  the  vagina  by  a  short  narrow 
pedicle.  Examining  the  lower  wall  of  the  vagina  attentively,  the  meatus 
urinarius  cannot  be  found,  but  on  the  soft  pulpy  surface  of  the  tumour 
will  be  obsen'ed  two  small  openings — the  aperturss  of  the  ureters — from 
which  a  fluid  continually  escapes,  and  which  may  be  recognised  by  its 
odour  as  urine  ;  this  fluid  may  even  be  thrown  out  with  a  certain  degree 
of  force  during  the  labour  pains.  These  characters  should  be  suflicient 
to  indicate  the  nature  of  the  obstacle. 

In  the  second  variety,  the  bladder  escapes  through  a  rent  in  the  wall 
of  the  vagina,  and  this  rent  may  only  involve  the  muscular  layer — tlie 
vaginal  mucous  membrane  remaining  intact ;  or,  whicli  is  more  frequent, 
the  muscular  and  mucous  tissues  may  be  ruptured.  In  either  case 
there  is  found  in  the  vagina  a  round,  smootli,  and  fluctuating  tumour, 
attached  to  the  floor  of  the  canal  by  a  pedicle  more  or  less  wide,  and 
beneath  which  the  meatus  urinarius  can  be  seen  or  felt.  The  most 
striking  pathognomonic  feature  of  this  kind  of  tumour  is  its  rapid  growth, 
in  consequence  of  the  accumulation  of  urine  in  the  interior  of  tlie  dis- 
placed bladder,  the  fundus  of  which  is  towards  the  vulva  and  the  neck 
directed  forwards — its  position  being  the  reverse  of  normal ;  the  fundus, 
by  pressing  on  the  urethra — which  is  doubled  on  itself — prevents  the 
urine  from  escaping,  and  we  have  in  this  way  a  rapidly  increasing 
vaginal  tumour.  In  a  case  recorded  by  Violet,'  the  tumour  had 
acquii-ed,  within  eight  hours,  a  diameter  of  from  eight  to  ten  inches. 
Such  a  tumour  must,  therefore,  constitute  a  more  or  less  serious  obstacle 
to  parturition. 

'  Rtcutil  dt  Mill.  Veterinaire  de  Lyon,  1S62,  p.  .371. 


352  MATERXAL  DYSTOKIA. 

"We  have  pointed  out  the  necessity  for  a  careful  examination  of  the 
tumoui",  in  order  to  avoid  making  a  mistake,  as  the  cystocele  resembles 
other  tumours,  and  especially  the  cysts  we  have  already  described,  or 
even  the  "  water-bag,"  and  an  error  in  diagnosis  may  lead  to  grave 
consequences.  Such  an  error  is  recorded  by  Chariot, ^  who,  being  called 
upon  to  attend  a  Cow  which  had  been  attempting  to  calve  for  three 
days,  found  on  separating  the  labia  of  the  vulva  a  whitish,  tense,  and 
fluctuating  tumour.  Thinking  that  this  was  only  the  "  water-bag,"  he 
punctured  it,  when  the  colour  and  odour  of  the  fluid  which  escaped 
quickly  undeceived  him.  When  the  bladder  had  collapsed,  he  then 
recognised  the  tear  in  the  vagina  through  which  the  viscus  had  passed. 
The  Cow  being  in  a  dying  condition  and  the  foetus  still  alive.  Chariot 
had  recourse  to  the  Caesarian  section ;  the  Calf  was  saved,  but  the 
mother  died. 

As  the  diagnosis  of  this  accident  is  of  so  much  importance,  we  will 
notice  the  symptoms  in  greater  detail. 

Protruding  through  the  opening  of  the  vulva,  or  immediately  within 
the  labia,  will  be  discovered  a  tumour  of  a  pyriform  shape,  and  varying 
in  size  and  colour  according  to  the  duration  of  the  accident.  Sometimes 
this  tumour  will  be  seen  hanging  from  within  the  vagina  by  a  kind  of 
pedicle,  for  at  least  eight  or  nine  inches,  and  will  contain  two  or  three 
pints  of  fluid.  At  times  the  protruded  part  will  be  nothing  more  than  a 
thickening  of  the  bladder,  produced  by  strangulation  and  inflammation  ; 
and  it  will  be  changed  from  its  normal  colour  to  that  of  an  inflamed 
surface,  or,  if  it  has  been  hernied  for  some  time,  to  a  darker  hue.  Some- 
times it  will  become  gangrenous  and  slough ;  at  other  times  its  surface 
appears  rugged  and  plicated,  and  on  occasions  a  large  quantity  of  blood 
has  exuded  from  its  surface.  Should  there  exist  any  doubts  as  to  the 
nature  of  the  tumour,  the  meatus  urinarius  must  be  looked  for  ;  if  that 
cannot  be  discovered,  then  the  greatest  circumspection  should  be  exer- 
cised. The  attachment  and  situation  of  the  protrusion  should  be  noted, 
and  also  whether  it  is  continuous  with  the  vagina.  The  nipple-shaped 
prominences  which  mark  the  openings  of  the  ureters  into  the  bladder 
should  likewise  be  looked  for,  as  their  presence  will  at  once  denote  the 
case  as  inversion  of  this  viscus,  as  will  also  the  escape  of  urine  from 
them. 

Treatment. 

The  chief  indication  in  vaginal  cystocele  is  reduction  or  reposition  of 
the  displaced  viscus.  This,  however,  is  not  always,  if  ever,  an  easy  task. 
In  a  case  of  simple  hernia,  the  bladder  is  soon  distended  by  the  urine, 
and  owing  to  the  increase  in  size,  it  cannot  be  returned  by  the  opening 
through  which  it  passed  when  it  was  empty.  Compression  of  its  walls 
will  not  suffice  in  the  majority  of  cases  to  evacuate  its  contents,  because, 
as  has  been  shown,  the  weight  of  the  organ  lies  upon  the  doubled 
urethra.  To  empty  the  bladder  a  catheter  must  be  employed ;  the 
shoot  of  an  elder-tree  deprived  of  its  pith  has  been  successfully  used  for 
this  purpose  on  an  emergency.  Once  emptied,  the  bladder  readily 
resumes  its  normal  situation. 

Puncture  of  the  organ  has  been  practised  when  catheterism  was  not 
tried  ;  a  fine  trocar  being  inserted  obliquely  into  the  upper  part  of  the 
viscus — which  was  now  of  course  the  inferior  part — so  as  to  make  it 

^  Joiu-nal  Pratique  de  Med.  Vtterinaire,  1826,  p.  165. 


MORBID  ALT  Kll  AT  IONS  IX  THE  GENERATIVE  OROANH.  353 

pass  for  a  certain  distance  between  the  membranes  before  entering  the 
cavity  of  the  sac,  in  this  way  imitating  the  entrance  of  the  ureters.  The 
operation  was  completely  successful,  as  the  bladder  had  been  little  more 
than  half  emptied  before  the  hernia  was  spontaneously  reduced. 

Cartwright  says,  with  regard  to  treatment  of  cystic  inversion  :  "Pro- 
vided we  are  called  to  the  case  at  an  early  period,  and  before  a  thicken- 
ing of  the  parietes  of  the  bladder  and  sphincter  has  taken  place,  we 
most  probably  will  succeed.  We  should,  with  the  left  hand,  press 
gently  upon  the  sides,  and  with  the  right  hand  the  fundus  of  the 
bladder,  until  we  feel  it  gradually  receding  from  us ;  after  which  we 
may  carefully  introduce  a  pessary  or  catheter,  so  as  fairly  to  force  it 
mto  its  natural  situation.  If  there  should  be  violent  straining  at  the 
moment  we  are  employing  the  staxis,  we  had  better  desist  for  a  time 
until  we  have  abstracted  four  or  live  quarts  of  blood,  or  give  a  dose  of 
opium  in  solution,  to  allay  any  irritation  or  spasm.  But  if  we  cannot 
succeed  in  this  way,  I  think  a  far  more  preferable  plan  will  be  to  get  a 
stick  with  a  round  blunt  point  that  will  pass  through  the  sphincter,  and 
force  it  against  the  base  of  the  protruded  fundus.  A  very  excellent 
instrument  would  be  a  female  catheter,  such  as  is  used  for  the  Cow  or 
Mare,  as  it  would  have  the  necessary  curve.  In  thus  trying  to  re-invert 
it,  we  may  use  considerable  force  without  rupturing  it ;  though,  of 
course,  we  must  be  cautious  in  our  pressure." 

Sometimes  it  is  no  sooner  returned  than  it  is  again  everted,  and  this 
repeatedly.  In  such  cases  pencilling  around  the  meatus  with  nitrate  of 
silver,  dashing  cold  water  on  the  vulva,  and  walking  the  animal  quickly 
about,  have  caused  its  retention. 

Should  the  distended  cystocele  be  immediately  in  the  track  of  the 
foetus,  and  the  expulsion  of  the  latter  urgent,  if  the  bladder  cannot  be 
returned  before  birth  it  must  at  least  be  emptied,  to  allow  the  young 
creature  to  get  through  the  vagina.  As  the  latter  passes  over  it,  the 
viscus  should  be  protected  from  injury  by  the  fingers. 

We  will  return  to  a  consideration  of  this  condition  when  treating  of 
the  accidents  occurring  as  a  sequel  of  parturition. 


TUMOUKS   IN    THE   VICINITY   OF    THE    GENITAL   ORGANS. 

Tumours  in  the  bladder,  when  of  large  size — as  polypi,  steatomatous 
growths,  etc.,  as  well  as  calcareous  concretions,  may  hinder  parturition, 
or  even  render  it  impossible,  j-^ven  an  excessively  distended  bladder 
may  ofifer  an  obstacle  to  the  accomplishment  of  this  act,  either  in 
checking  the  advance  of  the  foetus,  or  by  sympathetically  disturbing  the 
uterine  contractions. 

The  indications  here  are  obvious. 

Tumours  of  various  kinds  may  be  developed  in  the  connective  tissue 
of  the  pelvic  organs,  and  especially  between  the  vagina  and  rectum,  and 
more  or  less  obstruct  labour.  Ovarian  tumours  may  also  prove  trouble- 
some, as  may  likewise  multiple  abscesses  and  cysts  in  the  neighbour- 
hood of  the  genital  passages.  In  some  cases  these  may  be  successfully 
punctured ;  in  others  extirpation  may  be  possible ;  while  in  others, 
again,  the  obstetrist  can  only  choose  between  embryotomy  and  the 
Caesarian  section. 

Distention  of  the  rectum  from  an  accumulation  of  faeces  may  prove  a 
cause  of  dystokia — particularly  in  the  Mare ;  but  this  should  be  easily 

23 


354  MATERNAL  DYSTOKIA. 

discovered,  and  readily  removed.     Tumours  in  the  immediate  vicinity 
of  the  anus  are  rarely  a  cause  of  difficult  parturition. 
We  have  already  alluded  to  melanotic  tumours. 

2.  EiGiDiTY  OR  Spasm  of  the  Cervix  Utebi. 

Rigidity  or  spasm  of  the  cervix  uteri,  or  stenosis  of  the  os,  is  a  con- 
dition not  infrequently  met  with  among  animals — most  frequently  in 
the  Cow,  next  in  the  Goat,  and  less  often  in- the  Mare.  It  appears  to 
be  more  common  with  nervous,  irritable  animals,  and  especially  primi- 
parae,  than  others ;  though  it  is  sometimes  noted  in  emaciated  and 
debilitated  animals,  and  even  in  those  which  are  old,  and  which  have 
previously  brought  forth  without  any  trouble. 

"Without  any  modification  in  the  structure  of  the  cervix,  but  merely 
by  a  kind  of  rigid  contraction  of  its  fibres,  the  os  remains  closed,  and 
cannot  be  dilated  by  the  efforts  of  the  parturient  animal.  The  cervix  is 
not  soft  and  elastic,  as  in  the  normal  condition,  but  feels  prominent  and 
rigid,  and  shows  less  sensibility  than  usual ;  while  the  os  will  not  admit 
a  finger,  or  if  it  does,  it  grasps  it  most  powerfully. 

The  majority  of  veterinarians  admit  the  existence  of  spasm  of  the 
cervix,  while  others  maintain  that  rigidity  and  spasm  are  synonymous 
terms,  in  so  far  as  this  condition  is  concerned.  The  first  are  ready  to 
confess,  however,  that  spasm  is  not  always  present,  because  very  often 
the  "  pains"  are  feeble  and  few,  and  the  absence  of  dilatation  appears 
to  be  due  rather  to  something  abnormal  in  the  contractility  of  the 
uterus,  as  a  whole,  than  of  this  part  in  particular  ;  whei-eas,  when  there 
is  spasm,  it  has  usually  been  observed  that  there  are  inordinate  and 
disordered  contractions  of  the  organ.  In  short,  it  has  been  attempted 
to  prove  that  in  rigidity  of  the  cervix  there  is  a  purely  passive  condition 
of  this  part,  while  in  spasm  there  is  an  active  contraction  of  the  organ. 
In  reality,  there  is  no  marked  distinction  between  the  two  conditions, 
at  least  so  far  as  obstetrical  practice  is  concerned ;  and  this  form  of 
dystokia,  in  its  more  salient  features,  might  be  looked  upon  as  merely 
an  exaggerated  manifestation  of  that  derangement  which  has  been 
designated  tumultuous  or  irregular  parturition,  or  "false  labour" 
(metrijjercinesis ,  as  distinguished  from  mctracinesia,  or  feebleness  of  the 
uterine  contractions),  in  which  the  contractions  are  irregular  or  partial. 

We  have  remarked  that  there  are  two  sets  of  muscles  in  the  uterus — 
the  circular  and  longitudinal,  and  that  there  exists  a  marked  antagonism 
between  the  circular  fibres  of  the  cervix  and  fundus  of  the  organ,  and 
the  longitudinal  fibres.  So  that  if  the  first  are  more  active  than  the 
second,  and  the  latter  cannot,  as  a  consequence,  overcome  the  resist- 
ance they  offer,  the  os  remains  closed  and  labour  cannot  advance.  This 
is,  we  think,  the  true  explanation  of  this  condition. 

SijmiAoms. 

The  symptoms  vary  somewhat.  In  one  case  there  may  be  at  first 
nothing  unusual  to  be  noted,  the  pains  being  manifested  with  their 
usual  regularity  and  intensity,  and  the  animal  in  noways  distressed. 
The  only  thing  that  is  likely  to  awaken  suspicion,  is  the  unusual  dura- 
tion of  parturition,  which  may  extend  over  two,  three,  or  more  days,  if 
assistance  be  not  afforded.  As  the  period  is  prolonged,  the  animal  may 
in  some  instances  lose  condition,  exhibit  indications  of  exhaustion  and 
suffering,  and  gradually  sink ;  or  it  may  appear  ill  for  some  days,  then 


Mnnmi)  ALTERATIOXS  IX  THE  GENEKATIVK  ORHAXS.  355 

rally  and  assume  its  ordinax-y  appearance—  constituting  a  case  of  "  missed 
birth. "1 

In  other  instances,  the  creature  manifests  an  unusual  amount  of  ex- 
citement at  first ;  there  is  agitation,  strainin-,',  and  symptoms  of  colicky 
pains  ;  the  abdomen  is  frequently  looketl  at  by  the  aniinal,  whicli  lies 
down  but  soon  gets  up  again ;  the  pulse  is  full,  strong,  and  frequent ; 
the  conjunctivie  are  injected  ;  the  skin  is  hot ;  fajces  and  urine  are 
passed  at  frecjuent  intervals  ;  there  is  thirst  and  anorexia ;  and  some- 
times durhig  the  throes  the  vagina  is  protruded  beyond  the  vulva,  and 
appears  as  a  large  red  mass. 

A  vaginal  exploration  is  necessary,  in  order  to  learn  the  cause  of 
obstruction.  This  should  be  carefully  and  gently  made — the  latter 
precaution  being  most  important  to  observe  during  the  throes.  It  may 
be  necessary,  if  the  mucous  membrane  is  dry,  to  inject  some  emollient 
fluid  into  the  vagina,  or  introduce  it  by  a  sponge. 

When  the  hand  is  passed  through  the  vagina,  the  os  will  be  found 
more  or  less  contracted,  so  that  scarcely  one  or  two  fingers  can  be  in- 
troduced into  it,  owing  to  the  spasmodic  resistance  it  offers,  while  the 
cervix  preserves  its  elongated  shape. 

In  the  Cow,  the  cervix  and  vagina  are  frequently  filled  with  a 
tenacious  gluey  matter,  which  sticks  to  the  fingers  like  bird-lime,  and 
by  fixing  together  the  margin  and  walls  of  the  os  doubtless  increases 
the  resistance  the  canal  offers  to  dilatation. 

If  the  finger  can  be  introduced  into  the  os,  it  will  be  found  that  there 
is  neither  deformity  nor  morbid  induration,  and  that  the  constriction  is 
due  to  the  fibres  of  the  cervix  alone. 

It  has  been  pointed  out  that,  contrary  to  what  is  stated  above,  the 
cervix  uteri  is  sometimes  completely  effaced  ;  tiie  bottom  of  the  vagina 
being  occupied  by  a  kind  of  smooth-surfaced  ball,  in  the  centre  of  which 
is  a  narrow  opening,  and  through  which  the  fcetus  can  be  felt.  The 
convex  body  is  the  posterior  segment  of  the  uterus  which,  pressed  by 
the  head  or  some  other  part  of  the  f(i.'tus,  is  pushed  into  the  vagina  ; 
while  the  small  aperture  is  the  os — partially  effaced  and  undilated. 
This  trace  of  the  os,  instead  of  being  in  the  centre,  is  at  times  more  or 
less  to  one  side,  and  occasionally  it  can  only  be  found  with  much 
difficulty. 

\Vhat  seems  to  establish  the  spasmodic  nature  of  the  affection,  is  the 
fact  that  in  many  cases,  in  the  intervals  of  the  "  pains,"  the  cervix  feels 
soft,  and  the  os  becomes  dilated  sulliciently  to  permit  of  the  introduc- 
tion of  one  or  more  fingers,  or  even  of  one  or  two  limbs  of  the  fcetus. 
But  the  moment  attempts  are  made  to  dilate  it,  the  cervix  again 
becomes  rigid,  and  this  condition  is  greatly  exaggerated  when  the  next 
pain  comes  on. 

'  We  may  here  call  attention  to  certain  HigOH  presented  by  Cows,  ;in<l  which  have 
been  dLScribed  by  Biot  ( I'trtuil  ilc  Mid.  Vctrritiaire,  lS7t3,  p.  1007)  as  essentially  pathog- 
nomonic of  uterine  disturlmnce  in  these  aniinals,  and  for  this  reason  have  been  specially 
designated  as  uterine.  These  signs,  upon  which  hv  pl.ice^  the  >,'re.'itest  diagnostic  value, 
•re  observed  when  the  sick  Cow  is  approached  or  touched  in  any  way.  The  animal  then 
"suddenly  elongates  the  neck,  extends  the  head,  yawns,  protrudes  tlie  tongue,  and  emits 
•t  the  s.-vme  time  a  kind  of  dull  moan,  but  which  is  rather  a  powerful  expiration  than  a 
real  moan."  When  these  signs  are  present,  biot  asserts  that  the  cor/m  d/lit — the  dis- 
torbance — is  in  the  uterus,  and  never  elsewhere.  Laborious  or  protracted  parturition, 
iinalpositions  of  the  fcetus  or  monstrous  conformation,  occlusion  or  induration  of  the 
oervix  uteri,  hydramnios,  t«irsion  of  the  utenjs  ;  and  after  parturition,  inversion  of  the 
iVteras,  retention  of  the  placenta,  and  vitulary  apoplexy  with  or  without  paralysis  ; — all 
Uiese  may  give  rise  t<i  the  manifestation  of  this  singular  phenomenon,  which  he  has  never 
witnessed  in  any  other  affection — not  even  in  chronic  diseases  of  the  uterus. 


356  MATERNAL  DYSTOKIA. 

Diagnosis. 

From  the  symptoms  enumerated,  there  should  not  be  much  doubt  or 
delay  in  diagnosing  this  cause  of  dystokia.  As  in  so  many  other 
instances,  however,  the  necessity  for  a  correct  diagnosis  is  imperative, 
as  on  its  accuracy  will  depend  the  success  of  treatment. 

If  the  exploration  has  been  carefully  made,  the  state  of  the  cervix 
will  at  once  explain  the  delay  in  birth.  Perhaps  the  only  other  condi- 
tion of  the  cervix  with  which  it  might  be  confounded  is  "  induration  "; 
but  in  spasm  this  part  is  hot,  tense,  and  painful,  and  neither  hard, 
lumpy,  nor  deformed,  as  in  the  latter. 

Prognosis. 

Simple  rigidity  or  spasm  of  the  cervix  uteri,  provided  there  is  no 
alteration  in  its  texture,  is  not  in  itself  of  very  much  consequence.  In 
many  cases  Nature  overcomes  the  obstacle,  and  in  the  course  of  twenty- 
four,  forty-eight,  or  seventy-two  hours  of  more  or  less  severe  and  ex- 
hausting labour,  delivery  is  effected  spontaneously,  and  the  animal  and 
its  progeny  are  none  the  worse  after  a  short  time.  This  delay  has  been 
most  frequently  observed  in  the  Cow  and  Goat ;  in  the  Mare  it  is  rarely 
so  prolonged. 

But,  as  a  rule,  it  is  not  advisable  to  allow  so  much  time  to  elapse 
after  labour  has  commenced,  without  at  least  ascertaining  the  nature 
of  the  obstacle  which  delays  birth ;  as  during  the  longer  intervals 
especially,  complications  may  arise  which  might  lead  to  serious  results. 
The  foetus  may  die,  or  it  may  assume  a  wrong  position  in  the  uterus, 
which  may  afterwards  prove  troublesome  to  the  obstetrist ;  the  mother 
may  become  exhausted  and  the  uterus  paralysed,  so  that  the  foetus 
cannot  be  expelled  when  the  os  is  dilated  ;  or,  still  more  serious,  the 
energetic  contractions  of  the  uterus  may  produce  rupture  of  the  organ. 

So  that  a  prognosis  must  be  based  on  these  considerations ;  and  both 
the  owner  of  the  animal  and  the  veterinarian  must  bear  in  mind  the 
fact,  that  while  premature  and  too  active  intervention  in  such  a  case  is 
to  be  deprecated,  too  long  delay  in  affording  assistance  is  to  be  equally 
guarded  against. 

Treatment. 

As  this  condition  of  the  cervix  uteri  is,  at  the  commencement,  of  no 
great  importance,  and  merely  retards  natural  delivery,  active  inter- 
ference is  forbidden  for  some  time. 

When  the  first  signs  of  parturition  do  not  extend  beyond  some  hours 
— one  or  two  for  the  Mare,  five  or  six  for  the  Cow,  according  to  Saint- 
Cyr ;  when  the  obstetrist,  by  vaginal  exploration,  has  assured  himself 
that  the  genital  organs,  as  well  as  the  pelvis,  are  not  in  any  way 
deformed  or  altered ;  that  the  animal  is  all  right  otherwise  ;  and  that 
rigidity  of  the  cervix  is  alone  the  cause  of  delay  in  birth ;  then  he  ought 
to  wait,  while  being  prepared  at  the  same  time  for  any  emergency. 
The  glutinous  matter  which  has  been  mentioned  as  occupying  the  vagina 
and  OS,  and  covering  the  cervix,  should  be  removed  as  much  and  as 
gently  as  possible  from  these  parts,  so  as  to  permit  dilatation  to  take 
place  when  the  spasmodic  constriction  begins  to  yield. 

If,  however,  labour  appears  to  be  unduly  prolonged  without  any 
progress  being  made  in  parturition,  and  if  the  "  pains  "  are  energetic, 
while  the  animal's  condition  is  not  so  satisfactory,  then  intervention 
may  be  counselled.     But  this  intervention  should  be  of  the  simplest 


MORBID  ALTERATWXS  IN  THE  aEXEItATIl'E  ORGAXS.  357 

and  luiklest  character,  and  in  the  majority  of  cases  it  will  be  attended 
with  entire  success.  Injections  per  rectum  or  vaginani,  of  emollient  or 
oily  fluids,  to  which  tincture  of  opium  or  extract  of  belladonna  has 
been  added  ;  the  ointment  or  extract  of  belladonna  smeared  around  the 
cervix  or  introduced  into  the  os  ;  blankets  or  sacks  steeped  in  hot  water 
and  applied  over  the  loins  of  the  larger  animals,  or  warm-water  baths 
for  the  smaller  ones  ;  and,  in  certain  cases,  the  administration  of 
draughts  containing  some  soothing  medicament  —  such  as  chloral, 
chloroform,  or  opium  ; — these  are  the  means  to  be  adopted. 

Bleeding  has  been  advocated  by  some  authorities — particularly  on 
the  Continent ;  but  unless  something  very  unusual  in  the  general  con- 
dition of  the  animal  demands  it,  the  abstraction  of  blood  is  of  very 
questionable  value. 

Opium  is  of  much  service,  from  the  influence  it  possesses  in  con- 
trolling the  uterine  spasms  ;  it  is  therefore  to  be  recommended  when 
the  "  pains  "  are  severe  and  frequent.  It  may  be  given  in  large  doses, 
both  in  draught  and  enema,  and  frequently. 

Chloral  hydrate  and  chloroform,  particularly  the  former,  are  of  great 
utility,  and  possess  advantages  over  opium  as  soothing  agents. 

For  a  very  long  time,  belladonna  has  enjoyed  the  reputation — and 
apparently  with  justice — of  being  one  of  the  best  agents  for  combating 
spasm  of  the  cervix  uteri,  and  permitting  dilatation  of  the  os.  Occa- 
sionally its  efficacy  has  been  contested,  but  the  great  balance  of  evidence 
is  in  its  favour,  and  its  employment  is  almost  a  matter  of  course  with 
every  veterinary  obstetrist.  It  is  generally  applied  in  the  form  of 
extract  around  the  cen'ix,  about  a  drachm  or  so  being  required  for  one 
application — it  is  rare  that  a  second  application  is  needed.  Time  should 
be  allowed  for  its  action.  For  the  Bitch  one-fourth  or  one-fifth  of  the 
dose  is  sufficient. 

If  cocaine  were  not  so  expensive  it  would  also  prove  most  useful  in 
such  cases,  especially  in  the  smaller  animals,  as  a  solution  of  it  acts  so 
promptly  and  eifectively. 

Sometimes  it  is  attempted  to  dilate  the  os  uteri  by  manipulation — 
the  fingers  and  iiand  being  the  dilators  ;  but  this  means  should  not  be 
adopted  until  milder  measures  have  failed,  and  until  time  and  patience 
have  been  exhausted  over  them.  The  hand  and  fingers  well  oiled,  or 
smeared  with  extract  of  belladonna,  should  be  introduced  in  the  form 
of  a  cone,  towards  the  os ;  if  they  cannot  be  passed  into  the  canal  in 
this  shape,  then  the  insertion  of  one  finger  may  be  attempted,  followed 
by  a  second,  and  so  on  until  the  band  has  been  pushed  through. 

Very  frequently  this  cannot  be  accomplished  at  the  first  trial,  nor  yet 
at  the  second ;  but  with  patience  and  judgment  it  rarely  fails,  and  if 
conducted  with  the  care  and  gentleness  which  all  operations  of  this 
kind  should  receive,  such  manipulation  may  be  attempted  without  the 
least  danger  at  inter\'als  of  a  few  hours,  until  crowned  with  success. 
The  condition  of  the  os  should  be  ascertained,  after  a  certain  period 
has  elapsed  since  the  last  attempt,  every  precaution  being  adopted  to 
prevent  injury  ;  and  an  entrance  to  it  ought  only  to  be  effected  when 
the  resistance  has  greatly  diminished,  and  can  easily  be  overcome. 

Mechanical  dilatation  of  the  os  by  means  of  the  sponge  tent  has  been 
much,  and  most  successfully,  employed  in  human  obsteti-ics  for  a  long 
time,  and  the  method  has  recently  been  greatly  simplified  and  perfected 
by  Sims,  Joulin  and  others.  It  is  perfectly  applicable  to  animals.  The 
tent  can  perhaps  be  purchased  at  any  druggist's,  but  if  not  it  is  easily 


358  MATERNAL  DYSTOKIA. 

made.  Joulin  makes  those  he  uses  in  the  following  manner  : — From  a 
somewhat  fine  and  dry  sponge  of  inferior  quality,  he  cuts  two  long 
conical  pieces,  one  about  three  and  a  quarter  mches  in  length,  about  an 
inch  wide  at  the  base,  and  one-third  of  an  inch  at  the  apex ;  the  other  five 
or  six  inches  in  length,  two  and  a  half  inches  at  the  base,  and  one-third 
of  an  inch  at  the  apex.  Of  course  they  would  require  to  be  larger  for 
animals. 

These  cones  are  then  prepared  for  use  by  wrapping  them  closely 
round  in  twine,  the  circles  of  which  should  be  so  near  each  other  as  not 
to  leave  ridges  on  the  sponge.  By  this  pressure  the  tents  become 
extremely  compact,  and  look  like  a  thick  bougie. 

When  required  for  use,  the  twine  is  removed — this  should  not  be 
done  until  the  tent  has  been  prepared  for  at  least  two  or  three  hours, 
when  it  will  have  acquired  sufficient  rigidity.  A  piece  of  cord  should 
be  attached  to  its  base,  so  as  to  allow  it  to  be  w^ithdrawn  when  inserted 
in  the  os  ;  but  before  this  insertion  takes  place,  the  apex  must  be 
covered  with  a  little  lard,  cerate,  or  extract  of  belladonna.  The  sponge 
is  passed  into  the  os  as  far  as  possible,  either  by  the  fingers  or  forceps, 
and  until  the  base  of  the  tent  is  close  to  the  margin  of  that  opening. 
The  narrow  and  slightly  flexible  apex  of  the  tent  allows  of  its  passage 
through  the  os  into  the  uterine  cavity  ;  but  in  order  to  be  successful  the 
operation  must  be  quickly  performed,  otherwise  the  sponge  rapidly 
absorbs  mucus  and  loses  its  rigidity. 

No  plugging  or  other  means  are  necessary  to  retain  the  tent,  as  the 
portion  which  projects  into  the  uterus  quickly  increases  in  size  from  the 
absorption  of  moisture ;  so  that,  after  a  few  minutes,  a  certain  amount 
of  force  is  necessary  to  withdraw  it  therefrom  by  means  of  the  cord. 

The  sponge-tent  acts  in  several  ways,  and  simultaneously  :  1.  It 
detaches  the  membranes,  and  this  is  often  sufficient  to  induce  labour  ; 
2.  It  acts  as  a  foreign  body  in  irritating  the  posterior  segment  of  the 
uterus,  which  reacts  by  contracting ;  3.  It  dilates  the  inner  opening  of 
the  OS  ;  4.  It  also  dilates  the  entire  length  of  the  os,  by  swelling  through 
imbibition  of  the  uterine  mucus. 

To  obviate  the  risk  of  softening  before  it  is  inserted  into  the  os,  Joulin 
prepares  the  tent  in  the  following  manner.  Instead  of  wrapping  it 
round  with  twine  while  it  is  in  a  dry  state,  he  saturates  the  sponge  in  a 
solution  of  gum  arabic,  and  then  having  rolled  the  twine  round  it, 
leaves  it  to  dry  for  some  days.  After  this  treatment  it  preserves  a  cer- 
tain degree  of  suppleness,  but  may  remain  for  a  minute  or  two  in 
contact  with  mucus  before  imbibing  it. 

Barnes'  procedure  for  the  dilatation  of  the  os  uteri  in  woman,  has 
also  proved  of  great  service  in  human  obstetrics  ;  but  to  our  knowledge 
it  has  only  once  been  tried  with  animals,  though  there  is  no  reason  why 
it  should  not  be  successfully  employed,  not  only  in  producing  abortion 
in  those  cases  to  which  we  have  pi'eviously  alluded,  but  also  in  the 
morbid  condition  now  under  consideration. 

This  procedure  consists  in  dilating  the  os  by  means  of  fiddle-shaped 
india-rubber  bags,  which,  for  women,  are  of  three  different  sizes  ;  but 
the  very  largest  of  them  would  probably  be  required  as  the  smallest  size 
that  could  advantageously  be  used  for  the  Cow  or  Mare.^ 

The  bag  (Fig.  95),  in  an  empty  condition,  is  introduced  into  the  os  by 
means  of  a  whalebone  sound  or  director,  which  fits  into  a  small  pocket 

^  These  bags  are  made  by  Weiss  and  Son,  surgical  instniment  makers.  Strand, 
London.     When  ordered,  the  animal  for  which  they  are  to  be  used  should  be  mentioned. 


MORBID  ALTKIiATIOXS  IX  THE  UEXERATIVE  ORir'AXS.  359 

at  the  side  ;  it  is  pushed  through  the  canal  until  the  pocket  end  projects 
into  the  uterus ;  then  water  is  steadily  injected  into  it  by  means  of  the 
tube  attached  to  the  other  end.  When  lilled  with  water  the  bag 
remains  in  the  os,  in  consequence  of  the  middle  portion  being  narrower 
than  the  two  ends. 

This  dilator  produces  the  same  results  as  the  sponge  tent,  over  which 
it  has  some  advantages.  The  only  drawback  to  it  is,  perhaps,  the  thick- 
ness of  its  substance ;  as  it  cannot  be  passed  into  the  os  unless  this  is 
permeable  to  two  or  three  lingers. 

A  simpler  contrivance  than  that  of  Barnes,  and  which  will  perhaps 
be  found  useful  on  similar  occasions,  is  that  designed  by  Schnakenburg, 
and  named  the  "  Sphenosiphon."  It  is  merely  the  bladder  of  an  animal 
tied  to  a  syringe,  and  which,  when  water  is  injected  into  it,  mechani- 
cally dilates  the  cers'ix.  For  veterinary  purposes,  the  bladder  might  be 
attached  to  a  piece  of  indiarubber  tubing,  which  again  could  be  fixed 
to  the  nozzle  of  the  syringe.  It  and  Barnes'  dilator  act  in  the  same 
manner  as  the  natural  "  water-bag,"  formed  by  the  foetal  membranes 
and  liquor  amnii. 


Fig.  95. 
Bau.nks'  Uterine  Dilator. 

Another  means  which  has  been  successfully  employed  in  such  cases, 
as  it  is  simple  and  without  danger,  and  at  the  same  time  efifective  in 
producing  premature  artificial  delivery  in  woman,  is  the  uterine  douche 
introduced  into  obstetrical  practice  in  1848,  by  Kiwisch  of  Dresden. 
This  is  generally  known  as  the  "  ascending  uterine  douche,"  and  con- 
sists of  a  jet  of  water  at  a  certain  temperature  directed  against  the 
posterior  uterine  segment  for  some  minutes,  and  repeated,  if  necessary, 
at  intervals  of  two  or  three  hours.  It  is  often  resorted  to  in  woman  to 
favour  the  dilatation  of  an  cntirehj  closed  os,  and  to  prepare  it  for  the 
application  of  another  method,  which  may  be  either  Barnes'  or  Schna- 
kenburg's. 

This  method  might  be  adapted  to  animals  in  the  following  manner. 
The  apparatus  may  consist  merely  of  a  bucket,  or  barrel  with  one  end 
out,  such  as  may  be  found  in  almost  every  stable  or  cow-shed,  and  a 
long  piece  of  indiarubber  tubing  about  half-an-inch  in  diameter,  which 
can  be  procured  easily  and  cheaply.  To  one  end  of  this  tubing  is  fitted 
the  pipe  of  an  ordinary  sjTinge — either  enema  or  garden  ;  the  other  end 
is  immersed  in  the  barrel  or  pail,  which  should  be  filled  with  tepid 
water  at  a  temperature  of  about  10-i'  Fahr.,  and  placed  sufliciently  high 
to  yield  a  pretty  strong  jet. 


360  MATEEXAL  DY ST  OKI  A 

In  order  to  set  the  water  flowing,  the  tube  must  be  exhausted  of  air 
by  suction  with  the  mouth,  and  the  end  provided  with  the  syringe  pipe 
carried  into  the  vagina  and  directed  towards  the  cervix  uteri.  Each 
douche  should  continue  for  about  ten  or  fifteen  minutes,  or  longer ; 
and  it  may  be  repeated  every  two  or  three  hours,  or  even  at  shorter 
intervals,  according  to  circumstances,  until  the  desired  effect  has  been 
produced. 

Cazeaux  speaks  highly  of  this  method  of  dilating  the  cervix  in 
woman,  and  for  the  following  reasons  : 

1.  The  uterine  douche  prepares  the  act  of  premature  birth  with  the 
greatest  possible  gentleness,  by  means  of  the  softening  and  the  necessary 
dilatation  of  the  inferior  segment  of  the  uterus. 

2.  By  this  means  all  preparatory  treatment  is  needless. 

3.  This  procedure  is  easily  employed,  and  not  at  all  disagreeable  to 
the  woman,  as  the  injection  of  warm  water  does  not  produce  any 
discomfort. 

4.  It  does  not  require  much  time. 

5.  Its  action  can  be  graduated  at  the  will  of  the  obstetrist,  who  may, 
according  to  requirements,  increase  or  diminish  the  duration  of  the 
douche  and  the  temperature  of  the  water,  as  well  as  vary  the  parts  of 
the  cervix  on  which  he  directs  it. 

6.  Finally,  it  can  never  occasion  lesions  of  the  genital  organs,  nor 
yet  injure  the  foetal  membranes  or  the  foetus. 

This  uterine  douche  is  well  worthy  of  notice,  and  though  there  are 
only,  so  far  as  we  can  ascertain,  three  cases  on  record  in  which  it  has 
been  tried  with  animals,  yet  as  these  were  most  successfully  treated 
by  it,  it  may  be  assumed  that  it  will  be  found  a  most  valuable  means 
of  not  only  dilating  the  os  uteri,  but  also  of  controlling  the  action,  or 
relieving  certain  morbid  conditions,  of  the  uterus  itself. 

Eougher  treatment  for  the  dilatation  of  the  cervix  than  that  which 
has  been  described,  is  sometimes  resorted  to,  either  through  impatience, 
ignorance,  or  in  cases  which  demand  prompt  action  ;  as  the  other 
measures  require  a  certain  amount  of  time,  from  the  slowness  of  their 
operation — though  perhaps  this  is  rather  an  advantage  than  otherwise. 

Forcible  dilatation  of  the  os  uteri  has  been  practised  in  human 
obstetrics,  and  special  instruments  have  been  devised  with  this  object. 
Such  dilators  have  been  constructed  by  Osiander,  Busch,  Mende,  and 
Krause,  but  they  have  not  been  much  used,  as  milder  measures  are 
preferable.  The  same  remark  is  applicable  to  veterinary  obstetricy, 
in  which  there  is  only  too  often  a  tendency  to  imagine  that  because 
the  patient  is  an  animal,  so  all  the  more  force  and  brusqueness  can  be 
resorted  to. 

Forcible  dilatation  of  the  cervix,  which  is  not  to  be  recommended, 
except  perhaps  in  very  exceptional  instances,  has  its  advocates,  and 
two  cases  reported  by  Oschner,  a  Swiss  veterinary  surgeon,  prove  that 
it  may  be  successful,  notwithstanding  its  disadvantages.  In  these 
cases,  every  other  known  means  had  failed  ;  so  Oschner  procured  a  pair 
of  large  fire-tongs  used  by  blacksmiths,  and  wrapping  their  jaws  round 
with  tow  which  was  smeared  with  grease,  he  introduced  them,  closed, 
through  the  os ;  then  an  assistant  gradually  opened  the  shanks  or 
handles  of  the  tongs,  and  so  produced  the  desired  widening  of  the 
passage.  The  inflammation  set  up  by  this  manoeuvre  was  dissipated 
by  the  employment  of  soothing  remedies,  after  fifteen  days'  treatment. 

It  is  obvious  that  such  a  mode  of  dilatation  should  not  be  practised. 


MORIill)  JLTA'j;.tTlOXS  IX  T/fK  C KXi:UATirE  OIKiAXS.  361 

unless  there  is  something  most  unusual  in  the  case ;  as  it  is  a  most 
painful  operation,  and  likely  to  produce  contusions  and  lacerations  of 
the  cervix,  which  may  require  much  time  and  attention  to  repair. 

Incision  of  the  cervix  {vaijinal  Jii/stcrotoviy)  is  another  operation 
which  can  scarcely  ever  be  required  for  rigidity  or  spasm  of  tliis  part, 
and  ought  to  bo  reserved  for  more  serious  conditions.  At  any  rate,  it 
should  not  be  practised  until  the  other  measures  we  have  eimmerated 
have  been  fairly  tried,  as  it  is  an  operation  not  without  rislt  of  ill 
consequences. 

In  some  cases,  in  which  the  spasmodic  action  of  the  uterus  is 
irregular,  and  leads  to  occlusion  of  the  os,  it  might  be  advisable  to 
resort  to  anaesthesia,  produced  by  the  inhalation  of  ether  or  chloroform. 
Of  course  the  anaesthesia  should  not  be  pushed  to  complete  insensibility, 
but  be  limited  to  semi-consciousness  or  "  obstetrical  anaesthesia."  This 
is  more  particularly  to  be  recommended  for  the  smaller  animals. 

In  the  majority  of  cases,  when  the  rigidity  has  been  dispelled  or  the 
spasm  relaxed,  birth  will  take  place  without  further  assistance  being 
required ;  though  it  may  be  well  that  the  obstetrist  assure  himself 
that  the  foetus  is  in  a  favourable  position  for  delivery.  If  there  appears 
to  be  atony  of  the  uterus  or  the  mother  is  exhausted,  or  if  the  fu'tus 
is  dead  or  in  a  faulty  position,  then  it  will  be  necessary  to  afford  aid  in 
parturition  by  adjustment  and  traction. 

In  very  many  instances,  it  must  be  remembered,  this  rigid  condition 
of  the  cervix  is  due  to  malpresentation  or  malposition  of  the  foetus  in 
the  uterus ;  and  even  when  the  os  has  been  sufliciently  relaxed,  the 
young  creature  cannot  pass  through  until  it  has  been  properly  placed, 
and  not  unfrequently  aided  through  the  genital  canal. 

3.  Indiuation  of  the  Cervix  Uteri. 

Induration  of  the  cervix  is  the  term  applied  to  this  part  when  its 
texture  is  altered  in  any  way — whether  the  alteration  be  librous,  sarco- 
matous, or  cancerous — so  that  its  elasticity  being  destroyed,  and  its 
structure  inextensible,  it  offers  an  obstacle  to  parturition. 

This  alteration,  or  "  scirrhus,"  as  it  has  sometimes  been  designated, 
is  not  at  all  infrequent ;  but  it  has  been  observed,  it  appears,  nearly 
always  in  the  Cow,  and  would  seem  to  be  almost,  if  not  quite,  peculiar 
to  that  animal.'  The  reason  for  this  partiality  has  been  variously 
accounted  for,  but  probably  Bouley,  in  an  unpublished  note  to  Saint- 
Cyr,  has  afforded  the  most  satisfactory  explanation.  He  remarks  that 
"  irritation  produces  in  the  Bovine  species  phenomena  of  induration 
much  more  durable  than  in  any  other  species ;  in  proof  of  this,  witness 
tlie  plastic  engorgements — so  adverse  to  suppuration,  and  so  slow  to 
disappear — which  are  caused  by  a  seton  introduced  beneath  the  skin 
of  an  Ox  ;  witness,  also,  the  enormous  swellings  obsei^ved  as  a  con- 
sequence of  inoculation  for  pleuro-jineumonia  (Bovine),  and  those  in- 
durated tumours  vulgai"ly  designated  osteo-sarconuitous,  so  frequent  on 

'  I  can  only  find  one  case  mentioned  as  occurring  in  any  other  animal,  and  that 
happened  in  a  Ewe.  It  is  reported  by  Shentone  (  Veterinarian,  vol.  xxix.,  p.  36),  who 
says  thiit  the  creature  had  been  in  lal>>ur  since  the  previous  night,  but  i>ad  made  no 
progrei*s,  and  was  very  much  exhausted.  "It  w.as  a  c.%se  of  scirrhous  os  uteri.  I  told 
him  (the  owner)  I  would  <livide  the  stricture  as  the  only  means  of  saving  her,  but  in  her 
case  it  was  almost  a  'forlorn  hope.'  However.  I  did  divide  it,  cutting  in  two  placet", 
parallel  to  each  other,  and  with  a  g.iod  deal  of  ditficidty  extracted  a  large  Lamb  that  had, 
from  its  appearance,  been  dead  fur  some  time."     The  Ewe  recovered. 


362  MATERXAL  DY,STOKIA. 

the  maxilla,  and  which  repeated  irritation  caused  by  the  prick  of  a 
needle  are  sufficient  to  produce.  This  seems  to  be  a  general  organic 
fact,  of  which  induration  of  the  cervix  uteri  is  only  a  particular  instance." 

This  induration  must  not  be  confounded  w^ith  the  dense,  fibrous, 
though  normal,  consistence  of  the  cervix  of  the  Cow's  uterus,  which, 
there  can  be  no  doubt,  has  often  been  mistaken  for  a  diseased  condition, 
and  particularly  when  in  a  rigid  or  spasmodic  state.  The  distinction 
between  what  we  may  term  the  functional  derangement  and  the  jja;J/io- 
logical  alteration  of  this  part,  is  of  great  importance  from  an  obstetrical 
point  of  view  ;  as  the  first  may  be  remedied  by  the  mild  and  innocuous 
measures  enumerated,  while  the  second  can  only  be  overcome  by  a 
more  or  less  serious  surgical  operation. 

In  some  cases,  perhaps,  the  induration  is  congenital ;  but  it  must  be 
admitted  that,  as  a  rule,  it  is  due  to  the  influence  of  disease  or  injury — 
past  or  present — in  the  textures.  It  may,  therefore,  be  expected  to  be 
more  frequent  in  old  animals,  or  those  which  have  already  been  bred 
from,  than  in  those  which  are  young  or  are  pregnant  for  the  first  time, 
though  these  do  not  appear  to  be  exempt. 

Eancon  assured  Eainard  that  morbid  induration  of  this  part  was  wit- 
nessed more  frequently  in  the  ancient  Briangonnais,  where  he  practised 
for  thirty-six  years,  than  in  other  regions  of  France.  "We  are  not  aware 
whether  the  influence  of  breed  or  locality  has  been  observed  to  influence 
its  prevalence  in  other  countries. 

Sy7n2:)to7ns. 

Owing  to  the  situation  of  the  cervix,  and  the  nature  of  the  tissues 
entering  into  its  composition,  as  well  as  to  the  slowness  with  which 
the  pathological  alterations  take  place,  this  condition  may  be  in  exist- 
ence for  a  long  time  without  any  appreciable  change  being  observable 
in  the  animal's  health.  Therefore  it  is  that  Cows  which  are  so  affected 
do  not  exhibit  anything  during  the  whole  period  of  pregnancy,  which 
might  lead  a  person  to  suspect  the  existence  of  uterine  disease. 

In  some  cases,  however,  towards  the  termination  of  pregnancy  there 
has  been  remarked  a  listlessness  or  gradually  increasing  debility,  which 
has  been  so  great  at  last  that  the  animal  assumed  the  recumbent  posi- 
tion, and  could  not  get  up  without  assistance.  This  general  weakness 
has  been  mistaken  for  paraplegia,  though  it  has  sometimes  been  supposed 
to  be  due  to  lumbago  ;  though  it  may  have  been  merely  a  symptom  of 
generalised  cancerous  infection,  the  part  itself  being  the  seat  of  cancer. 

But  in  the  great  majority  of  cases,  the  existence  of  induration  is  not 
suspected  until  parturition  sets  in,  when  the  labour  pains,  which  may 
continue  for  a  long  time,  attract  more  than  ordinary  attention,  as  birth 
does  not  take  place.  And  not  infrequently  during  the  pains,  and  more 
especially  when  the  animal  is  lying,  a  livid,  irregular-shaped,  and  nodu- 
lated kind  of  tumour  appears  between  the  labia  of  the  vulva  ;  this  is  the 
undilated  cervix  uteri. 

In  other  instances,  however,  nothing  is  observable  externally,  and  a 
vaginal  exploration  is  necessary.  The  cervix  is  then  discovered  to  be 
more  or  less  dense  without  being  much  increased  in  size,  or  it  may 
protrude  into  the  vagina,  and  form  a  voluminous,  irregular,  nodulated 
tumour  which  in  some  cases  feels  as  hard  as  wood,  and  in  others  has  a 
rugged,  soft,  and  ulcerated  surface.  Some  veterinary  obstetrists  have 
described  transverse  rugas,  composed  of  a  solid,  unyielding,  fibro-carti- 
laginous  material,  in  the  os. 


MO  null)  ALTHlLiriOys  IX  THE  nHXKIlATll'E  VHnAXS.  303 

The  OS  is  not  always  easily  fouiul,  and  it  is  sometimes  so  contracted 
that  one  finger  cannot  be  introduced  into  it ;  at  other  times  it  is  not  so 
constricted,  and  the  ftotus  may  be  felt  through  it.  But  in  every  case  it 
is  irregular  and  deformed,  deviated  from  its  usual  direction,  and  its 
walls  greatly  thickened,  perliaps  corrugated.  Its  degree  of  hardness 
and  thickness  will  indicate  whether,  and  to  what  extent,  it  can  he 
dilated  ;  and  this  condition  may  not  only  involve  the  whole  of  the 
cervix,  hut  also  the  walls  of  the  uterus  itself,  as  well  as  those  of  the 
vagina. 

When  the  cervix  is  ulcerated,  the  hand  will  be  found  covered  with 
blood  after  the  examination. 

Diagnosis. 

The  diagnosis  of  this  condition  must  be  left,  to  a  large  extent,  to  the 
tactile  impressions  derived  from  a  vaginal  exploration.  In  some  cases 
an  ocular  inspection  of  the  cervix  may  be  possible,  and  the  previous 
history  of  the  case  may  also  be  useful  in  this  direction. 

Proijnosis. 

The  influence  of  the  induration  on  the  act  of  parturition  will  depend 
upon  the  degree  and  extent  of  the  alteration  in  the  cervix.  If  this  is 
not  very  serious,  and  does  not  implicate  the  organ  very  much,  and  par- 
ticularly if  the  induration  is  localized  in  some  unimportant  part,  par- 
turition, though  protracted,  may  nevertheless  be  accomplished  without 
assistance.  Often,  however,  the  results  are  troublesome  ;  one  of  these 
is  laceration  of  the  cervix,  from  its  unequal  dilatation. 

Though  there  is  a  great  difference,  pathologically  speaking,  between 
the  various  alterations — for  example,  between  simple  fibrous  trans- 
formation and  cancerous  degeneration — yet  it  is  admitted  that  the  most 
benignant  alteration  is  infinitely  more  serious,  from  an  obstetrical  point 
of  view,  than  simple  rigidity  of  the  cervix,  either  in  its  immediate  or 
remote  results.  This  Saint-Cyr  has  proved  to  be  the  case  in  nineteen 
recorded  observations.  Of  these,  seven  were  more  or  less  unfortunate  in 
their  results  ;  in  three  instances  the  mother  and  fti^tus  succumbed  ;  in 
other  three  the  mother  died,  but  the  progeny  was  saved  ;  and  in  the 
seventli,  the  Calf  died,  but  the  Cow  lived.  This  is  a  very  high  rate  of 
mortality,  and  yet  Saint-Cyr  is  not  quite  certain  that  in  these  nineteen 
observations  there  were  not  some  which  were  rather  cases  of  simple 
rigidity  than  induration  of  the  cervix.  For  as  Rainard  remarks— and 
the  remark  would  also  apply  to  the  observations  recorded  in  English 
veterinary  literature — it  is  not  always  easy,  for  lack  of  sufticient  details, 
to  discern  clearly  to  which  category  belongs  such  or  such  an  obsei"va- 
tion  given  by  writers  under  the  title  of  "  indurated  cen'ix,"  "  schirrous 
cen-ix,"  "  stricture  of  the  os  uteri,"  etc. 

In  arriving  at  a  prognosis  in  a  case  of  this  description,  the  immediate 
results  are  not  alone  to  be  taken  into  consideration  ;  as  pregnancy  and 
the  manipulatory  operations  necessary  to  effect  delivery— which  is 
always  tedious  and  difficult — give  to  morbid  alterations  of  these  parts — 
even  when  quite  benignant  in  their  nature — an  exceptional  gravity  ;  so 
that  many  animals,  even  after  a  comparatively  easy  delivery,  succumb 
soon  afterwards  to  the  diseased  condition.  The  uterus  may  be  ruptured 
through  the  efforts  at  delivery. 


364  MATERNAL  DYSTOKIA. 

Pathological  Anatomy. 

The  lesions  found  after  death  are  generally  alluded  to  as  "fibrous 
degeneration,"  "  scirrhus,"  or  "  cancer  "  of  the  cervix  ;  and  it  is  usually 
mentioned  that  this  part  was  "  hard  and  like  cartilage,"  "  creaking  under 
the  knife  like  cutting  an  unripe  apple  or  turnip "  ;  or  that  there  was 
"  schirrus  "  or  "  cancer,"  "  nodular  and  hard  like  cartilage.'' 

Macgillivray  states  that  when  the  contraction  of  the  os  uteri  is  the 
result  of  prior  disease,  it  will  generally  be  found  of  a  hard  fibroid  nature  ; 
while,  on  the  other  hand,  where  the  contracted  parts  are  soft  and  very 
much  thickened,  acute  disease  will  commonly  be  found  accompanying 
the  stricture.  "  In  hard  stricture,  the  transverse  rugae  or  folds  appear 
generally  to  be  transformed  into  a  compact,  unyielding  fibro-cartilaginous 
material ;  in  one  very  serious  case  I  found  six  of  these  hardened  unyield- 
ing transverse  rugae  or  folds  between  the  os  tincce  and  os  internum.  In 
soft  stricture,  without  any  actual  disease  being  present,  the  contraction 
is  generally  confined  to  the  os  and  the  vaginal  portion  of  the  cervix 
uteri.  In  cases  of  complicated  stricture,  or,  in  other  words,  stricture 
accompanied  by  some  active  disease,  it  will  often  be  found  that  the 
stricture  is  merely  the  concomitant  eilect  of  the  disease,  and  such 
causative  disease  will  almost  invariably  prove  to  be  either  ulcerative, 
schirrous,  really  cancerous,  or  fungous  in  its  nature.  .  .  .  Deposits  of  a 
fibrinous  nature  are  only  too  common  in  patients  of  rheumatic  constitu- 
tion." 

Treatment. 

The  condition  of  the  cervix  uteri  being  ascertained,  there  should  be 
no  delay  in  resorting  to  active  measures,  as  it  is  impossible  for  delivery 
to  be  effected,  in  the  great  majority  of  cases,  without  such  interfei-ence. 
Here  the  necessity  for  a  correct  diagnosis  is,  as  we  have  already  urged, 
of  the  greatest  moment ;  for  if  the  obstacle  to  birth  is  only  rigidity  or 
spasm  of  the  uterus,  this  can  generally  be  overcome  by  mild  measures 
and  without  risk  or  injury  to  the  animal ;  whereas,  in  induration  these 
measures  would  be  ineffective,  and  valuable  time  must  be  lost  in  trying 
them. 

Delivery,  in  induration  of  the  cervix,  must  be  effected  by  one  of  two 
serious  operations.  This  must  be  eitlier  vagiiial-hystcrotomy  or  (jastro- 
liysterotomy.  We  shall  again  allude  to  and  describe  these,  in  speaking 
of  obstetrical  operations. 

It  may  only  be  necessary  in  this  place  to  say  that  vaginal  hysterotomy 
— by  which  is  meant  incising  the  cervix,  either  completely  or  partially, 
in  one  or  more  places — does  not  offer  any  very  dangerous  consequences 
when  the  textures  are  healthy  ;  though  when  they  are  much  degenerated, 
the  operation  may  be  followed  by  troublesome,  if  not  fatal  results. 
Nevertheless,  dilating  the  cervix  by  incision  is  rarely  so  serious  for  the 
mother  as  the  Caesarian  section  ;  though  the  foetus  may  incur  more  risk, 
as,  after  the  cervix  has  been  relaxed,  it  is  often  a  tedious  and  difficult 
operation  to  effect  delivery,  and  strong  traction  may  even  be  necessary. 
As  this  measure  offers  a  chance  of  saving  both  mother  and  foetus,  it 
should,  as  a  rule,  be  preferred  to  gastro-hysterotomy ;  and  this  prefer- 
ence is  still  further  warranted  by  the  fact  that  the  life  of  the  mother  is 
of  more  value  than  that  of  the  foetus,  and  if  one  must  be  sacrificed  it 
should  be  the  latter.  Should  the  foetus  happen  to  be  dead,  then  there 
is  an  additional  motive  in  preferring  incision  of  the  cervix. 


MUllBID  ALTKIIATIUXS  IX  THE  (JEXERATIl'E  OliGAXS.  365 

When  the  os  has  been  considered  sufliciently  dilated  for  the  intro- 
duction of  the  hand  and  arm  into  the  uterus,  then  the  foitus  should  be 
placed  in  position  for  extraction — the  most  favourable  bein^',  of  course, 
the  vertebro-sacral,  with  the  head  and  fore-limbs  towards  the  os. 
Should  it  be  found  impossible  to  engage  these  in  the  passage,  tlien 
more  incisions  may  be  made  in  the  cervix,  and  this  can  be  done  with- 
out displacing  the  foetus. 

It  is  well  to  remember  that  it  is  very  much  better  to  dilate  the  os  by 
incision  than  by  laceration,  through  unduly  forcing  the  foetus  into  it. 
At  the  same  time,  judicious  traction  should  be  made  during  the  maternal 
eflbrts. 

Aubry,  Van  Dam,  and  some  others,  have  witnessed  fatal  haemorrhage 
resulting  from  the  incisions ;  while  metro-peritonitis  has  also  been 
reported  as  an  equally  unfortunate  sequel. 

But  these  cases  are  exceptional.  Those  veterinary  obstetrists  in  this 
country  and  on  the  Continent  who  have  had  most  experience  in  the 
operation,  are  unanimous  in  asserting  that,  provided  certain  pre- 
cautions are  adopted  in  making  the  incisions,  no  such  results  are  likely 
to  follow. 

Donnarieix  states  that,  in  thirty  years,  he  has  performed  vaginal 
hysterotomy  in  sixty  cases  of  schirrus  and  other  kinds  of  induration 
of  the  cervix  leading  to  occlusion  of  the  os  uteri,  and  of  these  only  one 
(Jied,  though  the  cause  of  death  was  not  ascertained.  Recovery  is  the 
rule  and  death  the  exception. 

Of  course,  recovery  must  always  be  doubtful  if  the  disease  of  the 
cervix  is  of  a  malignant  nature,  as  the  operation  and  the  irritation  caused 
by  the  extraction  of  the  foetus  will,  in  all  probability,  hasten  its  progress. 

In  some  rare  instances  it  may  be  advisable  to  have  recourse  to  the 
Caesarian  section  at  once.  When,  for  example,  labour  has  been  severe 
and  prolonged — when  some  days  have  elapsed  since  parturition  com- 
menced, and  the  veterinary  surgeon  is  not  sent  for  until  amateurs  have 
exhausted  their  efforts  and  the  animal  is  sinking;  or  when,  from  a 
vaginal  exploration,  it  is  ascertained  that  uterine  or  vaginal  disease  is 
so  extensive  and  advanced  that  the  mother  cannot  live  much  longer, 
and  the  foetus  is  alive  ;  then  this  formidable  operation  should  be  adopted 
without  delay. 

4.  Complete  Ohliteuation  (Atresia)  of  the  Os  Uteri. 

Congenital  atresia  of  the  os  uteri  may  at  once  be  admitted  as  an 
impossibility  in  obstetrics,  as  if  this  canal  is  completely  closed  impreg- 
nation cannot  take  place.  But  between  fecundation  and  parturition 
certain  alterations  may  occur  which,  by  leading  to  more  or  less  persis- 
tent closure  of  this  passage,  will  prove  an  obstacle  to  birth.  These 
alterations  may  indeed  exist  at  the  period  of  fecundation,  but  then  the 
uterine  opening  must  be  only  partially  closed  ;  and,  in  fact,  at  parturi- 
tion the  OS  may  be  superficially  and  partially,  as  well  as  completely, 
occluded.  This  condition  has  been  observed  in  the  Mare,  Cow,  and 
Sheep. 

Causes. 

The  occlusion  may  be  due  to  agglutination  of  the  walls  of  the  os, 
the  formation  of  fibrinous  membranes  or  bands,  the  development  of 
cicatricial  tissue  from  wounds  or  injuries  sustained  in  previous  preg- 
nancies, etc. 


366  MATERNAL  LYSTOKIA. 

Symptoms. 

These  are,  of  course,  the  usual  external  symptoms  of  retarded 
parturition.  Internally,  the  hand,  on  being  introduced  into  the  vagina 
and  pushed  towards  the  cervix,  comes  in  contact  v^ith  a  round, 
smooth,  and  tense,  but  fluctuating  tumour  at  a  variable  distance  from 
the  vulva,  or  even  between  its  labia ;  the  foetus  can  be  felt  through  this 
tumour,  and  this  might  lead  to  the  supposition  that  this  is  the  "  water- 
bag."  But  on  passing  the  hand  to  the  base  of  the  tumour,  instead  of 
finding  the  borders  of  the  os — as  we  should  do  if  it  were  the  foetal 
membranes — there  is  discovered  a  circular  furrow,  one  side  of  which  is 
the  extremity  of  the  vagina,  and  the  other  is  continuous  with  the 
tumour— which  is  the  posterior  segment  of  the  uterus  pushed  into  the 
vaginal  canal.  On  the  surface  of  this  tumour  may  be  found  a  small 
imperforate  depression ;  in  other  instances  there  is  a  kind  of  prominent 
ring,  like  the  top  of  the  neck  of  a  bottle,  but  without  an  opening ;  this 
is  the  cervix.  In  other  cases  no  trace  of  the  cervix  or  os  can  be 
distinguished. 

Results. 

If  relief  is  not  afforded,  the  mother  may  die  from  exhaustion  or 
rupture  of  the  uterus ;  or  a  rupture  may  occur  through  which  the 
foetus  and  its  membranes  will  pass,  and  the  mother  survive  for  a  longer 
or  shorter  period,  constituting  a  case  of  extra-uterine  pregnancy.  Or 
neither  of  these  results  may  happen,  but  after  a  certain  time  the  labour 
pains  and  the  other  indications  of  parturition  subside,  the  dead  foetus 
is  gradually  desiccated  as  the  fluids  surrounding  it  become  absorbed, 
and  the  parent  does  not  appear  at  all  amiss,  its  condition  being  per- 
haps only  accidentally  discovered,  either  when  it  dies  or  is  killed  long 
afterwards,  or  when  the  remains  of  the  foetus  begin  to  be  expelled  in  a 
vicarious  manner. 

Diagnosis. 

The  diagnosis  of  this  condition  must  be  based  on  the  signs  just 
alluded  to.  The  only  other  anomaly,  perhaps,  with  which  it  might  be 
confounded  is  deviation  of  the  uterus,  in  which  the  cervix  maybe  tilted 
up  towards  the  vertebro-sacral  angle,  even  almost  beyond  the  reach  of 
the  hand.  The  position  of  the  cervix  and  os  tincae  should  be  the  guide 
in  diagnosis. 

Treatment. 

As  in  induration  of  the  cervix,  so  in  atresia;  delivery  must  be  effected 
by  incision,  or  puncture  if  the  os  is  found  to  be  obstructed  by  super- 
ficial fibrinous  bands  or  membranes.  For  the  latter,  the  extremity  of 
the  finger  or  a  metal  catheter  may  suffice,  the  pressure  being  gradual 
and  the  movement  semi-rotatory.  The  bands  may,  in  rare  instances, 
be  ruptured  by  means  of  the  finger-nails  or  divided  by  scissors.  If, 
however,  the  resistance  is  too  great,  and  the  os  is  closed  either  through 
the  production  of  cicatricial  tissue  or  other  morbid  alteration,  then  it 
will  be  necessary  to  incise  it  as  for  induration,  and  in  the  way  to  be 
hereafter  described. 

But  if  the  OS  is  obliterated  and  the  cervix  cannot  be  found,  then  the 
portion  of  the  uterus  which  protrudes  into  the  vagina  must  be  incised, 
and  the  foetus  removed  by  this  artificial  opening.  With  this  object, 
Hubert  recommends  a  convex  bistoury,  the  blade  of  which  is  covered 


OTHER  CAUSES  OF  MATERXAL  I'YsToKIA.  3r>7 

to  ^Yithill  a  few  lines  of  its  point.  The  instrument  is  to  be  directed  to 
the  part  where  the  os  is  supposed  to  be ;  then  the  coats  of  the  uterus 
are  to  be  carefully  incised  to  a  small  extent — layer  after  layer,  until 
the  escape  of  the  liquor  amnii  announces  that  the  fd'tal  membranes  are 
opened.  The  small  slit  thus  made  is  to  be  enlarged  by  a  probe-pointed 
bistoury — the  enlargement  being  either  crucial  or  T-shaped.  Then  the 
foetus  is  to  be  extracted. 

Hubert  has  performed  this  opei-ation  once  on  a  Sheep,  and  a  shepherd 
by  his  direction  also  performed  it  on  another  Sheep,  and  in  both  cases 
the  result  was  favourable  for  mother  and  offspring. 


CHAPTER  lY. 
Other  Causes  of  Maternal  Dystokia. 

There  are  some  other  causes  of  Dystokia  which,  though  comparatively 
rare,  yet  deserve  the  attention  of  the  veterinary  obstetrist,  and  will 
complete  our  notice  of  the  maternal  obstacles  to  parturition.  These 
are:  (1)  Anomalies  of  the  placenta;  (2)  Morbid  adhesion  heticecn  the 
fa:tus  and  uterus;  (3)  Stricture  of  the  uterus  by  external  bands; 
(4)  Persistent  hymen  ;  (5)   Vatjinal  and  vulvar  atresia. 

1.  Anomalies  in  the  Placenta, 

We  are  but  little  acquainted  with  the  morbid  alterations  of  the 
fcetal  membranes  of  animals,  and  of  those  changes  which  lead  to  their 
more  or  less  permanent  adhesion  to  the  foetus  and  the  uterus.  The 
subject  appears  to  have  received  very  little  attention,  and  the  observa- 
tions are  so  few  that  Saint-Cyr  makes  no  mention  of  these  adhesions 
as  a  cause  of  difHicult  or  impossible  birth. 

It  is  very  probable  that  animals  are  less  subject  to  disease  of  the 
uterus  and  the  placental  membranes  than  the  human  species,  and  tliis 
would  account  to  a  certain  extent  for  the  absence  of  notice  of  such 
occurrences.  Nevertheless,  that  animals  are  disposed  to  metritis,  endo- 
metritis, and  perimetritis,  no  one  can  deny  ;  and  that  we  may  also 
have  such  anomalies  as  hyperplasia  of  the  chorion,  as  well  as  myxomata 
of  that  membrane,  in  addition  to  new  formations  of  the  placenta,  as 
well  as  placentitis,  might  be  expected.  But,  as  we  have  observed, 
there  is  indeed  but  little  direct  evidence  to  prove  that  any  of  these 
morbid  conditions  ever  exist,  thougli  some  of  them  at  least  may  lead 
to  abortion,  while  others  might  give  rise  to  obstacles  which  would 
retard  or  altogether  prevent  birth. 

Scirrhous  Chorion. 

According  to  Cox,^  scirrhous  chorion  is  occasionally  met  with  in 
animals,  and  proves  an  obstacle  to  parturition. 

The  membrane  is  found  to  be  separated  from  the  uterus,  and  envelops 
the  fcetus,  as  it  were,  in  a  leather  bag,  no  part  of  the  creature  being 
distinguishable.  This  is  probably  the  condition  known  in  woman  as 
7nyxo)na  fibrosum  placcntiv. 

The  labour  pains  are  seldom  violent,  though  the  foetal  membranes 

'    Veterinary  Journal,  1877,  p.  105. 


368  MATERNAL  DYSTOKIA. 

(water-bag)  cannot  be  expelled  into  the  vagina,  even  v\^hen  the  os  uteri 
offers  no  obstacle. 

An  early  examination  is  necessary,  as  the  foetus  soon  perishes.  An 
incision  must  be  made  through  the  chorion,  and  the  foetus  extracted. 

2.  Morbid  Adhesion  between  the  Fcetus  and  Uterus. 

Adhesion  between  the  uterus  and  its  contents  may  be  due  to  in- 
flammation of  a  portion  of  the  mucous  membrane,  to  hyperplasia  of 
the  chorion,  or  to  disease  of  the  ovum  or  placenta,  by  which  the  two 
latter  are  brought  into  direct  contact  with  the  interior  of  the  organ. 
Or  it  may  be  owing  to  a  deficient  quantity  of  liquor  amnii  when  the 
foetus  begins  to  be  formed  ;  for  if  the  amnion,  in  the  course  of  its 
development,  is  not  separated  from  the  growing  foetus  by  a  sufficient 
quantity  of  fluid,  connection  between  them  is  almost  certain  to  be 
established  either  in  isolated  spots  (Simonart's  "bands"),  or  over  a 
wide  surface.  Adhesion  between  the  amnion,  chorion,  and  lining 
membrane  of  the  uterus,  is  then  not  only  possible  but  probable,  and 
in  this  way  the  foetus  is  brought  into  a  solid  union  with  the  maternal 
organ.  It  can  readily  be  understood  that  such  an  occurrence  will 
prove  a  very  serious  obstacle  to  birth,  and  greatly  endanger  the  life  of 
the  mother. 

Eainard^  furnishes  us  with  two  observations,  a  writer  in  the 
Veterinary  Journal  ("  Nemo  ")-  with  another,  and  Naylor^  with  two. 

Eainard  justly  remarks  that  veterinary  surgeons  should  be  aware 
of  the  possibility  of  such  adhesions,  either  with  the  placenta  or  the 
envelopes,  and,  through  them,  with  the  uterus  ;  and  that  they  are 
otherwise  easier  recognised  than  those  external  to  the  uterus. 

The  hand,  introduced  into  the  uterine  cavity,  is  passed  over  its 
inner  surface,  around  the  foetus,  as  it  were  :  and  by  this  means  the 
existence,  seat,  extent,  and  resistance  of  the  adhesions  will,  in  the 
majority  of  cases,  be  ascertained.  When  the  adhesions  are  situated 
towards  the  fundus  of  the  organ — its  most  distant  part,  and  where  the 
hand  cannot  reach,  then  there  will  be  difficulty  ;  but  this  must  be 
overcome  by  raising  the  uterus  and  throwing  it  backwards,  by  elevating 
the  front  part  of  the  animal's  body,  and  lifting  the  abdomen  by  means 
of  a  plank,  blanket,  or  sack. 

Most  frequently  the  adhesions  can  be  broken  up  by  the  fingers  ;  but 
if  they  are  too  strong,  then  a  bistoury  or  other  convenient  instrument 
will  have  to  be  employed.  Their  incision  must  be  carefully  made,  and 
the  "  crutch"  or  "  repeller  "  (to  be  hereafter  described)  will  be  useful 
in  keeping  the  foetus  away  from  the  part  where  the  separation  is  being 
effected.  The  cutting  should  be  done  gradually  and  steadily,  the  point 
of  the  instrument  being  kept  at  an  equal  distance  between  the  foetus 
and  the  mucous  surface  of  the  uterus. 

In  alluding  to  these  internal  adhesions,  it  may  be  observed  that 
some  very  rare  cases  are  recorded,  in  which  parturition  was  opposed 
by  external  adhesions  between  the  peritoneal  covering  of  the  uterus  and 
the  sac  of  a  hernia,  or  neighbouring  viscera. 

^   Traite  Complet  de  la  Parturition,  vol.  i. ,  p.  461. 
-   Veterinary  Journal,  vol.  iii.,  p.  262. 
3    Veter'inarian,  vol.  xxiii.,  p.  324. 


OTHER  CAUSES  OF  MATEJLXJL  JJYSTOKIA.  ^69 

3.  Stkictuke  ok  Occlusion  of  the  Uterus  by  External  Bands 

OR  Mkmhuanes. 

A  number  of  writers,  especially  in  foreign  periodicals,  have  described 
the  pi'esence  of  bands  or  membranes  external  to  the  uterus — either  in 
the  peritoneal  cavity  or  vagina — obstructing  the  passage  of  the  ftctus 
and  rendering  birth  almost,  if  not  quite,  impossible  without  an  operation. 

With  regard  to  the  treatment  of  these  cases,  but  little  can  be  said. 
When  the  bands  are  in  the  vagina,  their  division  is  the  principal  object, 
after  which,  if  no  other  obstacle  is  present,  delivery  can  take  place. 
When,  however,  the  uterus  is  constricted  by  an  external  abdominal 
band — though  this  condition  will  be  ditlicult  to  diagnose — then  probably 
no  course  can  promise  anything  like  a  successful  result  except  the 
Ciesarian  section. 

4.  Persistent  Hymen. 

At  p.  30  there  was  described  a  wide  duplicature  of  the  lining  mem- 
brane of  the  vagina  which  covers  the  meatus  urinarius,  and  which 
looks  like,  while  it  acts  as,  a  valve  {valvula  vaijiiue)  to  that  opening. 
This  membrane,  which  stretches  across  the  passage  and  separates  the 
vulvar  from  the  vaginal  canal,  is  the  analogue  of  the  hymen  of  woman; 
and,  as  in  her,  it  may  persist  after  the  impregnation  of  piimiparas — 
having  escaped  rupture  during  coitus — and  becoming  abnormally  rigid, 
may  prove  an  impediment  to  birth  in  some  instances,  though  it  must 
be  confessed  they  appear  to  be  exceedingly  rare. 

This  cause  of  dystokia  should  be  very  much  less  frequently  met  with 
in  the  Equine  and  Asinine  species  than  other  of  the  domesticated 
animals,  in  consequence  of  the  size  and  conformation  of  the  male 
organ  of  copulation,  from  which  the  membranous  vaginal  partition  can 
scarcely  escape  rupture,  when  it  is  present,  which  is  only  occasionally.^ 
With  the  Bovine,  Caprine,  Ovine,  and  Porcine  species,  however,  the 
case  is  different,  as  the  penis,  from  its  volume  and  shape,  is  far  less 
likely  to  lacerate  the  hymen  ;  and  it  is  in  the  Bovine  species  alone  that 
the  persistence  of  the  latter  at  parturition  has  been  found — at  least  so 
far  as  published  observations  show  ;  and  in  all  the  instances  the 
animals  have  been  young  and  primipane. 

It  is  just  possible  that  in  many  animals  of  these  species,  the  hymen 
may  be  more  or  less  intact  until  parturition  sets  in,  when  the  foetus,  in 
its  passage  through  the  vagina,  ruptures  and  effaces  it  without  much 
delay  resulting,  or  any  other  cause  which  might  attract  attention. 

But  in  others — few  though  they  be — the  membrane  would  appear  to 

^  The  hymen  appears  to  be  only  exceptionally  present  io  the  Mare,  though  it  is  an 
error  to  assume  tli.'it  it  is  always  absent.  Not  only  is  it  sometimes  to  be  found,  and 
occasionally  of  large  size  and  extr.iordinary  tenacity,  t)ut  it  may  even  become  a  source  of 
trouble  in  uniniprejjnated  Mares.  Of  this  we  have  an  example  by  Mr.  Thomson,  of 
Belch  (  yeleriiiarian,  vol.  vii.,  p.  147).  That  veterinarian  was  called  to  see  a  young 
Mare,  said  t<"i  have  inversion  of  the  bladder.  On  his  arrival,  he  saw  protruding  from 
the  vulva  a  membranous  sac  containing  about  a  quart  of  Huid  in  its  cavity.  An  exami- 
nation proved  the  s.ac  to  be  a  simple  membrane,  extremely  vascular  and  miich  inflamed. 
It  was  easily  pushed  hack  into  the  vaginal  cavity,  wh^re  it  was  found  to  be  attached  to 
the  posterior  part  of  the  urethra  and  all  around  the  vaginal  canal,  so  that  the  paHsage  to 
the  OS  uteri  w.-va  completely  obstructed  ;  the  membrane  could  not  be  pushed  so  far 
forward  as  the  cervix.  On  removing  the  hand,  it  again  protruded  whenever  the  Mare 
made  an  effort. 

In  another  instance — a  year  and  a  half  old  Filly — Mr.  Thomson  observed  an  intact 
hymen — but  there  was  a  small  opening  in  it — immediately  behind  the  urethra. 

24 


370  MATERNAL  DYSTOKIA. 

offer  a  rather  serious  amount  of  resistance  to  the  expulsion  of  the  young 
creature,  and  demands  the  services  of  the  obstetrist. 
The  cases  recorded  are  exceedingly  few. 

Treatment. 

The  indications  for  treatment,  when  the  hymen  is  present  and  an 
obstacle  to  birth,  are  obvious  :  divide  it  at  once.  This  division  may  be 
made  in  the  middle  of  the  membrane,  and  does  not  demand  any  parti- 
cular care  or  surgical  knowledge  ;  though  it  is  well  to  make  a  close 
examination  before  the  incision  is  made,  in  order  to  avoid  making  a 
mistake  should  the  membrane  appear  as  a  tumour. 

5.  Vaginal  and  Vulvae  Constriction  or  Atresia. 

Stenosis  and  atresia  of  the  vulva  and  vagina  have  not  infrequently 
been  recorded  as  either  delaying,  or  altogether  preventing,  parturition 
in  animals,  according  as  the  obstruction  was  incomplete  or  complete. 

This  condition  may  exist  previous  to  impregnation,  but  to  such  an 
extent  as  to  offer  no  obstacle  whatever  to  that  act ;  or  it  may  become 
developed  in  the  interval  between  impregnation  and  parturition.  Of 
course,  if  atresia  is  complete,  and  of  such  a  character  that  the  spermatic 
particles  cannot  pass  into  the  os  uteri,  impregnation  will  not  take 
place,  and  the  animal  remains  sterile. 

The  condition  may,  therefore,  be  congenital  or  acquired.  Incomplete 
congenital  stenosis  of  these  passages  is  not  at  all  uncommon  in  young 
animals,  in  which  the  vulva  and  vagina  are  often  so  constricted  and 
inelastic,  that  during  copulation  they  are  injured,  and  this  injury  tends 
still  more  to  diminish  their  calibre  and  dilatability  during  pregnancy. 
Congenital  stenosis  to  a  very  abnormal  degree  may  sometimes  exist, 
however,  without  any  apparent  traumatic  influence. 
I  Acquired  stenosis  or  atresia  is  generally  the  result  of  certain  diseases 
or  injuries,  such  as  inflammation,  suppuration,  ulceration,  and  lacera- 
tion, often  due  to  difficult  parturition.  These  may  lead  to  hypertrophy 
and  density  of  the  tissues,  hard  resisting  cicatrices,  solid  adhesions, 
or  partial  or  complete  obliteration. 

Malposition  of  the  vulva  may  also  lead  to  atresia.  I  witnessed  a 
case  of  this  kind  in  an  Arab  Mare  of  high  pedigree  in  Syria.  The  vulva 
was  partly  below  the  ischial  arch. 

In  primiparae,  cases  of  abortion,  in  which  birth  occurs  in  a  hurried 
manner,  as  well  as  when  the  water-bag  is  ruptured  too  soon,  or  in  those 
breech  presentations  in  which  the  hind  legs  are  bent  forward  and  only 
the  hocks  ofier — in  all  these  the  narrowness  of  the  vulva  and  vagina, 
from  lack  of  preparation,  is  often  an  obstacle  to  parturition,  their 
tissues  being  "hard." 

But  with  patience  and  warm  emollient  injections,  as  well  as  careftil 
and  gradual  manual  dilatation,  this  obstacle  may  be  overcome.  When 
birth  is  taking  place  too  hurriedly,  Eainard  recommends  closing  the 
animal's  nostrils  and  opening  its  mouth,  pulling  out  its  tongue  and 
pressing  on  the  loins  to  prevent  its  arching  the  back  and  straining.  It 
is  very  rare  that  the  resistance  is  serious,  and  in  the  great  majority  of 
cases  birth  occurs  spontaneously,  or  with  trifling  assistance. 

Some  authorities,  however,  have  met  with  instances  in  which  it  was 
necessary  to  dilate  the  vulvar  orifice  by  incision,  in  order  to  prevent  this 
part  being  lacerated,  and  to  spare  the  animal  pain  and  subsequent 
deterioration. 


OTHER  CAUSES  OF  MATERNAL  DYSTOKIA.  371 

When  the  dystokia  is  due  to  disease  or  a  traumatic  cause,  birth  is 
more  ditVicult ;  and  this  difliculty  is  increased  as  the  pathological  altera- 
tion is  extensive. 

Treatment. 

Tlie  treatment  of  stenosis  of  the  vulva  and  vagina  must  be,  of  course, 
surgical,  and  will  vary  according  to  the  cause  producing  the  constric- 
tion. But  it  will  chiefly  consist  in  incisions  carried  to  a  depth  and 
extent  commensurate  with  the  exigencies  of  each  case,  and  modified 
according  to  the  anatomy  of  the  part  which  forms  the  seat  of  stricture. 
It  will  be  found  that  lateral  incisions  are,  when  they  can  possibly  be 
practised,  preferable  to  those  made  either  superiorly  or  inferiorly,  as 
they  are  less  lil<ely  to  be  followed  by  inconvenient  alterations  and  un- 
favourable consequences  ;  while,  with  regard  to  the  vulva,  the  textures 
at  the  sides  of  that  orifice  have  more  vitality,  and  therefore  cicatrise 
more  rapidly  than  at  the  superior  commissure. 


372  FCETAL  DYSTOKIA. 

BOOK  11. 

FCETAL  DYSTOKIA. 

Though  the  obstacles  to  parturition  offered  by  the  maternal  organs  are 
somewhat  considerable  in  number,  yet  it  is  found  in  practice  that  those 
due  to  the  foetus  are  far  more  frequently  met  with,  and  are  much  more 
numerous  ;  though  all  of  them  may  not  constitute  real  or  serious 
obstacles,  some  being  easily  removed  or  overcome,  when  birth  takes 
place  without  any  difficulty. 

The  obstacles  which  the  foetus  may  offer  to  birth  are,  for  convenience 
of  study,  divided  into  two  natural  groups,  according  as  they  result  from 
some  physical  condition  of  the  young  creature  itself,  or  from  the  more 
or  less  irregular  manner  in  which  it  is  presented  at  the  pelvic  inlet. 
Each  of  these  groups,  again,  it  is  needless  to  add,  embraces  a  certain 
number  of  varieties  of  obstacles  ;  but  though  grouped  and  classified  in 
this  way,  it  must  be  remembered  that  difficult  parturition  due  to  the 
foetus  may  not  be  owing  exclusively  to  any  one  of  these  obstacles  in 
every  case,  but  in  some  instances  may  result  from  a  combination  of  two 
or  more  of  them 

This  combination,  however,  does  not  preclude  us  from  studying  them 
separately ;  indeed,  their  separate  consideration  is  absolutely  necessary, 
as  it  is  only  by  analysing  them  that  we  can  realize  their  influence  in  hin- 
dering birth,  either  when  alone  or  combined. 

As  will  be  seen  from  the  following  synoptic  table,  the  obstacles  in  the 
first  group  are  very  numerous  and  varied,  and  require  careful  considera- 
tion from  the  obstetrist — opening,  as  they  do,  a  wide  field  for  investiga- 
tion and  reflection,  as  well  as  practical  deduction ;  and  none  the  less 
so  with  those  of  the  second  group,  to  be  dealt  with  hereafter. 

Synoptic  Table   of   Fcetal   Dtstokias  independent  ob'   Pbesentations 
AND  Positions. 

(  Umbilical  Cord. 
Excess  in  Volume. 
Excess  in  Growth  of  Hair. 
Anomalies  and  Diseases  of  Membranes. 
Abnormal  Quantity  of  Placental  Fluid. 

'Hydrocephalus. 
Ascites,  Anasarca,  and 
Hydrothorax. 
Diseases  ■^  Emphysema. 
Polysarcia. 
Contractions. 
Tumours. 

Monstrosities. 
^Multiparity. 


Dystokia  from 


GROUP  I. 

OBSTACLES   INDEPENDENT    OP   PKESENTATIONS   AND    POSITIONS. 

In  this  group,  the  maternal  organs  of  generation  and  those  parts  imme- 
diately concerned  in  parturition  may  be  perfectly  healthy,  and  the  foetus 
itself  may  be  in  a  favourable  position  for  expulsion ;  yet  birth  is  either 
protracted  or  rendered  impossible  without  assistance,  because  of  the 
umbilical  cord,  the  excessive  volume  of  the  foetus,  excess  in  growth  of 


THE  LMlilLICAL  CORD  AS  AN  OL'STACLE  TO  BIRTH.  37'5 

hair,  anomalies  in  or  diseases  of  its  enveloping  membranes,  an  abnormal 
quantity  of  placental  fluid,  anomalies  in  the  umbilical  cord,  disease 
or  malformation  of  the  young  creature,  or  a  plurality  of  foetuses  in 
animals  ordinarily  uniparous. 


CHAPTER   I. 

Various  Extraordinary  Causes. 

The  Umiulical.  Cohu  as  an  Obstacle  to  Birth. 

Akomalies  in    the   umbilical  cord  are  not  a  very  common  cause   of 
dystokia. 

The  cord  may  be  unusually  short ;  but  this  deficiency  does  not  appear 
to  operate  prejudicially  in  parturition,  as  the  natural  twist  in  it  admits 
of  its  elongation  to  a  certain  extent,  while  during  the  act  of  expulsion 
the  walls  of  the  body  of  the  uterus  approach  the  cervix  as  the  fcctus 
advances  into  the  vagina.  Even  if  the  coi'd  happened  to  be  too  short, 
it  is  questionable  whether  it  would  constitute  a  serious  obstacle  to  birth, 
as  it  would  most  probably  either  rupture  or  the  placenta  would  separate 
from  the  uterus. 

If  by  chance  the  foetus  should  not  be  expelled  until  it  was  discovered 
that  the  cord  was  insufficiently  long,  this  might  easily  be  cut  in  the 
vagina,  as  far  as  possible  from  the  foetus,  the  ends  being  compressed  by 
the  fingers  and  ligatured  after  deliver)'. 

In  the  domestic  animals  the  cord  is  never  so  long  as  to  occasion 
what  has  been  designated  in  human  obstetrics  prolajjsus  of  the  cord,  i.e., 
its  descent  into  the  os,  vagina,  or  outside  the  vulva,  after  rupture  of  the 
membranes,  and  alongside  the  presenting  part  of  the  child — an  accident 
attended  sometimes  with  great  danger  to  the  latter,  from  compression 
of  the  funis. 

The  comparatively  short  coi'd  of  the  domestic  animals  also  exempts 
them  to  some  extent  from  another  frequent  cause  of  difficult  labour  met 
with  in  woman — -the  coil'nvj  of  tlic  funis  around  some  part  or  parts  of 
the  foetus.  Nevertheless,  this  coiling  has  been  obsers-ed  in  animals — 
more  often,  perhaps,  with  the  Mare  than  the  Cow.  Havon,  Dclwart, 
Hurtrel  D'Arboval,  Rueflf,  and  Sacchers  have  seen  the  cord  coiled  around 
the  neck,  and  more  especially  when  the  foetus  was  in  a  wrong  position — 
head  bent  towards  the  flanks,  near  the  cord.  Gaven  has  found  it  round 
the  loins  ;  and  numerous  observers  have  noted  it  encircling  one  or 
more  of  the  limbs.  Remondeau  found  Hie  cord  round  both  hocks  of 
the  fcctus  in  an  Ass  ;  this  formed  a  serious  obstacle  to  birth,  and  em- 
bryotomy had  to  be  resorted  to  before  delivery  was  effected.  Daubenton 
had  remarked  the  frequency  of  leg  coils  in  Sheep. 

Coiling  of  the  funis  around  any  part  of  the  foetus  is  not  in  itself  a 
common  cause  of  dystokia,  although  it  may  render  delivery  protracted 
and  fatiguing.  It  is  more  likely  to  induce  asphyxia  in  the  young  crea- 
ture, from  the  stretching  and  diminished  calibre  of  the  bloodvessels 
composing  it,  and  consequent  check  to  the  flow  of  blood. 

Rainard  is  of  opinion  that  the  obstacle  to  parturition  from  coiling  is 
less  serious  in  the  Mare  and  Carnivorous  animals  than  other  creatures, 
because  of  the  readiness  with  which  the  placenta  is  detached  in  them. 


374  F(ETAL  DYSTOKIA. 

The  dangers  of  strangulation  are  also  much  less  when  the  foetus 
presents  anteriorly ;  when  the  presentation  is  posterior,  there  is  risk  of 
suffocation,  because  it  is  difficult  to  ascertain  the  situation  of  the  cord 
in  order  to  divide  it ;  and  the  uterine  contractions,  as  well  as  the  arti- 
ficial traction,  tend  to  tighten  the  funis  around  the  neck. 

In  the  human  species,  it  has  often  been  remarked  that  children  are 
sometimes  born  with  their  limbs  deficient,  and  the  spontaneous  amputa- 
tion has  been  attributed  to  the  constriction  produced  by  this  coiling  or 
twisting  of  the  umbilical  cord  around  the  part,  during  the  development 
of  the  foetus.  Vrolig,  Hillairet,  and  Goubaux  have  recorded  similar 
mutilations  in  animals. 

Diagnosis. 

There  are  so  many  causes  of  dystokia,  that  it  is  often  a  puzzhng 
matter  to  ascertain  that  which  is  really  in  operation  in  some  instances, 
and  this  is  one  of  them.  When  nothing  can  be  discovered  as  likely 
to  hinder  birth — neither  narrowness  of  the  passages,  excessive  size 
of  the  foetus,  malpresentation,  or  other  obstacle — a  careful  examination 
should  be  made  of  the  umbilical  cord,  in  order  to  ascertain  whether 
it  is  relaxed  or  tight,  or  encircling  any  part  of  the  body.  If  it  is 
relaxed,  then  the  obstacle  must  be  sought  in  something  else  ;  but  if  it 
is  in  a  state  of  tension,  and  especially  if  round  the  neck  or  limbs,  then 
to  it  may  be  ascribed  the  dystokia. 

Indications. 

When  coiling  of  the  funis  is  ascertained  to  be  the  cause  of  difficult 
parturition,  the  indications  are  to  uncoil  it ;  or  if  this  cannot  be  effected, 
then  it  must  be  divided  either  by  the  fingers,  scissors,  or  a  probe- 
pointed  bistoury — hastening  delivery  as  much  as  possible  afterwards. 
There  is  not  much  to  be  feared  from  haemorrhage  after  section  of  the 
vessels,  as  they  seldom  bleed. 

But  to  avert  danger  from  haemorrhage  or  asphyxia,  delivery  must  be 
delayed  as  little  as  possible.  A  ligature  around  the  cord  before  birth  will 
certainly  produce  asphyxia  very  promptly.  In  order  to  prevent  both  of 
these  occurrences — asphyxia  and  haemorrhage — Saint-Cyr  proposes  to 
pass  a  string  around  the  umbilical  cord,  leaving  its  two  ends  outside  the 
vulva  ;  these  are  passed  through  the  two  holes  at  the  end  of  a  porte-cord, 
one  of  them  being  fastened  with  a  knot  there,  while  the  other  is  carried 
through  the  ring  at  the  handle.  When  the  umbilical  cord  is  about  to  be 
cut,  this  instrument  is  pushed  into  the  uterus  close  to  the  body  of  the 
foetus,  and  the  line  being  pulled  tight,  the  vessel  is  divided  on  the 
placental  side.  This  checks  haemorrhage,  and  delivery  can  be  effected 
without  much,  if  any,  hindrance  from  the  porte-cord,  which  can  be 
held  by  an  assistant,  the  string  being  tied  firmly  round  the  handle,  if 
need  be. 

Excess  in  Volume  of  the  Fcetus. 

Excess  in  volume  of  the  foetus,  due  to  normal  or  abnormal  development 
of  either  the  whole  or  only  part  of  its  body,  is  far  from  constituting  an 
unfrequent  cause  of  dystokia  in  the  domestic  animals  —  rendering 
spontaneous  birth  more  or  less  difficult  or  altogether  impossible,  not- 
withstanding the  healthy  condition  of  the  maternal  organs,  the  regu- 


EXCESS  IN  VOLUME  OF  THE  FCETUS.  375 

larity  and  energy  of  the  uterine  contractions,  and  the  favourable  position 
of  the  foetus. 

Causes. 

Several  causes  may  be  in  operation  to  lead  to  excessive  development 
of  the  foetus — either  wholly  or  partially.  Among  these  we  may  cite  the 
following  as  the  principal : 

Prolonged  Gestation. — It  has  been  shown  that  the  fcctus  may  be 
retained  without  injury  for  several  wrecks  beyond  the  period  usually 
allotted  for  its  expulsion,  and  there  can  be  little  doubt  that  during  this 
interval  its  development  is  continued.  This  extra-development  being 
unprovided  for  in  the  dimensions  of  the  genital  passages  of  the  mother, 
leads  of  course  to  protracted  or  difficult  parturition. 

There  are  instances  recorded  of  the  foetus  of  the  Cow  and  Mare 
weighing  117,  165,  and  189  pounds.  It  may  therefore  be  readily 
understood  that  the  greatly  exaggerated  volume  which  this  weight 
represents,  must  meet  with  much  resistance  in  passing  through  a  canal 
that,  in  ordinary  circumstances,  gives  exit  to  a  foetus  weighing  from 
56  to  80  pounds. 

lieduced  Number  of  Fivtuses. — With  multiparous  animals,  when  the 
number  of  foetuses  is  smaller  than  usual — as  with  the  Bitch  which  has 
only  one  or  two,  instead  of  five  or  six — the  excess  of  nutriment  they 
receive  often  increases  their  bulk  to  an  abnormal  degree  ;  and  as  almost 
every  breeder  of  dogs  knows,  this  frequently  leads  to  serious  results  in 
parturition. 

Disproportion  in  Size  between  the  Male  and  Female. — There  can  bo 
no  doubt  that  a  disproportion  in  size  between  the  male  and  female,  in 
many  instances,  exerts  a  marked  influence  in  this  direction.  More 
especially  is  this  the  case  in  crossing  with  different  breeds,  or  in  attempt- 
ing to  breed  from  too  young  females. 

Delorme,  quoted  by  Rainard  (vol.  i.,  p.  474),  says  that  he  has  known 
a  certain  number  of  Camargue  Ewes  die  every  year  through  non- 
delivery, they  having  been  put  to  Dishley  Rams,  which  were  much  larger 
than  the  native  Sheep. 

The  case  of  small  Bitches  crossed  by  large  Dogs  is  familiar  to  all 
dog-breeders.  There  appears,  indeed,  to  be  a  natural  tendency  in  some 
small-sized  Bitches  to  seek  intercourse  with  Dogs  much  larger  than 
themselves,  and  this  preference  not  infrequently  leads  to  fatal  conse- 
quences in  parturition. 

But  in  many  instances  dystokia  is  due  to  exaggerated  development 
of  some  particular  region  of  the  fa-tus,  and  more  especially  of  the 
head — a  peculiarity  derived  from  crossing,  or  breeding  from  a  male 
possessing  this  character.  Indeed,  some  authorities  deny  that  cross- 
ing small  female  animals  with  males  which  are  generally  larger,  is 
likely  to  prove  a  source  of  difficult  parturition,  provided  there  is  nothing 
unusual  in  the  proportion  of  any  region  of  the  latter.  It  is  pointed  out 
that,  in  the  human  species,  small  women  are  very  often  married  to  very 
large  men,  and  yet  their  accouchements  are  more  or  less  easy.  It  has 
also  been  remarked  that  Melingie,  in  order  to  form  the  breed  of  Sheep 
known  in  France  as  the  Charmoise,  coupled  the  small  Bcrrichonne  Sheep 
with  the  great  New  Kent  Earns ;  and  yet  in  two  thousand  births  only 
one  was  diffictdt. 

A  German  veterinary  surgeon,  Nathusius,  mentioned  by  Rueff  and 
Baumeister,  asserts  that  in  the  cross  between  the  small  Merino  Sheep 


376  FCETAL  DYSTOKIA. 

with  the  huge  EngHsh  Earns,  he  has  observed  fewer  difficult  births 
than  in  flocks  composed  solely  of  Merinos.  And  Saint-Cyr  states  that 
he  has  often  seen  little  "Bressanne"  Mares,  which  were  put  to  big 
Percheron  or  Anglo-Norman  Stallions,  foal  without  difficulty  at  the 
ordinary  period.  We  might  also  adduce  the  small  female  Ass  coupled 
with  the  Horse-Stallion,  and  which  rarely  suffers  during  birth.  Abor- 
tion or  premature  birth  may  be  more  frequently  the  consequence  of 
such  "  mesalliances." 

Though  certain  facts  could  be  opposed  to  the  above  conclusions,  yet 
it  must  be  admitted  that  the  uniformly  exaggerated  development  of  the 
foetus  is  not  a  very  common  cause  of  dystokia,  and  is,  as  a  rule,  only 
so  when  the  pelvis  of  the  female  is  smaller  than  usual.  So  that  we 
must  look  rather  to  special  conformation  than  exaggerated  develop- 
ment. And  so  far  as  conformation  is  concerned,  we  find  that  excessive 
development  of  the  croup,  chest,  or  head  have  the  principal  influence. 

With  regard  to  the  head,  it  is  indisputable  that  of  the  three  regions 
this  most  frequently  proves  an  obstacle  to  parturition.  In  the  Bitch  this 
is  most  particularly  remarked.     But  it  is  also  noted  in  other  animals. 

Price,  in  his  book  on  Sheep,  mentions  that  a  grazier  in  Appledore 
employed  Leicester  Eams  for  several  years,  and  obtained  a  breed  with 
very  small  heads  and  "  kindly  disposition  ";  but  he  did  not  approve  of 
them,  because  they  were  not  sufficiently  large,  and  did  not  fetch  a  good 
price  in  the  market.  He  therefore,  in  the  summer  of  1804,  hired  some 
large  Kentish  Eams,  in  order  to  give  size  to  his  flock.  In  the  following 
lambing  season,  he  lost  twelve  Ewes,  from  the  immense  size  of  the 
lambs'  heads,  and  he  was  obliged  to  "draw"  (extract  artificially) 
nearly  all  his  Ewe  lambs.  In  1806  he  had  the  same  difficulty,  and 
lost  nine  Ewes  in  a  flock  of  two  hundred  and  fifty,  from  this  cause. 

Mr.  Cartwright  (Whitchurch)  casually  states  that  he  has  frequently 
known  of  some  Bulls  "getting  Calves  with  very  large  heads,  and 
causing  great  difficulty  in  calving;  and  the  owners,  finding  what  trouble 
there  was  at  calving-time,  and  the  danger  of  losing  their  Cows,  have 
sold  them,  and  obtained  others  whose  breed  have  not  this  objection." 

Euelf  and  Baumeister,i  in  alluding  to  this  subject,  remark  that  in  the 
Bovine  species  it  is  nearly  always  the  head  which  forms  the  chief 
obstacle  to  birth ;  and  they  refer  for  proof  of  this  statement  to  the 
small  native  Cows  of  Wurtemberg,  which,  when  crossed  by  the  original 
Simmenthalern  Bull,  have  often  difficult  labour,  as  the  latter  breed  has 
often  a  large  head. 

And  Schaack  writes  to  Saint-Cyr,  stating  that  for  thirty  years  the 
Cows  in  the  district  of  Lyons  were  all  put  to  a  Bull  remarkable  for  its 
massive  framework.  The  head  especially  was  very  developed,  and  as 
the  animal  transmitted  this  conformation  to  nearly  the  whole  of  its 
progeny,  the  size  of  the  head  of  the  foetus  very  often  rendered  parturi- 
tion difficult. 

Breeding  from  immature  undeveloped  animals  is  almost  certain  to 
produce  laborious  births ;  and  the  reason  for  this  is  not  difficult  to  find  : 
the  genital  canal,  and  particularly  the  pelvis,  is  not  sufficiently  de- 
veloped for  the  passage  of  the  foetus.  A  very  striking  instance  of  this, 
as  well  as  of  very  remarkable  precocity  in  the  Bovine  species,  is  given 
by  Mr.  Barker.2 

Influence  of  Food. — There  is  no  convincing  proof  before  us  that  the 

^  Op.  cit.,  p.  247. 

^   Veterinary  Journal,  vol.  iii.,  p.  336. 


EXCESS  IX  VOLUME  Of  THE  EO-JTCS.  377 

manner  of  feeding  or  kind  of  food  has  much  influence  on  pregnant 
animals,  so  far  as  excessive  volume  of  the  fa3tus,  and  consequent  difli- 
cult  parturition,  is  concerned. 

Cox' says:  "The  size  of  the  fo-tus  depends  considerably  upon  the 
condition  of  the  parent  and  the  kind  of  food  given  to  it.  Fat  animals, 
and  those  emaciated  from  the  continuous  use  of  food  of  a  ])oor  nature 
or  insutVicient  in  quantity,  bring  forth  a  small  foetus.  Where  the  de- 
bility is  the  result  of  pregnancy,  and  food  has  been  given  of  a  nutritious 
character  and  in  suthciency  during  that  period,  the  fcEtus  will  be  dis- 
proportionately large,  the  extra  nutriment  having  been  diverted  to  its 
growth.  Green  food,  or  '  depasturing,'  causes  the  foetus  to  grow  rapidly 
and  attain  a  gi-eat  size  ;  but  Nature  compensates  for  this  by  giving  with 
such  diet  greater  relaxation  of  the  tissues  of  the  dam,  and  an  increase 
of  the  placental  fluids  to  lubricate  and  assist  at  delivery." 

Diagnosis. 

The  diagnosis  of  excessive  volume  of  the  foetus  is  difficult,  and  can 
only  be  established,  as  a  rule,  at  parturition  ;  for  we  do  not  possess 
any  certain  means  of  appreciating  the  dimensions  of  the  fa'tus  in  iitcro 
before  its  enveloping  membranes  have  ruptured  and  the  os  is  dilated. 
An  unusual  size  of  the  maternal  abdomen  towards  the  termination  of 
pregnancy,  is  an  uncertain  and  very  often  a  deceptive  sign. 

Nasse,  a  German  veterinarian,  imagined  that  this  excess  in  develop- 
ment might  be  ascertained  by  weighing  the  animal  during  pregnancy. 
With  regard  to  the  Bitch,  he  thought  there  was  danger  when  the 
weight  was  increased  by  two-lifths  dui'ing  this  period,  the  normal  in- 
crease being  only  one-third.  But  it  is  evident  that  an  inordinate  in- 
crease in  weight  may  be  due  to  other  causes  than  the  foetus  or  fa}tuse3 
— such  as  an  unusual  number  of  these,  an  excess  of  amniotic  or  allan- 
toic fluid,  gi-eater  obesity  of  the  Bitch,  etc.  Otherwise,  if  this  test 
could  be  applied  to  the  13itch  with  practical  results,  the  conclusions 
derived  from  it  could  not  be  made  applicable  to  the  other  animals. 

The  only  circumstance  which  might  give  rise  to  suspicion,  is  the  pro- 
longation of  pregnancy  beyond  its  ordinary  period;  though  this  suspicion, 
as  we  have  seen,  will  not  always,  nor  yet  very  often,  be  confirmed. 

It  is  only,  then,  at  partm-ition  that  this  obstacle  on  the  part  of  the 
foetus  can  be  ascertained.  If  at  this  time,  in  spite  of  energetic  and 
sustained  uterine  contractions",  labour  is  protracted  and  does  not 
advance,  and  if  on  exploration  the  pelvis  and  genital  organs  are  found 
to  be  well  formed  and  normal,  the  os  dilated,  the  foetus  in  a  favourable 
position  and  not  malformed,  it  may  be  suspected  that  the  obstacle  to 
birth  is  dependent  on  the  large  size  of  the  latter.  A  closer  examination 
will  probably  confirm  this  suspicion. 

With  the  Bitch,  the  principal  obstacle,  as  has  been  already  said,  is 
generally  the  head  of  the  Puppy,  which,  when  it  is  large,  is  lodged  at 
the  entrance  to  the  pelvic  inlet,  where  it  can  be  touched  j^cf  vaginani. 

The  common-bred  Bitch,  with  muzzle  more  or  less  elongated,  when 
fecundated  by  a  male  of  the  same  size  and  conformation,  and  bringing 
forth  from  five  to  eight  young,  has  usually  no  difficulty  in  pupping. 
The  tapering  or  conical  form  of  the  muzzle  of  the  Puppies  allows  it  to 
enter  the  passage  and  pass  easily  through,  under  the  influence  of  the 
uterine  and  abdominal  contractions.  But  when  the  Bitch  is  of  small 
size,  and  has  been  impregnated  by  a  larger  and  young  vigorous  Dog, 
'    Vft'^rinary  Journal  vol.  i. ,  p.  265. 


378  FCETAL  DYSTOKIA. 

and  especially  if  the  muzzle  of  either  or  both  of  the  parents  is  short 
and  the  cranium  brachycephalic — as  in  the  King  Charles  Spaniels, 
Pugs,  and  Bull-dogs — parturition  is  oftentimes  extremely  difficult,  as 
the  forehead  in  these  breeds  is  very  large  and  cylindrical.  This  diffi- 
culty, as  has  been  mentioned,  is  increased  as  the  number  of  Puppies  is 
small,  as  then  the  latter  are  more  developed. 

With  the  Coio,  the  head  of  the  Calf  may  also  be  the  chief  impediment, 
and  provided  the  young  creature  is  otherwise  in  .a  favourable  position, 
the  muffle  may  pass  through  the  inlet,  but  the  remainder  of  the  head 
remains  fixed  like  a  wedge  in  the  long  and  almost  undilatable  bony 
canal.  The  head  is  often  so  firmly  wedged  at  this  part  that  it  can 
scarcely,  even  with  much  force,  be  advanced  or  pushed  forward,  and 
this  "wedging"  is  always  one  of  the  most  serious  difficulties  which 
the  obstetrist  has  to  overcome. 

With  the  Mare,  the  head  of  the  Foal  is  smaller,  longer,  and  more 
tapering  than  that  of  the  Calf,  and  meets  with  much  less  resistance  in 
passing  through  the  comparatively  short  and  wide  canal.  But  as 
Saint-Cyr  points  out,  and  as  w^e  have  previously  shown,  in  the  Equine 
and  Bovine  species  the  young  creature  finds  more  difficulty  when  the 
anterior  part  of  its  body — chest  and  shoulders — begins  to  enter  this 
part ;  and  from  their  respective  dimensions  it  is  evident  that,  even 
under  ordinary  conditions,  the  anterior  region  of  the  foetal  trunk  must 
submit  to  a  certain  degree  of  diminution  in  order  to  pass  the  pelvic 
inlet  of  the  mother. 

The  limits  within  which  this  diminution  is  compatible  with  physio- 
logical parturition  are  not  yet  perfectly  ascertained ;  though  there  can 
be  no  doubt  whatever — for  we  have  facts  to  prove  it — that  the  develop- 
ment of  the  young  creature  may  be  so  exaggerated  that  sufficient 
reduction  cannot  be  effected  to  allow  of  its  being  born. 

In  some  cases  the  head  is  so  large  that  it  can  scarcely  pass  through 
the  pelvis  of  the  mother  ;  but  it  is  generally  the  thorax  that  forms  the 
greatest  obstacle — especially  in  the  Cow,  and  if  it  is  to  get  through 
the  genital  canal  this  is  the  part  that  has  to  undergo  most  reduction  by 
compression.  In  other  instances,  and  especially  with  the  Foal,  the 
passage  of  the  croup  presents  the  greatest  obstacle,  and  the  difficulty 
may  even  be  serious. 

Prognosis. 

In  such  cases  as  those  we  are  now  studying,  in  which  birth  is 
delayed  through  undue  development  of  the  foetus,  it  generally  happens 
that  the  membranes  have  ruptured  and  the  liquor  amnii  has  escaped 
at  an  early  stage  ;  consequently,  the  maternal  passage  is  dry  and 
tenacious,  and  perhaps  swollen  and  irritated ;  while  the  foetus,  no 
longer  protected  in  its  hydrostatic  bed,  is  directly  exposed  to  the 
uterine  contractions,  and  in  proportion  as  these  are  energetic,  so  does 
it  the  more  rapidly  succumb.  The  mother,  in  turn,  becomes  exhausted 
through  unavailing  efforts  at  expulsion,  and  if  judicious  assistance  is 
not  opportunely  rendered,  is  not  long  before  it  also  perishes. 

It  will,  therefore,  be  seen  that  a  prognosis  in  such  cases  of  dystokia 
cannot  always  be  of  a  favourable  kind,  as  very  often  the  death  of  the 
foetus,  if  not  of  the  mother,  has  to  be  taken  into  consideration.  More 
particularly  is  this  the  case  with  the  smaller  animals— and  especially 
the  Bitch,  though,  as  has  been  shown,  the  larger  females,  if  they  do 
not  die  so  frequently,  yet  are  not  exempt  from  danger. 


KXOE^'S  AV  GPJJU'TII  OF  HAIR.  379 

Indications. 

The  indications  for  the  treatment  of  these  cases  arc  similar  to 
those  given  for  constricted  or  contracted  pelvis:  (1)  Extraction  of  the 
ftt'tus  entire  by  manipulation;  (2)  Removal  by  embryotomy. 

1.  Extraction  of  the  Fcvttts  entire. — If  the  "waters"  have  escaped 
for  any  length  of  time  and  the  parts  are  dry  and  viscid,  warm  emollient 
fluids — as  linseed-tea— should  be  injected  into  the  vagina,  and  if  neces- 
sary the  portions  of  the  foetus  presenting  may  be  lubricated  with 
glycerine,  oil,  unsalted  lard,  or  any  other  lubricant.  The  hand  should 
then  adjust  the  foetus,  if  this  is  requisite,  and  attempts  be  made  to 
extract  it  by  judicious  traction — cords  on  the  head  and  limbs,  and 
other  accessory  means  to  be  hereafter  described,  being  employed  as 
occasion  demands. 

The  degree  of  traction  will  depend  upon  the  amount  of  resistance  to 
be  overcome,  it  being  carefully  borne  in  mind  that  a  medium  degree  of 
force  well  directed  is  often  more  effective  than  severe  traction  mis- 
directed and  inopportune. 

For  this  reason  it  is  that  a  careful  adjustment  of  the  foetus  should 
be  made  before  any  force  is  resorted  to,  the  "  wedged  "  portions  being 
"  eased"  and  well  smeared.  It  not  unfrequently  happens  that  a  very 
trifling  displacement  of  the  foetus  will  allow  it  to  pass  gradually  through 
the  pelvic  canal,  and  lead  to  the  successful  termination  of  a  case  which 
otherwise  many  would  consider  impossible  to  deliver. 

2.  Embryotomy. — When  forcible  extraction  is  deemed  impossible,  or 
dangerous  for  the  mother,  and  when  the  latter  has  ceased  to  aid  in 
expelling  the  foetus,  then  the  only  alternative  is  embryotomy,  which, 
entailing  as  it  does  the  destruction  of  the  progeny,  yet  affords  the  only 
chance  of  saving  the  parent.  The  operation  will  be  described  hereafter. 
In  the  meantime  it  may  be  noted  that  if  the  obstruction  is  due  to  a 
large  head,  this  must  be  removed  by  decapitation  ;  then  if  the  thorax 
be  also  found  too  voluminous,  perhaps  a  slight  half-screwing  movement 
of  this  part,  coupled  with  traction,  will  move  it  outwards.  Otherwise 
the  body  must  be  taken  away  piecemeal. 

In  the  Bitch  a  similar  process  is  resorted  to  ;  if  the  head  is  too  large 
to  pass  through  the  pelvis  by  means  of  any  of  the  apparatus  to  be  here- 
after described,  it  must  be  crushed  in  every  direction  by  forceps  ;  then, 
if  extraction  cannot  be  effected,  the  Ciesarian  section  is  the  last  resource. 

Excess  in  Guowth  of  IIaijj, 

The  only  instance  of  this  cause  of  dystokia  I  can  find  is  that  recorded 
by  Eberhardt,'  of  Fulda,  who  found  a  Cow  unable  to  calve,  and  on 
examination  discovered  the  fa-tus  fixed  in  the  genital  canal,  the  presenta- 
tion and  position  being  normal.  A  careful  examination  discovered  no 
other  obstacle  to  birth  than  a  most  unusual  quantity  of  long,  thick, 
shaggy  hair — which  was  quite  dry,  from  the  waters  having  escaped 
some  time  previously.  This  offered  most  resistance  at  the  upper  part 
of  the  vagina,  and  so  great  was  it  that  the  fu'tus  could  not  be  moved. 
Having  secured  the  fore-limbs  and  head  by  cords,  Ebcrhardt  smeared 
his  hand  and  arm  well  with  grease,  lubricated  the  passage  thoroughly, 
and  rubbed  the  hair  plentifully  with  the  same  material  ;  then  by 
suitable  traction  and  manipulation  birth  was  readily  effected. 

>  Deutsche  ZeiUchnflfur  Thiermedicin  und  VergleichemU  PcUhologie,  1877,  p.  299. 


380  FCETAL  DYSTOKIA. 

Anomalies  in,  and  Disease  of,  the  Fcetal  Membranes. 

It  is  very  rare  indeed,  so  far  as  published  observations  are  evidence, 
that  anomalies  in,  or  disease  of,  the  foetal  membranes  prove  an  obstacle 
to  birth.  That  they  may  sometimes  do  so,  however,  is  evident  from 
what  we  have  previously  described.  As  Franck  justly  remarks,  it  is 
not  unlikely  that  the  retention  of  the  foetal  membranes  after  birth  is 
due,  in  many  cases,  to  inflammation  of  the  placenta  {i)lacsntitis).  A 
not  unfrequent  condition  of  the  membranes  is  congestion  of,  or  extra- 
vasation into,  the  placenta,  rupture  of  the  capillaries  [capillary 
aiJoplexy),  and  haemorrhage  between  the  placenta  materna  and  placenta 
uterina.  Partial  separation  of  the  two  placentaB  is  also  not  very  un- 
common in  the  Mare  ;  and  metrorrhagia  may  be  due,  at  times,  to 
2:)laccnta  pravia.  Such  haemorrhage,  when  it  occurs  in  the  uterus  (see 
Fig.  53,  p.  88),  and  the  blood  mixes  with  the  uterine  milk,  gives  rise 
to  a  chocolate-coloured  fluid  between  that  organ  and  the  foetal  mem- 
branes ;  and  in  the  asphyxia  and  intra-uterine  respiration  (pulmonary) 
of  the  foetus,  this  reddish-coloured  fluid  is  often  present  in  the  lungs. 

Hartmann  alludes  to  a  case  in  which  the  chorion  papillae  of  an 
aborted  Foal  were  small,  pale,  hard,  and  cartilaginous ;  and  Broers^ 
describes  two  foetuses  in  the  uterus  of  a  Cat,  on  the  inner  surface  of 
the  membranes  of  one  of  which  were  numerous  vesicular  extravasa- 
tions, while  the  other  could  scarcely  be  recognised.  It  may  be  surmised 
that  many  abortions  or  foetal  deaths  are  due  to  disease  of  the  ]Dlacentae. 

The  foetal  membranes  may  be  too  thick  and  resisting,  or  too  thin  and 
friable.  In  the  first  condition,  they  resist  the  labour  pains  too  long, 
and  after  the  os  uteri  is  completely  dilated  they  may  be  found  intact 
outside  the  vulva  ;  the  foetus  may  even  be  expelled  in  them.  Such 
tenacious  membranes  may,  to  a  certain  extent,  hinder  delivery — though 
they  seldom,  if  ever,  produce  dangerous  consequences,  except  to  the 
foetus. 

Very  thin  membranes  may,  on  the  contrary,  not  resist  the  uterine 
contractions  for  a  sufficient  length  of  time,  and  therefore  rupture  before 
the  OS  is  sufficiently  dilated.  The  consequent  escape  of  the  "  waters  " 
will  render  labour  longer  and  more  difficult.  The  utero-vaginal  canal  is 
dry  and  retentive,  and  the  contractions  of  the  uterus  are  weaker  and 
much  less  effective. 

The  treatment  for  both  of  these  conditions  has  been  already 
indicated. 

At  p.  368  we  alluded  to  adhesions  between  the  foetus  and  its  mem- 
branes, and  the  uterus,  as  a  cause  of  protracted  or  impotent  labour. 
We  have  now  to  refer  to  adhesion  of  the  membranes  to  each  other,  or 
to  the  foetus  only,  as  a  cause  of  difficult  labour. 

These  adhesions  are  generally  of  the  nature  of  fibrinous  bands  passing 
between  the  membranes,  or  from  the  surface  of  the  young  creature's 
body  to  the  interior  of  its  envelopes,  due  to  the  development  of  some 
local  inflammation.  Such  cases  are  certainly  rare,  but  their  occurrence 
must  nevertheless  be  taken  into  account. 

Eainard-  mentions  an  instance  in  which  a  hairy  band  or  cord  attached 
the  envelopes  to  the  head  of  the  foetus — a  shred  of  skin  having  prob- 
ably been  partially  detached  from  the  forehead,  from  a  kick  received  by 

^  Caustatt's  .Taliresbericht,  1861,  p.  53. 
-  Op.  cit.,  vol.  i.,  p.  492. 


DISEASES  OF  THE  F(ETUS.  381 

the  Cow  some  time  previously,  and,  becoming  fixed  to  the  membranes, 
formed  an  obstacle  to  birth. 

Vincent  describes  a  very  interesting  case,  in  which  the  skin  covering 
the  joints  of  the  first  and  second  phalanges  of  the  right  fore-leg  of  the 
fcctus  had  contracted  close  and  strong  adhesions  with  the  envelopes, 
and  these  with  the  uterine  mucous  membrane.  These  adhesions 
opposed  a  serious  obstacle  to  birth,  which  could  not  be  accomplished 
until  they  were  broken  up  by  the  fingers. 

Adhesion  of  the  membranes  to  the  uterus  does  not  always  prove  an 
obstacle  to  spontaneous  delivery,  however. 

Indications. 

Adhesions,  when  they  exist  and  are  a  cause  of  dystokia,  and  when 
they  can  be  reached,  must  be  broken  up  or  cut  through.  In  the  majority 
of  cases,  the  fingers  will  suffice ;  if  not,  then  a  bistoury  must  be  used. 

Difficulty  in  parturition  in  the  Cow  is  sometimes  experienced  from 
the  envelopes  being  torn  in  several  places,  and  the  head  or  limbs,  or 
both,  passing  through  these  fissures. 

In  such  cases  the  entangled  parts  of  the  foetus  must  be  sought  for, 
released,  and  brought  into  a  favourable  position  by  tearing  or  cutting 
through  the  obstacles. 

Abnormal  Quantity  of  Placental  Fluid. 

"We  have  already  described  the  condition  known  as  "  hydramnios," 
and  have  pointed  out  that  when  it  exists  abortion  nearly  always  takes 
place.  When  the  accumulation  of  fluid  interferes  with  parturition, 
labour  is  slow  and  delivery  difficult,  owing  to  the  great  distention  of  the 
uterus  and  the  pendulous  state  of  the  abdomen. 

The  indications  for  treatment  have  been  given  at  p.  186. 

An  unusually  small  quantity  of  the  liquor  amnii,  when  it  is  not  due 
to  premature  rupture  of  the  envelopes,  has  not,  to  my  knowledge,  been 
mentioned  as  a  cause  of  dystokia  ;  though  there  is  no  reason  why  this 
deficiency  should  not  lead  to  protracted  labour,  if  we  call  to  mind  what 
has  been  said  as  to  the  uses  of  this  fluid. 

The  indications  will  be  the  same  as  for  those  cases  in  which  the  fluid 
has  escaped  prematurely. 


CHAPTER  II. 
Diseases  of  the  Foetus. 

While  in  the  uterus  the  foetus  may  be  affected  with  disease,  which, 
causing  its  death,  will  lead  to  abortion  or  premature  expulsion,  or  per- 
haps undue  retention.  Other  abnormal  conditions,  more  or  less  allied 
to  disease,  may  give  rise  to  vicious  conformation  or  excess  of  volume, 
generally  or  locally,  and  thus  prove  a  cause  of  dillicult  parturition. 
These  conditions  may  produce  hydrocephalus,  ascites  and  anasarca, 
emphysema,  polysarcia,  muscular  contractions,  and  tumours  of  various 
kinds. 

Hydrocephalus. 

As  the  term  implies,  "  hydrocephalus  "  signifies  dropsy  of  the  brain, 
the  dropsy  being  constituted  by  the  accumulation  of  a  more  or  less  con- 


382  FiETAL  DYSTOKIA. 

siderable  quantity  of  fluid  in  the  cranium  of  the  foetus,  leading  to  a 
proportionate  enlargement  of  that  region. 

This  diseased  condition  is  not  at  all  uncommon  in  the  Bovine  and 
Equine  species,  and  some  of  the  specimens  of  craniums  found  in  museums 
are  wonderfully  deformed,  through  the  accumulation  of  fluid  in  their 
interior. 

Pathological  Anatomy. 

This  diseased  condition  is  recognised  by  a  more  or  less  exaggerated 
development  or  volume  of  the  cranium,  the  vault  of  which  has  been 
elevated  and  distended  by  the  fluid  collected  in  the  brain  ventricles. 

In  some  cases  the  distention  has  been  so  slight  that  the  frontal  bones 
are  not  much  raised ;  while  in  others  the  collection  of  serum  has  been 
so  great  that  these  and  other  bones  of  the  cranium  are  displaced,  and 
the  forehead — rising  almost  at  right  angles  to  the  face — suddenly  reaches 
an  extraordinary  height,  giving  the  creature  a  startling  appearance. 
The  hydrocephalic  tumour  varies  in  shape  as  well  as  in  volume.  It  is 
sometimes  quite  globular,  and  protrudes  so  high  and  so  much  over  the 


rig.  96. 
Skull  or  a  Hydrocephalic  Calf  :  the  Cranial  Bones  are  partially 

DESTROYED    AND    DEFECTIVE. 

face,  as  to  give  the  physiognomy  a  strangely  human  appearance  (Fig.  99); 
in  rare  cases  it  is  narrow,  but  excessively  protuberant,  involving  only  a 
part  of  the  cranium  (Fig.  100);  at  other  times  it  is  bilobular,  and  the 
divisions  may  be  either  alike  or  unequal  in  volume.  Not  unfrequently 
the  diameter  of  such  a  tumour  in  the  Calf  measures  more  than  a  foot. 
The  tumour  is  soft  and  depressible  in  parts,  hard  and  resisting  in  others, 
owing  to  the  bones  of  the  cranium  being  altered  and  separated  in  places. 
These  bones — and  particularly  the  frontal,  temporal  and  parietal — are, 
as  a  rule,  considerably  deformed  and  thrown  out  of  their  natural  posi- 
tion, and  in  places  so  expanded  and  rarified  as  to  be  no  thicker  than 
tissue-paper ;  when  the  internal  distention  has  been  very  considerable, 
so  that  their  borders  do  not  meet  as  in  their  normal  condition,  but  are 
often  widely  separated,  leaving  between  them  vast  fontanellge  occupied 
only  by  a  thin  translucid  membrane — the  dura  mater,  which  is  in  im- 
mediate contact  with,  and  adheres  closely  to,  the  skin. 

In  some  instances — especially  in  the  Calf^the  bones  in  their  upper 
part  do  not  join  at  all,  and  the  roof  of  the  cranium — or,  rather,  of  the 


H  YDKOCEI'HA  L I 'S. 


883 


cranial  tumour — is  entirely  absent  (Fig.  97).  In  other  instances,  and 
particularly  in  the  Foal,  a  kind  of  bony  arch  extends  from  the  nasal  to 
the  occipital  bones,  in  the  direction  of  the  saggital  suture,  with  only 
here  and  there,  on  each  side,  small  osseous  patches  from  the  parietal  or 
temporal  bones,  which  adhere  to  the  dura  mater. 


Fig.  97. 
Skull  or  a  Hydbockphalic  Calk  :  the  Roof  oi-  thk  Cranium  i.v  abse.vt. 

The  tumour  is  always  entirely  covered  by  intact,  though  sometimes 
Tery  thin  skin,  to  which  the  hair  is  ordinarily  attached,  and  is  indeed 
at  times  longer  than  usual,  especially  at  the  sides.  This  often  makes 
the  animal  appear  as  if  it  wore  a  high  fur  cap  (Fig.  99). 

Owing  to  the  great  development  of  the  forehead,  the  upper  jaw  appears 
to  be  shorter  than  usual ;  and,  indeed,  it  will  be  found  that  it  is  really 
so  (Fig.  96). 


Fig.  98. 

Skull  of  a  HrnRotErHALic  Foal:  the  Cranial  K<x)f  i.i  DEKicreNT 
AT  THK  Sides. 


When  the  cranial  cavity  is  opened  and  the  dura  mater  incised,  there 
is  found  a  quantity — varying  with  the  dimensions  of  the  tumour — of 
limpid,  colourless,  or  slightly  yellow  or  greenish  serum. 

The  quantity  of  fluid  varies  considerably,  but  it  is  generally  from  two 
to  four  pints  in  the  Foal  and  Calf.  Eainard  estimated  the  quantity  of 
fluid  that  had  been  contained  in  the  skull  of  a  Calf  sent  to  him,  at  two 


384 


F(ETAL  DYSTOKIA. 


and  a  quarter  litres — the  largest  quantity  he  had  met  with.  Drouard, 
however,  in  1842,  published  the  details  of  a  case  of  a  Foal  whose  cranium 
held  four  and  a  half  litres  (about  eight  imperial  pints). 

Fig.  98  represents  a  Foal's  skull,  now  in  the  museum  of  the  Lyons 
Veterinary  School,  and  which,  from  its  dimensions,  Saint-Cyr  calculates 
to  have  contained  eight  litres  (about  thirteen  pints).  Kopp  not  long 
since  exhibited  the  head  of  a  Foal  before  the  Veterinary  Society  of 
Alsace,  the  diameter  of  the  dropsical  cranium  of  which  was  fourteen 
inches,  and  which,  it  was  computed,  would  contain  about  twelve  litres 
of  fluid  (more  than  two  and  a  half  gallons).  And  Quesnel  has  also 
shown  a  skull  of  about  the  same  dimensions,  to  the  Veterinary  Society 
of  Calvados  et  de  la  Manche. 

Mr.  Olver^  describes  the  cranium  of  a  hydrocephalic  Foal  which 
measured  thirty-six  inches  in  circumference,  ten  inches  from  one  orbit 
to  the  other,  and  twenty-seven  inches  from  the  occipital  crest  to  the 
nasal  bones.  At  least  twelve  pints  of  fluid  were  contained  in  the  cavity, 
and  the  cerebral  substance  remaining  was  quite  disorganised,  the  dura 


Fig.  99. 
Calf  affected  with  Hydeockphalus  :  its  Skull  is  kepresknted  in  Fig.  97. 


mater  being  much  thickened.  The  cranial  cavity  was  almost  wholly 
surrounded  by  bone ;  the  only  portion  which  was  only  enclosed  by  skin 
was  a  space  about  four  inches  in  circumference  at  the  top. 

In  the  Museum  of  the  Munich  Veterinary  School  is  a  skull,  the 
cranium  of  which  measures  nine  by  eleven  inches  in  diameter. 

Professor  Lombardini-  speaks  of  the  head  of  a  Calf,  the  cranium  of 
which  was  more  than  fourteen  inches  high  ;  it  was  eight  and  a  half 
inches  long,  and  four  and  a  half  broad.  This  Calf,  with  two  others — 
well  formed — was  aborted  at  six  months,  without  any  injury  to  the  Cow 
which  was  six  years  old.  There  can  be  no  doubt  that  if  the  full  period 
of  pregnancy  had  been  reached,  this  Calf  would  have  proved  trouble- 
some to  extract. 

But  these  latter  are  quite  exceptional  instances,  and  are  three 
four  times  larger  than  those  usually  met  with. 

^   Veterinarian,  1874,  p.  481. 
"  GiornaJt  di  Veteriaaria,  1873. 


msEASES  i>F  TlIK  FiETL'S.  3S5 

This  accumulation  of  Huid  takes  place  in  the  ventricles  of  the  brain, 
as  has  been  ascertained  from  dissection  by  liainard,  Taiche,  Chouard, 
Axe,  and  others,  who  have  found  the  tumour  formed  externally  by  the 
skin,  and  internally  by  the  membranes  of  the  brain,  to  which  adhered  a 
thin  layer  of  cerebral  substance.  The  spinal  cord,  plexus  choroides,  and 
cerebellum,  have  been  generally  observed  to  be  intact,  and  only  the 
cerebral  hemispheres  are  destroyed  more  or  less  completely. 

Thou^'h  this  alteration,  or  rather  destruction,  of  the  brain  is  of  so 
serious  a  character,  and  thougii  it  must  have  be^'un  at  an  early  period 
of  uterine  life,  yet  it  does  not  appear  to  liave  much  influence  on  the 
development  of  the  fa'tus  ;  as  tliis  is  usually  found  to  be  full  grown,  its 
skin  covered  with  hair,  and  well  formed  everywhere  except  in  the  head. 
Exceptional  cases  occur,  however,  in  which  development  is  arrested; 
as  in  some  mentioned  by  Lecoq,  of  hydrocephalic  Calves  whose  limbs 
were  atrophied  and  the  bones  cartilaginous. 

If  intra-uterine  existence  can  be  maintained  by  the  hydrocephalic 
foetus  until  the  period  of  parturition,  it  generally  perishes  during  birth 
or  soon  after — usually  after  one  or  two  respirations.  In  some  excep- 
tional cases,  however,  such  creatures  have  lived  to  the  eighth  day  after 


Fig.  100. 

EXTILVOKDINAKY    DEVKLOPMKNT   OK   THK   Ck.\MIM    OK    \    HyDKOCEPH.M.K'    CaLF. 

birth,  and  they  may  survive  even  longer  if  the  dropsy  is  not  very  ex- 
tensive. 

\n  the  most  favourable  cases,  nevertheless,  there  is  little  profit  to  be 
expected  from  keeping  such  animals  alive,  as  they  are  ordinarily  weak 
and  thrive  badly ;  they  can  rarely  stand,  and  they  refuse  the  teat,  being 
usually  in  a  semi-comatose  state  ;  if  the  tumour  chances  to  be  pressed 
upon,  the  young  creature  becomes  completely  unconscious  and  lies  in 
convulsions. 

Ver)-  few  cases  of  recovery,  even  in  the  mildest  form  of  the  malady, 
are  recorded. 

The  obstacle  this  congenital  condition  of  the  fcctus  presents  during 
birth,  must,  of  course,  depend  upon  the  volume  of  the  cranial  tumour. 
The  birth  of  a  hydrocephalic  fcetus  often  takes  place  spontaneously, 
though  perhaps  only  after  much  straining.  If  the  cranium  is  not  very 
large,  and  provided  the  labour  pains  are  sufficiently  energetic  and  the 
position  favourable,  the  tumour  yields,  and  the  head  becomes  elongated 
in  its  passage  through  the  os  and  the  pelvis,  or  it  may  rupture  internally 
and  the  fluid  escape  by  the  ears,  nostrils  and  eves.     When  extremely 

25 


386  FCETAL  DY ST  OKI  A. 

large,  the  cranium  may  offer  an  invincible  obstacle  to  spontaneous 
delivery,  notwithstanding  the  most  powerful  labour  pains. 

And,  iDesides,  the  mechanism  of  parturition  in  such  cases  varies  with 
the  presentation — anterior  or  posterior.  The  head  of  the  hydrocephalic 
foetus  being  more  or  less  spherical — instead  of  conical,  as  in  the  normal 
condition — it  results  that  this  part,  when  the  young  creature  is  pressed 
upon  by  the  uterus,  no  longer  acts  as  a  wedge  to  gradually  dilate  the 
OS  uteri.  The  head  certainly  commences  the  work  of  dilatation,  but  in 
a  very  incomplete  manner,  and  when  the  jaws — particularly  the  upper 
one — have  cleared  the  os,  further  progress  is  checked  by  the  voluminous 
forehead.  If  the  hand  is  introduced  into  the  vagina,  the  cervix  uteri  is 
found  to  be  contracted  on  the  nose  or  jaws  of  the  foetus  ;  and  the  delay 
in  further  expulsion  depends  upon  the  size  of  the  cranium,  the  pro- 
trusion of  the  uterus  into  the  pelvic  cavity,  and  the  exhaustion  of  the 
organ  by  futile  contractions. 

In  the  posterior  presentation,  birth  takes  place  in  the  manner  already 
described ;  the  hinder  extremities  advance  through  the  os,  then  the 
body  and  neck,  and  birth  is  apparently  taking  place  satisfactorily  until 
the  head  reaches  this  aperture,  when  further  advancement  is  stopped — 
the  resistance  to  expulsion  being  in  proportion  to  the  volume  of  the  head. 

Not  infrequently,  with  such  a  condition  of  the  foetus  we  have  also  a 
malposition  to  complicate  matters. 

Diagnosis. 

In  the  anterior  position,  there  is  not  much  difficulty  in  diagnosing  the 
presence  of  hydrocephalus ;  as  the  hand  can  feel  the  voluminous  spherical 
cranium  beyond  the  muzzle  and  eyes,  with  the  ears  on  each  side,  and 
its  unequally  resisting  surface — hard  in  some  parts,  soft  or  fluctuating 
in  others.  When,  however,  there  is  a  malposition  of  the  foetus,  then  it 
is  sometimes  more  difficult  to  discover  the  hydrocephalus ;  and  often 
this  cannot  be  done  until  the  position  is  remedied.  The  head  should 
be  sought  for  in  every  case,  and  it  will  be  recognised  by  the  mouth,  eyes, 
and  ears  ;  after  which  the  size,  consistence,  and  form  of  the  cranium 
can  be  estimated  by  passing  the  hand  over  it. 

In  the  posterior  presentation,  hydrocephalus  has  been  recognised 
while  the  foetus  was  still  in  the  uterus.  The  greatly  enlarged  head 
may  be  felt  per  rectum,  or  even  through  the  abdominal  walls.  But,  as 
a  rule,  it  is  only  at  an  advanced  period  of  labour,  and  when  the  body  of 
the  young  creature  is  already  beyond  the  os,  and  perhaps  without  the 
vulva,  that  a  difficulty  is  discovered  and  the  cause  sought  for. 

In  such  a  case  manual  exploration  is  necessary,  and  this  should  be 
effected,  if  possible,  by  passing  the  hand  between  the  foetus  and  the 
wall  of  the  vagina.  This  is  difficult  if  the  body  is  still  in  the  passage, 
and  it  may  be  requisite  to  have  recourse  to  traction  to  withdraw  it 
therefrom.  If,  however,  it  is  beyond  the  vulva,  then  the  hand  can  be 
easily  passed  along  the  neck  as  far  as  the  head,  when  the  real  state  of 
affairs  can  be  discovered. 

Indications. 

The  indications  for  treatment  in  cases  of  dystokia  from  hydrocephalus 
alone,  without  reference  to  such  a  complication  as  malposition  of  the 
foetus,  are  few  and  simple. 

"When  the  hydrocephalus  is  not  considerable,  judicious  traction  will 
often  accomplish  delivery ;  and  several  cases  are  on  record  in  which 


/J/\/;./.vA'.s-  nf  THE  FCETOs.  387 

Foals  and  Calves  whose  cnuiiuins  were  of  large  size  and  full  of  fluid, 
have  been  delivered  by  this  means,  some  of  them  alive,  and  in  the  pos- 
terior as  well  as  the  anterior  presentation.  In  such  a  case,  supposing  the 
fore-feet  present,  these  should  be  secured  by  cords,  the  ends  of  which 
may  be  given  to  an  assistant ;  tiien  the  hand  should  be  introduced  into 
the  vagina,  and  if  necessary  the  os  should  be  dilated  sulliciently  to  allow 
of  another  cord  being  fastened  on  the  upper,  or,  perhaps  better,  the 
lower  jaw,  which  is  often  wider.  Traction  can  then  be  made  during  the 
throes  of  the  mother. 

When,  however,  traction  will  not  etl'ect  delivery  because  of  the  size 
of  the  head,  and  the  mother  is  becoming  exhausted,  the  cranium  must 
be  punctured — an  easy  operation  when  the  presentation  is  anterior,  but 
more  ditVicult  when  it  is  posterior. 

The  puncture  may  be  made  by  means  of  a  bistoury,  a  scalpel  or 
ordinary  knife,  or,  which  is  preferable,  a  somewhat  large  trocar  and 
cannula,  curved  if  possible.  The  most  fluctuating  part  of  the  tumour 
should  be  penetrated,  and  the  fluid  having  escajDed,  the  cranial  parietes 
collapse,  or  give  way  to  pressure  ;  the  head  is  thus  greatly  reduced  in 
size,  and  delivery  can  be  completed. 

Rainard  recommends  the  puncture  to  be  made  on  the  side  of  the 
cranium  ;  and  should  it  be  necessary  to  still  further  reduce  the  size  of 
this  part  by  bone-forceps  or  other  means,  the  side  will  be  found  most 
suitable.  In  the  posterior  presentation,  the  back  of  the  head  may  be 
punctured,  and  the  weight  of  the  young  creature's  body,  hanging 
beyond  the  vulva,  will  sulliciently  steady  the  head  for  tliis  purpose  ; 
but  in  the  anterior  presentation,  traction  sliould  be  made  by  means  of 
the  cords  while  tlie  cranium  is  being  opened. 

Rainard  informs  us  that  C'onte,  being  called  to  assist  a  ^lare  in  foal- 
ing, found  a  posterior  presentation,  and  luiving  diagnosed  hydrocephalus, 
he  was  able  by  version  to  convert  it  into  an  anterior  presentation,  when 
the  head  was  easily  punctured. 

Embryotomy  has  been  recommended  in  such  cases  ;  but  beyond 
reducing  the  size  of  the  head,  if  that  is  the  only  obstacle,  there  is  no 
necessity  for  resorting  to  further  breaking  up  of  the  body  of  tlie  foetus. 
Indeed,  it  will  be  found  that,  in  ordinary  cases,  patience  and  judicious 
manipulation  will  often  enable  the  obstetrist  to  dispense  with  cranio- 
tomy. 


Ascites,  Anasarca,  and  Hydrothorax. 

"Ascites"  (fluid  in  the  abdominal  cavity)  and  "Anasarca"  (fluid 
beneath  tlie  skin),  either  partial  or  complete,  do  not  appear  to  be  such 
frequent  diseases  of  the  fcjctus  as  hydrocephalus,  the  cases  recorded 
being  comparatively  few. 

Anasarca  has  been  observed  in  the  Foal,  Calf,  and  Kid,  and  ascites 
chiefly  in  the  Calf.  These  pathological  conditions  have  generally  been 
confounded. 

With  regard  to  ascites,  it  appears  that  in  all  the  recorded  observa- 
tions, thefu'tus  was  in  what  we  have  designated  the  "  natural  presenta- 
tion and  position  "  ;  though  in  some  cases  these  were  complicated — 
the  head  being  turned  back  on  the  left  side  or  all  the  limbs  presented 
with  the  head. 

Sometimes  the  fcetus  has  ceased  to  live  before  the  full  period  of  preg- 


388 


FCETAL  DYSTOKIA. 


nancy  has  expired,  and  is  expelled  from  the  uterus  ;  at  other  times  it 
reaches  maturity,  and  living  through  a  few  of  the  early  pains,  it  suc- 
cumbs before  parturition  is  completed,  either  from  the  effects  of  pro- 
tracted labour  or  from  the  manoeuvres  adopted  to  extract  it.  None 
appear  to  have  been  born  alive  ;  nor  would  they  be  likely  to  live  if  by 
chance  they  were  extracted  before  death  seized  them.  In  addition  to 
the  abdominal  cavity,  the  scrotum  is  often  enormously  enlarged  through 


Fig.  101. 

AXASAECOUS    FcETAL    CaLF. 

its  communication  with  the  latter,  of  which  it  is  only  a  kind  of  diver- 
ticulum. Hydrothorax  is  often  combined  with  ascites,  and  in  one  case 
recorded  the  scrotum  was  enormously  distended  with  the  peritoneal 
fluid. 

With  regard  to  anasarca,  Noyes^  has  witnessed  a  number  of  cases 


Fig.  102. 
Anasarcous  Fcetal  Calf. 


of  general  anasarca  in  the  course  of  a  year,  in  the  neighbourhood  of 
Mirepoix,  France.  He  states  that  the  Calves  were  born  at  least  three 
weeks  before  their  time,  and  always  dead.  The  connective  tissue  of 
the  entire  body — from  the  head  to  the  croup — was  infiltrated  with 
serum,  the  young  creatures  being  double  or  treble  the  size  of  ordinary 
Calves ;  the  head  especially  was  enormously  large.  During  pregnancy 
^  Rainard,  op.  cit.,  p.  476. 


■  DISEASES  OF  THE  FCETUS.  381> 

the  abdomen  of  the  Cows  was  so  developed,  that  their  owners  thouj^ht 
they  were  bearing'  twin  Calves. 

Quetier  has  published  details  of  analof^ous  cases  of  general  infiltration, 
ill  which  the  fa-tus  was  at  least  twice  its  natural  size. 

This  condition  has  been  witnessed  in  the  fa3tus  of  the  Mare  by  Pauli' 
and  Lehnhardc,'-'  and  by  Ilerran'-  in  the  Goat.  The  latter  authority 
made  an  autopsy  of  a  Goat  which  had  died  from  injuries  intlicted  on 
its  head,  and  found  in  it  twin  fcetuses,  the  bodies  of  which  were  com- 
pletely infiltrated. 

Cause. 

The  cause  of  this  dropsical  condition  is  not  well  ascertained.  In 
some  cases  it  may  be  due  to  uterine  dropsy  of  the  mother  or  to  con- 
stitutional hydricmia  ;  but  in  other  instances  it  cannot  be  so,  as  the 
mother  is  in  good  health,  and  it  would  then  appear  to  be  owing  to 
derangement  of  the  fcetal  circulation,  and  particularly  of  the  venous 
system — probably  congestion  of  the  umbilical  cord.  At  times,  disease 
of  such  organs  as  the  kidneys  may  produce  it. 

Franck^  remarks,  that  the  fact  that  sometimes  a  Cow  will  for  a 
number  of  years  bring  forth  these  dropsical  Calves  {Wasscrkdlbcr)  in 
succession,  while  other  Cows  in  the  same  shed  produce  healthy  Calves, 
shows  that  there  is  probably  in  these  cases  at  least  some  anomaly  in 
the  uterine  vessels  ;  the  fact,  also,  that  sometimes  along  w'ith  general 
anasarca  and  ascites,  there  are  rachitic  alterations  of  the  bones,  points 
to  mal-assimilation,  or  deficient  supply  of  the  protein  substances  and 
phosphorus  salts,  the  deficiency  being  presumably  due  to  disease  on 
the  part  of  the  mother,  or  to  some  anomaly  in  the  composition  of  the 
uterine  milk. 

The  amount  of  difiiculty  met  with  during  delivery  in  these  cases  will 
depend  upon  the  quantity  of  fluid  effused  into  the  abdominal  cavity, 
chest,  or  sujjerticial  connective  tissue. 

Sometimes  delivery  is  possible  with  the  aid  of  traction.  But  in  the 
great  majority  of  instances,  when  the  head  and  fore-feet  have  passed 
through  the  os,  further  progress  appears  to  be  impossible.  In  these 
cases  we  have  extreme  distention,  but  even  in  some  of  them  delivery 
by  traction  is  not  hopeless.  Cazeaux'  says  of  this  condition  in  the 
human  fa'tus :  "  The  abdominal  parietes  have  been  observed  to  yield 
in  such  a  way  that  a  large  portion  of  the  tumour  remained  above  the 
inlet,  while  the  trunk  gradually  descended  into  the  pelvis  ;  and  when 
once  a  part  of  the  abdomen  had  cleared  the  passage,  the  fluid  escaped 
into  it  and  towards  the  point  where  there  was  least  resistance,  the 
volume  of  the  part  still  in  the  pelvis  progressively  diminishing,  and 
delivery  being  finally  accomplished  naturally." 

Saint-Cyr  is  of  opinion  that  it  is  probable  delivery  has  been  effected 
in  a  similar  manner,  in  those  cases  in  which  the  dropsical  fa3tus  of 
animals  has  been  extracted  without  operation  or  mutilation. 

Sometimes  the  walls  of  the  abdomen  give  way,  as  in  the  case  recorded 
by  Courjon."^     This  veterinarian  attended  a  Cow.  three  years  old,  which 

'  (iiirlt  tintl  Hertwig's  Magazin,  vol.  viii. 

-  It'ifl.,  vol.  ix. 

^  Journal  di  Vt'ft'rinnire  du  ^fidi,  1864. 

*  Handbuch  dcr  ThitriirzfUrhen  Gcliurlshiilfe,  p.  429. 

*  Traite  T/tt'orcli'pte  et  Pratique  de  VArt  dfn  Arcouchem€nt!>,  p.  659. 
^  Rainard,  op.  cit.,  p.  485. 


590  FCETAL  DYSTOKIA. 

was  in  the  act  of  parturition.  The  foetus  was  in  the  natural  position, 
and  the  head  and  fore-limbs  were  external  to  the  vulva.  Strong 
traction  was  employed  to  extract  it,  during  which  the  abdomen 
ruptured,  and  it  was  estimated  that  more  than  twenty  litres  of  fluid 
escaped.     The  Cow  was  in  great  danger  for  a  month  afterwards. 

Diagnosis. 

The  nature  of  the  obstacle  can  only  be  ascertained  by  vaginal  or 
uterine  exploration,  though  an  examination  per  rectum  may  assist  in 
leading  to  a  correct  diagnosis. 

In  vaginal  exploration  the  great  size  of  the  abdomen  in  ascites,  the 
distention  of  its  parietes,  and  the  fluctuation  on  pressure,  should  reveal 
the  state  of  affairs.  Not  unfrequently,  however,  the  body  of  the  foetus 
so  completely  blocks  up  the  passage  that  it  is  impossible  to  pass  the 
hand,  and  it  may  be  necessary  to  remove  the  protruding  limbs  by 
embryotomy  in  order  to  diminish  its  volume.  Hesitation  in  resorting 
to  this  operation  is  usually  unjustifiable,  as  the  foetus  is  nearly  always 
dead,  and  if  alive  it  cannot  exist  after  birth. 

It  has  been  recommended,  in  addition,  to  remove  the  two  first  ribs 
or  divide  them,  in  order  to  allow  the  hand  to  explore  the  interior  of 
the  foetus.  If  the  obstacle  is  due  to  ascites,  the  convex  condition  of 
the  diaphragm,  and  the  fluctuation  of  the  fluid  on  the  abdominal  side 
of  it,  will  be  remarked. 

When  the  dystokia  is  owing  to  anasarca,  this  will  be  distinguished 
by  the  general  roundness  of  the  surface  of  the  body,  owing  to  the 
presence  of  the  subcutaneous  fluid — which  effaces  all  the  prominences, 
and  to  the  oedematous  sensation  communicated  to  the  fingers  by 
pressure. 

Indications. 

When  the  condition  of  the  foetus  is  once  ascertained,  the  principal 
indication,  if  delivery  by  traction  cannot  be  effected,  is  to  diminish  its 
volume  by  producing  the  evacuation  of  the  fluid  which  distends  it,  as 
promptly  and  effectually  as  possible. 

In  ascites,  puncture  of  the  abdomen  through  the  parietes  of  that 
cavity,  if  they  can  be  reached,  or  puncturing  the  diaphragm  through 
the  chest,  if  they  cannot,  must  be  practised.  In  the  first,  a  bistoury 
or  anjr  kind  of  convenient  knife,  or  a  trocar,  will  suffice  ;  in  the  second, 
a  long  trocar  or  long-bladed  knife,  wrapped  round  with  tow  to  near  the 
point,  will  answer  the  same  purpose ;  or  if  the  hand  can  be  introduced 
into  the  thorax,  the  fingers  alone  will  rupture  the  diaphragm.  As  the 
fluid  escapes,  the  abdomen  collapses,  and  delivery  is  then  easy. 

When  anasarca  is  present,  the  fluid  must  be  got  rid  of  by  deep 
incisions  through  the  skin  wherever  the  hand  can  reach.  The 
mechanical  extraction  of  the  foetus  should  then  be  easy.  In  a  case 
reported  by  Anacker,i  however,  the  foetus  was  so  large  that  it  had  to 
be  removed  by  gastro-hysterotomy. 

An  extremely  rare  cause  of  dystokia  is  due  to  congenital  occlusion  of 
the  urachus,  which  leads  to  great  accumulation  of  urine  in  the  bladder, 
and  consequent  distention  of  the  abdomen.  A  very  good  example  is 
given  in  the  yearly  report  of  the  Veterinary  School  of  Hanover  for  1872. 

This  condition  will  be  diagnosed  in  the  same  way  as  ascites,  and  the 
same  indications  for  extraction  of  the  foetus  are  to  be  observed. 
^  Der  Thierarzt,  1868,  p.  85. 


DISEASES  OF  THE  FCETVS.  3SU 

EmI'HYSKMA. 

Emphysema  of  the  foetus  is  sometimes  found  to  be  a  cause  of  dystokia. 
Leconte  mentions  that  he  lias  met  witli  a  case  in  which  a  living  fcotus 
was  partially  emphysematous,  the  head  and  neck  as  far  as  the  shoulders 
being  involved. 

This  case  is  exceptional,  however,  as  this  condition  is,  as  a  rule, 
observed  only  after  the  fa»tus  has  perished  in  the  uterus.  It  sometimes 
happens  that  during  parturition  the  "  water-hag  "  is  ruptured  before 
the  young  creature  has  made  sulVicient  progress,  or  it  may  be  in  a  bad 
position.  Tiie  uterus  then  closely  contracts  on  it,  over  the  whole  of  its 
surface,  and  it  soon  succumbs.  In  the  course  of  two  or  three  days  its 
tissues  have  become  softened  and  decomposed  ;  the  subcutaneous  con- 
nective tissue  becomes  distended  with  gases — the  result  of  this  decom- 
position, and  in  a  short  time  the  entire  carcase  of  the  young  creature 
is  inflated.  This  inflation  directly  distends  the  uterus,  and  the  foetus 
sometimes  increases  so  immensely  in  volume  as  to  cause  rupture  of  the 
walls  of  that  organ. 

On  approaching  an  animal  in  whicli  tlie  fa'tus  is  emphysematous,  a 
powerful  stench  is  perceived  coming  from  the  vulva,  the  lining  mem- 
brane of  which  is  of  a  yellowish-red  tint.  On  introducing  the  hand 
into  the  uterus,  the  inflated  foetus  crejiitates  on  pressure  and  the  gas 
can  be  moved  beneath  the  skin  ;  the  hair  is  loose  and  easily  removed  ; 
the  skin  itself  is  often  dry,  and  the  fluids  small  in  quantity.  Gases  are 
not  unfrequently  disengaged  in  the  fcetal  membranes,  and  particularly 
in  the  anmion.  Bossetto'  mentions  a  curious  case  of  this  description, 
in  which,  after  rupturing  the  membranes  of  a  foetus  that  had  been  dead 
in  the  uterus  for  some  time,  on  withdrawing  his  hand  from  the  vagina 
there  was  a  rush  of  carburetted  hydrogen  ;  this  became  ignited  by  the 
flame  of  a  candle  held  some  distance  from  the  vulva  of  the  pregnant 
animal.  The  flame — ten  to  twelve  inches  long — ^burned  for  some  time, 
and  the  Cow  did  not  appear  to  suffer. 

Indications. 

The  dimness  of  the  skin  and  the  large  volume  of  the  foetus,  as  well 
as  the  inertia  of  the  uterus,  are  the  obstacles  to  extraction.  Conse- 
quently, version  and  retropulsion  cannot  be  beneficially  resorted  to 
here ;  but  deep  incisions  may  be  practised  on  the  surface  of  the  body 
of  the  fa>tus  as  far  as  the  hand  and  knife  can  reach.  The  maternal 
passages,  as  well  as  the  foetus,  should  then  be  well  lubricated  with  some 
fatty  agent,  and  if  the  carcase  is  in  a  favourable  position  traction  may 
be  tried — cords  and  hooks  being  employed  in  a  manner  hereafter  to  be 
described.     If  the  position  is  not  favourable,  it  nmst  be  corrected. 

Should  mechanical  extraction  fail,  then  embryotomy  must  be  prac- 
tised. After  the  foetus  has  been  removed,  thorough  cleansing  of  the 
uterus  will  be  necessary. 

In  these  cases,  the  practitioner  should  take  every  precaution  against 
danger  to  himself,  as  serious,  even  fatal,  consequences  have  resulted 
from  putrid  infection.  Tlie  hand  and  arm  should  be  well  smeared  with 
lard,  and  thorough  ablution  ought  to  be  practised  immediately  after  the 
operation  is  over. 

POLVS.VUtl.V. 

German  authors  only,  so  far  as  I  can  ascertain,  make  mention  of 
this  condition,  in  which  there  are  abnormal  accumulations  of  adipose 
'  OxornaU  di  Vtterinaria  Pracdca,  1859. 


392 


F(ETAL  DYSTOKIA. 


matter  in  the  subcutaneous  connective  tissue ;  so  that  at  birth  these  fat 
deposits  often  cause  the  Calf  to  weigh  more  than  a  hundredweight.  Such 
foetuses  are  designated  in  Germany  "  lard  Calves  "  {Speck-kdlber).    - 

Indications. 

The  indications  for  the  extraction  of  these  lardaceous  Calves  are,  as 
might  be  presumed,  tlie  same  as  those  for  over-developed  foetuses  in 
general. 

CONTEACTIONS, 

This  designation  has  been  given  to  the  permanent  contraction  or 
retraction  of  certain  muscles — and  we  might  add  tendons  and  liga- 
ments— which,  in  becoming  hard  and  rigid,  are  at  the  same  time  re- 
duced in  length  and  thickness,  so  as  to  form  inextensible  cords  that 


Fig.  103. 

Deformed  Head  and  Neck  of  a  Foal,  due  to  Contraction  and  Pkes.sure  in 

THE  Uterus. 


deform  the  part  they  are  attached  to,  and  prevent  its  assuming  its 
natural  position. 

This  state  of  contraction  and  rigidity  only  takes  place  slowly  and 
progressively,  and  it  chiefly,  though  not  exclusively,  affects  the  muscles 
of  the  neck  and  fore-limbs,  giving  these  a  vicious  direction  which  it  is 
very  difficult  to  change,  and  whicli  at  parturition  may  become  a  rather 
troublesome  cause  of  dystokia. 

The  causes  of  these  deviations,  which  bring  about  actual  alterations 
in  the  structure  of  the  bones  and  muscles  themselves,  are  very  obscure. 
Bouley  was  of  opinion  that  the  lesion  is  solely  due  to  the  passive  influence 
of  a  false  position  which  the  foetus  assumes  and  maintains  for  a  long 
time,  and  to  which  the  muscles  and  bones  finally  accommodate  them- 
selves. Eainard  thought  the  cause  might  be  of  a  mechanical  nature, 
and  due  to  the  pressure  exercised  on  the  foetus  by  the  colon  of  the 
mother — particularly  its   pelvic  portion — when  filled  with  hard  faecal 


JUSK.tSKS  nj-  Tilt:  F'KTrs.  3!t3 

matters,  the  residue  of  fibrous  provender.  He  also  considered  it 
possible  that  it  might  be  of  a  convulsive  kind,  owing  to  disease  of  the 
nerve  centres. 

When  the  neck  is  affected,  it  is  bent  round  to  the  side,  the  nose 
being  buried  in  the  Hank,  or  even  resting  on  the  hind  quarters  of  the 
faHus ;  and  so  rigidly  is  it  curved,  that  not  only  does  it  resist  all 
attempts  to  straighten  it  in  the  uterus,  but  even  when  extracted  and 
the  foetus  is  dead,  tlie  neck  cannot  be  made  to  assume  a  rectilinear 
direction. 

The  period  of  gestation  at  which  this  deviation  occurs  is,  of  course, 
dinicult  to  arrive  at ;  but  Kainard  and  Saint-C'yr  are  of  opinion  that  it 
takes  place  early,  as  the  bones  of  the  head  and  neck  are  more  or  less 
deformed  in  some  cases  (Fig.  103),  the  head  being  more  especially  dis- 
torted and  curved  laterally,  and  moulded,  so  to  speak,  to  tlie  parts  on 
which  it  has  rested  during  intra-uterine  existence. 

This  distortion  appears  to  be  more  frequent  in  Solipeds,  the  neck  of 
which  is  longer  than  that  of  Ruminants  or  other  domestic  animals  ; 
and  according  to  French  writers,  it  appears  to  be  more  common  in 
some  localities  than  others,  and  to  be  frequent  in  certain  years — par- 
ticularly in  those  of  scarcity  or  bad  forage.  Houssard  reported  that 
in  Franche-Comte  he  had  seen  the  majority  of  brood  Mares  abort  near 
tlie  termination  of  pregnancy,  or  experience  great  difficulty  in  foaling, 
from  this  abnormal  distortion  of  the  neck.  Courjon,  another  veterinary 
surgeon  practising  at  Mey/.ieux,  Isere,  has  remarked  on  the  frequency 
of  this  accident  under  the  influence,  it  was  presumed,  of  the  same 
causes.  Schaack  informed  Saint-Cyr,  that  in  his  long  experience  he 
had  met  with  several  cases  of  this  kind,  one  of  which  was  in  a  Calf 
that  lived,  notwithstanding  the  deformity. 

Contraction  of  the  limbs  also  appears  to  be  more  frequent  in  Foals 
than  Calves,  and  varies  in  degree  :  from  slight  bending  at  the  knees  — 
which  generally  more  or  less  disappears  after  birth,  and  as  the  animal 
acquires  strength — to  extreme  flexion  ;  so  that  ligaments  must  be 
ruptured,  and  perhaps  bones  broken,  before  the  distortion  can  be  cor- 
rected. The  accident  is  alluded  to  by  Favre,'  Gaven,-'  Lemaire, '  Verct,* 
and  Cartwright.^ 

Indications. 

The  indications  for  delivery  are  the  same  as  those  which  will  be 
given  for  extraction  of  the  fcctus  in  malposition  of  the  limbs  and 
head. 

Not  infrequently  recourse  must  be  had  to  embryotomy ;  and  tlie 
limbs  more  particularly  require  attention  in  this  operation,  as  l)y  divid- 
ing the  muscles,  tendons,  or  ligaments  of  those  which  are  contracted, 
they  may  be  straightened  and  delivery  effected.  A  careful  examination 
should  be  made  of  the  presenting  limbs  in  all  cases  in  which  they  are 
found  to  be  flexed,  in  order  to  discover  whether  the  joints  are  movable  ; 
and  gi-eat  care  ought  to  be  exercised  in  using  traction  before  they  are 
straightened  or  removed  by  the  knife  ;  as  rupture  of  the  uterus,  or 
severe  laceration  of  the  other  soft  parts,  may  be  the  result. 

'  La  V^lifrinaire  Campagnard,  p.  290. 

-  JouriuU  d*  Mil/.   I'r'frinnirf,  1850,  p.  201. 

*  Jfi-cueil  (if  Mill.   Velirinaire,  1856,  p.  444. 

*  Ihid.,  1837,  p.  289. 

••   77(6  Vtttriuarinn,  vol.  xvi.,  p.  4S7  ;  vol.  x.x.,  p.  ZQ^. 


394  F(ETAL  DY ST  OKI  A. 

Tumours. 

Tumours  of  various  kinds,  situated  either  externally  or  internally, 
may  prove  an  obstacle  to  birth  ;  though  the  cases  recorded  are  very 
few.  Some  of  the  former  are  cj'sts  which,  in  some  instances,  may  be 
looked  upon  as  due  to  a  second  undeveloped  ovum  which  has  grafted 
itself  on  the  foetus  (Fig.  121).  Hygromata  are  not  very  uncommon,  and 
some  of  these  are  often  ruptured  during  birth.  Sometimes  the  tumours 
are  fibro-adipose ;  in  other  instances  they  have  been  distended  cavities — 
as  the  guttural  pouches ;  and  even  scrofulous  tumours  have  been 
described. 

Indications. 

The  indications  will  depend  upon  circumstances.  Puncturing  the 
tumour  if  it  contains  fluid,  removing  it  if  it  be  accessible  and  solid,  and 
embryotomy  if  neither  of  these  operations  is  likely  to  be  successful,  are 
the  only  measures  which  can  be  recommended. 

Death. 

Many  practitioners  are  of  opinion  that  the  death  of  the  foetus  renders 
parturition  difficult.  In  certain  circumstances  it  may  do  so,  but,  as  a 
rule,  provided  the  creature  is  in  a  proper  position  and  perfectly  developed, 
its  death  has  but  little  influence  on  this  act.  We  have  already  alluded 
to  the  death  of  the  foetus  at  p.  259. 


CHAPTEE    III. 
Monstrosities. 

The  designation  "  Monster,"  "  Monstrosity,"  or  Lusus  Natures  (French, 
Monstre,  Monstruosite  ;  German,  Missgeburt ;  Italian,  Mostro  ;  Spanish, 
MonstriLo),  is  generally  applied  to  a  creatui'e  which  exhibits  some  vice 
in  conformation — some  remarkable  anomaly  or  organic  deviation  in  form 
or  structure,  or  both,  in  one  or  more  parts  of  its  body. 

Monstrosities  have  been  conveniently  divided  into  two  kinds — those 
which  are  anatomically  so,  and  those  which  are  so  by  reason  of  their 
vicious  conformation.  The  first  present  no  modifications  externally,  and 
there  is  no  disturbance  of  function,  but  merely  a  change  in  the  number 
or  position  of  certain  organs — a  change  only  discoverable  by  post- 
viortem  examination.  The  second  includes  those  defects  or  deformities 
which  more  or  less  seriously  impair  the  value  of  the  young  creature, 
either  by  destroying  the  symmetry  of  its  shape,  or  rendering  it  more  or 
less  useless  by  the  absence  or  incompleteness  of  certain  organs. 

The  term  "  monstrosity,"  however,  is  usually  reserved  for  a  creature 
which  presents  the  most  serious  kind  of  organic  alterations,  and  which 
involve  one  or  more  organs — external  or  internal — these  being  modified 
in  form,  structure,  and  relations.  In  this  class  we  may  have  a  de- 
ficiency in  one  or  more  limbs,  head,  part  of  the  head  or  trunk,  or  fusion 
more  or  less  incomplete  of  two  or  more  individuals,  etc. 

It  must  be  admitted,  however,  that  the  limits  between  these  groups 
of  anomalies  or  organic  deviations  are  not  well  defined,  and  that  they 
merge  into  each  other  imperceptibly ;  so  that  it  is  not  always  possible 
to  say  where  the  one  class  ends  and  the  other  begins,  and  we  can  only 
fix  upon  the  types  of  each  of  these  artificial  groups. 


MOXii  TJiOSl  TIKS.  :5i>r. 

In  ancient  times  the  appearance  of  monstrosities  were  ascribed  to  the 
influence  of  enraj^ed  j:jods,  and  they  were  regarded  with  fear  or  horror  ; 
or  they  were  looked  upon  as  prodigies  or  freaks  of  Nature,  and 
described  as  marvels  or  curiosities. 

Indeed,  it  was  not  until  the  end  of  the  last  and  commencement  of 
this  century  that  they  began  to  be  studied  in  a  scientific  spirit,  and 
their  anomalies  shown  to  be  only  simple  modifications  or  irregularities 
in  the  development  of  organs.  Haller  and  Meckel  commenced  this  new 
era,  but  it  was  not  until  the  philosophical  study  of  this  subject  had 
been  pursued  by  Etienne  and  Isidore  Geoffroy  Saint-IIilaire,  that  the 
science  of  Teratologji  was  founded  on  a  true  basis.  Then  it  was  clearly 
demonstrated  that  monstrosities  themselves  do  not  escape  the  general 
laws  of  organisation,  but  own  their  sway  and  prove  their  universality, 
and  that  Nature,  in  its  widest  divergencies,  never  ceases  to  be  faithful 
to  the  decrees  which  the  Creator  imposed  upon  it  at  the  commence- 
ment. 

In  1827,  E.  G.  Saint-Hilaire  proposed  a  scientific  classification  of 
monstrosities — those  beings  which  had  hitherto  been  looked  upon  as 
combinations  of  different  characters  or  individuals  ;  and  on  this  basis 
was  raised  the  science  of  Teratology  by  his  son  Isidore.  The  labours 
of  these  men  have  been  largely  su])i)lemented  by  the  researches  of  such 
authorities  as  Meckel,  Gurlt,  Otto,  Jiischoff,  Leyh,  ]Martin-Saint-Ange, 
Forster,  Dareste,  Panum,  Lombardini,  and  others.  Tbe  labours  of 
these  investigators  are  unknown  to  English  veterinary  literature — 
indeed,  the  entire  subject  is  nowhere  mentioned  }  it  will,  therefore,  be 
our  duty  to  notice  it  somewhat  fully,  not  only  from  its  novelty  in  this 
respect,  but  also  from  its  importance  in  a  physiological  and  obstet- 
rical point  of  view. 

Classification, 

Various  classifications  of  monstrosities  have  been  proposed  at  diiTerent 
times  by  investigators,  who  generally  based  tlieir  classification  either 
on  the  notions  they  entertained  as  to  the  mode  of  formation  of  these 
creatures,  or  on  some  physical  peculiarity  presented  in  their  organisa- 
tion. ButTon  divided  them  into  three  classes — 1,  monstrosities  by 
excess;  2,  monstrosities  by  defect ;  3,  monstrosities  by  irregularity  in 
structure  or  situation  of  parts.  To  these  classes  Meckel  added  a  fourth, 
which  included  tlie  herma))hrodites.  Martin-Saint-Ange  divided  tliem 
into:  1,  monsters  by  excess,  comprising  the  union  of  several  fcetuses — 
double  monsters,  in  fact  ;  '2,  monsters  by  excess  of  growth  ;  3,  monsters 
by  absence  of  one  or  more  parts  ;  1,  monsters  by  general  defect,  as 
dwarfs  :  5,  hermaphrodite  monsters. 

The  two  classifications  which  have  generally  been  adopted  by  Conti- 
nental veterinarians  are  those  of  Gurlt  and  GeolTroy  Saint-Hilaire  :  that 
of  the  former — the  eminent  Berlin  veterinai-y  professor — being  preferred 
by  the  Germans,  Italians,  Dutch,  and  Danish,  and  that  of  the  latter  by 
the  French. 

Gurlt's  classification  and  nomenclature  are  good  and  explicit,  and  in 
some  respects  to  be  preferred  to  Saint-IIilaire's  ;  wliile  tliose  of  the 
latter  offer  advantages  which  might  lead  us  to  give  them  the  prefer- 
ence, apart  from  the  fact  that  it  is  they  on  which  the  science  was 
based. 

'  A  monstrosity  is  generally  only  alluded  to  &»  such,  or  a-*  a  Luxtu  Xalnra  ;  a  scientific 
classification  has  not  been  attempted  in  this  country. 


396  F(ETAL  BFSTOKIJ. 

Guiiti  arranges  monstrosities  into  two  classes — Simple  and  Covi- 
poiuid.  The  first  comprises  eight  orders,  twenty-six  genera,  and 
seventy-three  species ;  the  second  includes  six  orders,  twenty-six 
genera,  and  fifty-nine  species. 

As  some  veterinarians  may  prefer  Gurlt's  classification  to  that  of 
Saint-Hilaire,  and  particularly  for  its  practical  utility,  we  give  it  here : 

CLASS  I. 

SIMPLE  MONSTROSITIES. 

This  class  is  occupied  with  a  single  individual,  and  refers  to  an 
absence  of  or  addition  to  parts,  exaggeration  of  them,  or  alteration  in 
their  form  or  position.  It  comprises  8  Oedees,  26  Geneea,  and  73 
Species. 

OEDER  I. — Simple  Monsteosities  theough  Absence  of  Paets  : — 

1.  Amoephus. — Absence  of  conformation  ;  1  species  :  A.  globosus. 

2.  AcEPHALus. — Headless ;  2  species  :  A.  unipes,  A.  hipes. 

3.  Peeocephalus. — Head  defective  ;  7  species ;  P.  j^seudocephalus 
(apparently  without  a  head),  P.  aprosopus  (head  without  a  face), 
P.  microcephalus  (small  head),  P.  agnatkiis  (head  without  a  jaw). 
Varieties  :  a,  P.  cKjnathus  hjpostomus  (mouth  a  longitudinal  fissure 
beneath  the  ordinary  situation) :  h,  P.  agnathus  microstomus  (small 
mouth)  :  c,  P.  agnathus  astomus  (without  a  mouth),  P.  bracJu/rhynchus 
(short  face  or  nose),  P.  anomatus  (without  eyes),  P.  aotus  (without  ears). 

4.  Peeoso:\ius. — The  whole  of  the  body  defective;  4  species:  P. 
liemiccplialicus  (body  defective  and  head  absent),  P.  horridus  (horrid 
deformity),  P.  elumbis  (loins  absent),  P.  pscudoscelus  (body  defective, 
with  posterior  limbs  incomplete). 

5.  Peeocoemus. — Trunk  defective  ;  3  species  :  P.  oligospond^jlus 
(defective  vertebrae),  P.  ecaudatus  (without  tail),  P.  anacdoca  (without 
external  generative  organs). 

6.  Peeomelus. — Limbs  defective ;  6  species :  P.  apus  (vrithout 
limbs),  P.  acliirus  (without  anterior  limbs),  P.  monocliirus  (with  only 
one  anterior  limb),  P.  ascehis  (without  posterior  limbs),  P.  monocelus 
(with  only  one  posterior  limb),  F.  micromclus  (liinhs  shortened);  with 
the  varieties,  P.  micromclus  microchirus  (anterior  limb  short),  P.  micro- 
mclus microscclus  (posterior  limb  short). 

ORDER    II,  —  Simple    Monsteosities    theough    Smallness    of 
Paets: — 

7.  Nanosomus. — Limbs  and  trunk  small — dwarf;  2  species:  N. 
pygmaus  (short  and  low,  but  without  disproportion  of  parts),  N.  caticeps 
(cat-faced  dwarf). 

8.  Nanocephalus. — Small  head  ;  8  species  :  N.micromatus  (eyes  too 
small),  N.  brachyotus  (ears  too  short),  N.  bracliygnotus  (lower  jaw  too 
short). 

9.  Nanocoemus.  —  Short  trunk ;  2  species  :  N.  rectus  (vertebral 
column  straight,  but  very  short),  N.  curvatus  (vertebral  column  short, 
and  curved  to  one  side.) 

10.  Nanomelus. — Limbs  short ;  5  species  :  K.  brevipcs  (all  the  limbs 

1  Pathologische  Avatomie,  Berlin,  1883.  Article:  "  Missbildungen."  Also  Ueber 
Thierische  jMissijebiirten,  Berlin,  1877. 


.VOXSTEOSI TIHS.  897 

short),  N.  brachychirus  (anterior  limbs  too  short),  N.  cavipylochirus 
(anterior  limbs  short  and  crooked),  iV.  chiroptcrus  (anterior  limbs  short, 
with  cutaneous  folds  resembling  wings),  N.  cowpylosceius  (posterior 
limbs  short  and  crooked). 

ORDER  III. — Simple  Monstkositiks  through  Aunokmal  Division 
OF  THK  Body : — 

11.  ScHisTOCKTHALUs. — DivisioH  of  the  head  ;  5  species  :  S.  hcmi- 
cephalus  (cleft  in  the  middle);  with  the  varieties  :  a,  S.  hcmiccphalus 
partialis,  or  hydrenccphalocclc  (partial  hernia  of  the  brain,  with  liydro- 
cephalus)  ;  b,  S.  hcviiccphalns  totalis  (absence  cf  all  the  cranium)  ; 
<;,  S.  hcmiceplialns  complicatus  (cleft  cranium,  face  defective)  ;  S.  bifidns 
(face  divided),  ^'.  fissipalatinus  or  rictus  liqnmis  (cleft  palate),  S.  fissi- 
labrus  or  labium  Icporinum  (cleft  or  hare  lip),  S.  mcgalostomus  (wide 
mouth). 

12.  ScHisTOCORMUs. — Divided  trunk;  G  species:  S.  fissicoll is  {neck 
cleft),  S.  fissistcrnalis  (sternum  divided),  .S.  schistcpiqastrico-sternalis 
(division  of  the  sternum  and  anterior  portion  of  the  abdomen),  S.  cxom- 
phalus  (divided  umbilicus),  S.  fissiventralis  (the  whole  of  the  abdomen 
divided),  S.  fissispinalis  or  spina  bifida  (division  of  the  spinal  column). 

13.  ScHisTosoMUs. — Division  of  the  head  and  trunk;  3  species:  .S'. 
rctlcxus  (division  of  the  body  and  iiivei'sion  of  the  spinal  column),  S. 
contortus  (division  of  the  body  and  torsion  of  the  vertebral  column), 
S.  microchirus  (division  of  the  body  and  anterior  limbs  shortened). 

14.  Schistomelus. — Cleft  limbs  ;  2  species  :  S.  fissimanus  (division 
of  the  anterior  limbs),  .S'.  fissungulus  (division  of  the  phalanges). 

ORDER  IV. — Simple    Monstkositiks    thuouchi    Absence  of  the 
Natuiul  Division  of  Pauts  : — 

15.  Atretocephalus. — Absence  of  openings  in  the  head  ;  1  species  : 
A.  astomus  (mouth  absent). 

16.  Atretocoumus. — Absence  of  the  natural  apertures  in  the  body  ; 
2  species  :  .-1.  aproctus  (anus  absent),  A.  anurcthra  (uretlira  absent). 

17.  Aschistodactyhs. — Phalanges  undivided  ;  1  species  :  .1.  solid- 
Htojnlus  (absence  of  division  of  the  phalanges  and  claws  in  those  animals 
which  usually  have  them  divided). 

ORDER  V. — Simple    Monstrosities    throucih    Fusion  or  Coali- 
tion  OF  OudANS  :  — 

IH.  Cyclops  or  Monophthalmus. — One  eye  in  the  middle  of  the 
face,  and  a  proboscis  in  addition  ;  3  species  :  C.  mcgalostomus  (large 
mouth),  of  which  there  are  two  varieties  ;  a,  C.  mcgalostomics  rhyn- 
chfenus  (large  mouth  and  probosyi^  ;  b,  C.  vicgalostomus  arhynchus 
(largo  mouth,  but  no  proboscis)  AC.  prostotuus  (irregular  mouth),  in 
which  are  two  varieties  :  a,  C.  prostomus  arhynchus  (irregular  mouth 
and  no  nose) ;  b,  C.  prostomus  rhynch<pnus  (irregular  mouth  and  nose) ; 
C.  astomus  (without  mouth),  with  two  varieties  :  a,  C.  astomus  arhytv- 
chus  (mouth  and  nose  absent) ;  b,  C.  astomus  rhynchanus  (proboscis 
present,  but  mouth  absent). 

ORDER  VI. — Simple  Monstrosities  through  Abnormal  Position 
AND  Form  of  Parts  : — 

19.  Campylorrhinus. — Curvature  of  the  nose  ;  1  species  ;  C.  lateralis 
(lateral  curvature  of  the  nose). 


398  FCETAL  LYSTOKIA. 

20.  Camyloerhacchis.  —  Curvature  of  the  vertebral  column  ;  2 
species  :  C.  scoliosa  (lateral  curvature  of  the  spine),  C.  contorta  (torsion 
of  the  spine). 

OEDEE  VII. — Simple  Monstrosities  through  Excess  in  Forma- 
tion : — 

21.  Megalocephalus. — Head  abnormally  large ;  2  species  :  M. 
hydrencc]_)halas  (with  hydrocephalus),  M.  polycerus  (head  with  large 
horns). 

22.  DiPHALLus. — Double  penis  ;  1  species  :  D.  imperfectus  (double 
penis,  incomplete). 

23.  Megalomelus. — Limbs  with  supernumerary  parts ;  1  species : 
M.  ■perissodactylus  (with  supernumerary  digits). 

OEDEE  VIII. — Hermaphrodites  : — 

24.  Heemaphroditus. — Double  sex,  with  predominance  of  organs 
belonging  to  one  sex  ;  2  species  :  H.  lateralis  (genital  organs  to  one 
side),  in  which  there  are  two  varieties  :  a,  H.  lateralis  masculinus  (with 
predominance  of  the  male  organs)  ;  b,  H.  lateralis  femininus  (with  pre-  y 
dominance  of  the  female  organs)  ;  H.  transversalis  (the  external  genera-  'J 
tive  organs  belonging  to  one  sex,  and  the  internal  to  the  opposite  sex), 
including  two  varieties  :  a,  H.  transversalis  masculinus  (external  genital 
organs  male,  internal  female) ;  b,  H.  transversalis  femininus  (external 
genital  organs  feminine,  internal  male — often  imperfect). 

25.  PsEUDO  -  hermaphroditus.  —  False  hermaphrodites ;  4  species  : 
P.  megalomastJius  (male  with  large  mammge),  P.  microphallus  (penis  un- 
usually small),  P.  hypospadiatus  (with  the  urethra  divided  inferiorly), 
P.  femininus  (false  feminine  hermaphrodite). 

26.  Androgynus. — Double  hermaphrodites,  the  male  and  female 
organs  existing  in  a  single  individual,  one  sex  being  incomplete  and  the 
other  predominating  ;  2  species  :  A.  masculinus  (the  external  organs  are 
masculine,  with  a  small  penis,  the  internal  organs  being  male  and 
female — though  the  one  set  is  more  complete  than  the  other),  A.  femi- 
ninus (the  external  organs  are  feminine,  with  abnormally  large  clitoris, 
the  internal  being  male  and  female,  with  predominance  of  the  one  over 
the  other). 

CLASS  11. 

TREBLE  AND  DOUBLE  MONSTROSITIES. 

In  these  monstrosities  there  is  a  union  of  two  or  three  individuals* 
neither  of  which  is  complete,  but  which  are  united  at  various  points 
often  with  a  completely-developed  body  is  united  a  portion  of  a  second 
individual.     It  comprises  6  Orders,  26  Genera,  and  59  Species. 

OEDEE  I. — Trigeminal  Monstrosities,  in  which  are  united  one 

OR  MORE  PARTS  OR  ORGANS  OF  THREE  INDIVIDUALS  : 

1.  Cephalotridymus. — Three  heads  united  to  a  single  trunk  ; 
1  species  :  G.  unicorporeus  (with  a  single  body). 

2.  CoRBiOTRiDYMUS. — Posterior  part  of  the  trunk  triplicate,  with  more 
than  four  limbs  ;  1  species  :  G.  tricaudatus  (three  croups  with  three  tails, 
but  only  one  anus  and  four  posterior  limbs). 

3.  Meloteidymus. — Posterior  part  of  the  body  double,  and  more  than 
eight  limbs ;  1  species :  M.  dccapus  (ten  limbs  of  unequal  length). 


MONSTROSITIES.  ;J99 

4.  SoMATOTRiDYMUS. — Triple  body  ;  1  species  :  .S".  slenialia  (three 
chests  united). 

ORDER  II. — MoNSTiiUs  with  Two  nE.\Ds — Cephaluilidi/ini: — 

5.  Diruosopus. — Double  face  ;  3  species  :  D.  scjunctus  (the  two  faces 
separate),  D.  distans  (the  two  faces  diverging),  including  three  varieties; 
a,  D.  distans  distomus  (a  mouth  in  each  face);  b,  D.  distans  monostomus 
(a  mouth  in  one  face  only);  c,  D.  distoma  hemicephalicus  (without  a 
cranium);  D.  conjunctns  (two  faces  united,)  has  two  varieties  :  a,D.con- 
junctus  distomus  (double  mouths);  b,  D.  conjunctns  monostomus  (with 
one  mouth). 

6.  MoNoc'KANLS. — Single crauiuui ;  4  species:  iV.  7;ieso{7na/«s (the  lower 
jaw  included  in  or  united  to  the  other  from  the  commencement  of  the 
branches),  M.  di'/natus  (lower  jaw  double),  M.  hcteroprosopus  (diverse 
faces),  M.  bimandibularis  (upper  jaw  double). 

7.  Hetekocei'halus. — Double  heads,  one  of  which  is  complete,  the 
other  very  incomplete  ;  2  species  :  //.  interpositus  (between  the  two 
branches  of  the  lower  jaw  of  the  complete  head  is  interposed  the  lower 
jaw  of  the  incomplete  one),  //,  oppositus  (the  lower  jaw  of  the  complete 
head  is  depressed  in  front,  and  on  its  upper  surface — anterior  extremity 
— it  is  united  to  the  corresponding  part  of  the  second  jaw,  with  which 
it  forms  an  acute  angle). 

ORDER    III. DOUHLE-HEADED     MONSTROSITIES,     WITH     THE    TUUNK 

WHOLLY    OK    I'AKTIALLY    DoUBLE  :  — 

8.  DicEi'HALUs.— Two  separate  heads;  7  species:  D.  biatlanticus 
(double  head  and  two  atlases),  D.  suhbicollis  (double  head  with  appar- 
ently two  necks),  I),  bicollis  (double  head  and  two  necks),  with  two 
varieties  :  D.  bicollis  omoceplialus  (both  heads  alike),  D.  bicollis  hetcro- 
cephalus  (one  head  perfect,  the  other  imperfect) ;  D.  subbidorsiialis 
(double  head,  with  apparently  a  double  back),  D.  bidorsualis  (double 
head  with  double  back),  J),  bilumbis  (double  head  and  double  loins), 
D.  bispinalis  (double  head  and  vertebral  column),  has  two  varieties  :  a, 
D.  bispinalis  quadrupcs  (with  four  limbs);  b,D.  bispinalis  acliirus  (with- 
out anterior  limbs). 

9.  DicHANUs. — Double  cranium  ;  1  species  :  D.  bisjyinalis  (cranium  and 
vertebral  colunm  double). 

ORDER   IV. — Monstrosities    with    a    Single    Head,   hut    the 
Trunk    or    Limhs    more    or    less    completely    Douhle — 

Cormo-nielodidi/mi : — 

10.  DiPYGUs. — Double  croups  ;  3  species  :  D.  bidorsualis  (double  croup 
and  back),  D.  subbidorsualis  (double  croup,  with  half  the  back  doubled), 
D.  bilutnbis  (croup  and  loins  doubled;,  containing  two  varieties:  a,  i). 
bilumbus  teleoccplialus  (with  head  regular) ;  b,  D.  bilumbis  cacoccpJialus 
(with  head  irregular). 

11.  Heterodidymus. — Unequally-developed  twins,  the  body  of  one 
being  large  and  regularly  or  irregularly  formed,  the  other  being  small 
and  slenderly  attached  to  some  part  of  its  fellow  ;  3  species  :  II.  octipcs 
(with  eight  feet),  containing  two  varieties  :  a,  II.  octipcs  cmprosthochiro- 
pliorus  {the  anterior  limbs  of  the  parasitic  twin  situated  in  front)  ;  b,  II. 
octipcs  plcurochirophorus  (the  anterior  limbs  of  the  parasitic  twin  situ- 
ated at  the  side)  ;  //.  tctrasulus  (with  four  posterior  extremities),  also 
containing  two  varieties  :  a,  II.  tctrasulus  monopygus  (with  one  croup) ; 


400  FCETAL  DY ST  OKI  A. 

b,  H.  tetrasulns  dipygus  (with  a  double  croup) ;  H.  triscekis  (with  three 
posterior  Hmbs). 

OEDEE  V. — Monstrosities  w^th  a  Single  Head  and  Tkunk,  and 
MOKE  THAN  FouB  LiMBS — Melocliclymi: — 

12. — Opisthomelophokus. — An  animal  regularly  formed,  but  which 
bears  on  its  back  or  croup  a  supernumerary  limb  or  limbs  ;  3  species  : 
O.  trichirus  (with  an  anterior  limb  on  the  back),  0.  tetrachirus  (with 
two  anterior  limbs  on  the  back),  0.  tetrascelus  (with  two  posterior  limbs 
on  the  croup). 

13.  Emprosthomelophorus. — With  a  supernumerary  limb  or  limbs 
on  the  neck,  thorax,  or  beneath  the  pelvis  ;  5  species  :  E.  octipes  (with 
four  supernumerary  limbs  beneath  the  thorax),  E.  trichims  (with  an 
anterior  limb  on  the  thorax),  E.  tetrachirus  (with  two  anterior  limbs  on 
the  neck),  E.  triscchis  (with  a  posterior  limb  beneath  the  pelvis),  E. 
tetrascelus  (with  two  posterior  limbs  beneath  the  pelvis). 

14.  Pleuromelophorus. — With  a  supernumerary  limb  or  limbs 
situated  on  the  side  ;  4  species  :  P.  octipes  (with  four  limbs  on  the  side), 
P.  tetracliirus  (with  two  anterior  limbs  on  the  side),  P.  trichirus  (with 
an  anterior  supernumerary  limb),  P.  triscclus  (with  a  posterior  super- 
numerary limb). 

OEDEE  VI. — Monstrosities  with  the  Head,  Trunk,  and  Limbs 
MORE  OR  less  COMPLETELY  DouBLE — Somatodiclymi  :— 

15.  Octopus. — With  eight  limbs  ;  4  species  :  0.  janus  (two  faces 
placed  opposite  each  other,  and  eight  limbs),  0.  quadriauritus  (eight 
limbs  and  four  ears),  containing  two  varieties :  a,  0.  quadriauritus 
monoprosopus  (with  a  perfect  face) ;  b,  0.  quadriauritus  aprosopus  (face 
absent) ;  0.  biauritus  (eight  limbs  and  two  ears),  0.  synapheocephahis 
(eight  limbs,  and  the  heads  joined  externally  only  by  the  skin). 

16.  Tetrachirus. — With  four  anterior  limbs  ;  2  species  :  T.  sympho- 
cephalus  (four  anterior  limbs,  two  lateral  and  two  incomplete,  on  the 
back,  and  heads  joined),  T.  choristocephalus  (four  anterior  limbs,  and 
heads  separate). 

17.  Tetrasculus. — With  four  posterior  limbs  ;  2  species  :  T.  sympho- 
cephalus  (four  posterior  limbs,  and  heads  united),  T.  bifacialis  (four 
posterior  limbs,  and  the  two  faces  separate). 

18.  Gastkodidymus. — Twins  united  at  the  abdomen  ;  3  species : 
G.  quadrupes  (twins  united  at  the  abdomen,  and  furnished  with  four 
limbs),  G.  tetrachirus  (with  four  anterior  limbs),  G.  octipes  (with  eight 
hmbs). 

19.  Gastro-Thoracodidymus. — Twins  united  at  the  thorax  and  abdo- 
men ;  1  species  :  G.  thoracodidymus  octipes  (with  eight  limbs). 

20.  Epigastkodidymus.- — Twins  united  at  the  thorax  and  epigastrium ; 
1  species  :  G.  octipes  (wdth  eight  limbs). 

21.  Thoracodidymus.  —  Twins  united  at  the  thorax;  1  species: 
T.  octipes  (with  eight  limbs). 

22.  Schelodidymus. — Twins  united  at  the  posterior  extremities  ; 
1  species  :  S.  hcptamelus  (with  seven  limbs,  the  posterior  pair  being 
united  into  one,  the  next  pair  at  the  side,  and  the  other  four  in  front). 

23.  Ischiodidymus. — Twins  uaited  at  the  pelvis;  1  species:  /.  ex- 
avielus  (with  six  limbs,  four  anterior  and  two  posterior). 

24.  Omphalo-Chronodidymus. — Twins  united  at  the  umbilicus  and 
the  head  ;  1  species  :  0.  disomatus  (the  bodies  separate). 


MONSTROSITIES.  401 

25.  Pygodidymus. — Twins  united  at  the  croup  ;  1  species  :  P.  averstin 
(bodies  united  at  the  ischia  and  sometimes  at  the  buttock,  and  in 
opposite  directions). 

26.  CuYi'TODiuYMUs.  —  Inclusiou  of  one  twin  within  the  other  ; 
2  species:  C.  abdoininalis  (twin  included  in  the  abdomen),  C.  snhcutaiicus 
(incomplete  fix'tus  included  beneath  the  skin  of  the  complete  one). 

Such  is  the  classification  adopted  by  Gurlt,  and  it  will  be  seen  that 
it  is  very  complete,  while  the  nomenclature  scarcely  leaves  anything  to 
be  desired.  Nevertheless,  as  Saint-IIilaire's  classification  and  nomen- 
clature are  also  employed,  and  are  in  some  respects  advantageous  to 
know,  we  will  now  allude  to  them,  though  not  in  such  detail  as  we 
have  done  those  of  Gurlt,  following  the  summary  given  by  Zundel. 
Saint -Hilaire  separates  monstrosities  from  vices  of  conformation, 
which  he  distinguishes  as  Ilcinitcrics,  or  simple  and  trifling  organic 
anomalies,  and  Ilctcrotiuies,  or  mere  changes  in  the  situation  of  organs, 
and  nearly  always  without  alteration  in  relative  position  and  connec- 
tions. For  the  llcnnapJirodisms — due  to  the  union  of  the  sexes  or 
some  of  their  characters  in  the  same  individual — he  forms  a  separate 
class,  which  he  again  divides  into  two  sub-classes,  according  as  there 
is  an  absence  or  excess  in  the  number  of  parts  ;  he  distinguishes  male 
hermaphrodism,  female  hcrmaphrodism,  and  neutral  hermaphrodism  ; 
mixed  ;  complex — masculine  or  feminine  ;  and  bi-sexual — perfect  or 
imperfect.  The  monstrosities — properly  so  called — exhibiting  anomalies 
which  are  more  or  less  serious,  either  because  of  the  injurious  intiuence 
they  exercise  on  the  functions  of  the  individual,  or  the  vicious  con- 
formation they  give  rise  to — are  divided  into  two  classes  :  Simple 
Monstrosities  and  Composite,  Double,  or  Triple  Monstrosities. 

The  first  class  comprises  three  orders:  1.  Autositic  Monstrosities 
(avTO'i,  self,  cr/to5,  nourisliment) — whose  organs  are  capable  of  maintain- 
ing them  for  a  variable  period  after  birth.  Only  one  or  more  regions 
of  the  body  are  involved,  the  majority  being  little,  if  at  all,  ditlerent 
from  the  normal  standard  ;  the  circulatory  apparatus  is  always  more 
or  less  complete,  particularly  the  heart ;  the  lungs,  nearly  all  the 
digestive  viscera,  and  at  least  a  portion  of  the  head,  are  present ;  and 
all  the  anatomical  and  physiological  characters  are  manifested  exter- 
nally by  the  general  conformation,  which,  in  the  greater  part  of  the 
body,  remains  symmetrical  and  almost  normal.  2.  Omphalositic 
Monstrosities  (d/x<^aAos,  u)nhilicus,  and  ytros-,  noiirislnnent) — those  whicli 
live  imperfectly,  being  maintained  by  the  nourishment  derived  from 
the  mother  through  the  umbilical  cord,  and  dying  as  soon  as  the  cord 
is  ruptured.  These  omphalositcs  are  deficient  in  a  large  number  of 
organs,  and  those  which  are  present  are  generally  very  imperfect ; 
externally  all  the  regions  appear  to  be  anomalous,  and  the  symmetry 
is  imperfect,  or  even  effaced.  3.  Parasitic  Monstrosities — the  most  im- 
perfect of  all,  and  generally  inert,  irregular  masses,  composed  of  bones, 
adipose  tissue,  etc.,  destitute  of  umbilical  cord,  and  attached  to  the 
generative  apparatus  of  the  mother,  at  whose  expense  they  maintain 
an  obscure  parasitic  existence,  by  means  of  a  vascular  pedicle. 

The  double  monstrosities  are  divided  into  autositarian  and  double 
parasitic.  The  first  are  composed  of  two  individuals  more  or  less 
intimately  united,  and  somewhat  equal  in  development  ;  this  equality 
indicating  that  they  both  have  been  equally  nourished,  and  that  their 

functions  have  been  alike  complete.     The  second  are  composed  of  two 

26 


402  FCETAL  DY ST  OKI  A. 

distinct  individuals,  very  unequal  in  development,  the  smallest  being 
the  most  imperfect ;  testifying  that  it,  Hke  a  parasite,  has  lived  at  the 
expense  of  the  other.  It  would  appear  that  the  triple  monstrosities 
have  not  been  met  with  in  sufficiently  large  number  to  establish  a 
trustworthy  classification. 

Each  of  the  orders  of  Saint-Hilaire,  like  those  of  Gurlt,  contains 
several  families,  subdivided  again  into  genera  and  species,  according 


Fig.  104. 

EcTROMELiAN  MONSTROSITY  (Saint-Hilaiee)  ;  Nanomclus  Campylochirus  (Gurlt;i  : 

Horse. 

to  their  affinities,  and  which  include  all  the  monstrosities  he  had  met 
with.  With  regard  to  these  families,  it  may  be  mentioned  that  among 
the  single  autositic  monstrosities,  there  are  the  ectromelians  {ixTpdm, 
to  make  abort,  yueAos,  limb),  in  which  we  have  a  more  or  less  complete 
deficiency  in  the  development  of  the  limbs,  either  anteriorly  or 
posteriorly,  and  involving  one  or  more  of  these  (Figs.  104,  105). 


Fig.  105. 

EcTROMELiAN  M0NSTRO8ITY  (Saint-Hilaire)  ;  Xanomelus  Ccunpylochirus  (Gurlt) 

Goat. 


The  Symclian  Monstrosities  (o-vu,  with,  /xeAo§,  limb)  are  those  which 
Gurlt  includes  in  his  first  Class  and  Order,  there  being  an  absence  of 
parts,  with  fusion  of  others  (Fig.  106). 

The  Cclosomian  Monstrosities  (x^/A?/,  hernia,  i7i7)jia,bocly),  more  frequent, 
perhaps,  than  any  others,  are  those  which  Gurlt  places  in  his  third 
Order — Schistocorvms,  and  are  chiefly  characterized  by  the  absence, 
more  or   less    complete,   of   the  abdominal  parietes,   and   the   abrupt 


MONSTJlUaiTIES. 


403 


curvature  of  the  spine  backwards,  downwards,  or  to  one  side  ;  so  that 
the  pelvis  and  posterior  limbs  are  directed  forwards,  to  one  side,  or 
over  the  back,  while  the  abdominal  cavity  bein^  open,  allows  its  viscera 
to  Hoat  about  unprotected.  There  are  many  degrees  of  this  deformity. 
Sometimes  tlie  abdominal  cavity  is  open,  the  thorax  being  undeformed 
and  closed  in  posteriorly  by  the  diaphragm,  and  the  ribs  attached  to 
the  sternum  (Schistoconniis  fissicentralis,  Gurlt,  Fig.  107).  Sometimes 
the  posterior  end  of  the  spine  is  curved  forward  to  the  middle  of  the 


Fig.  106. 
Sv>iELi.\.v  Mo.NsTKOsrrv  (SAiNT-HiL.vntK)  ;  Perosomits  jiiendotceluti  (iiiiu.T) :  Vig. 

back  (ScJiistoconmis  rcflcxus,  Gurlt) ;  the  ribs  follow  in  the  same 
direction,  but  instead  of  bending  downwards  to  enclose  the  chest,  they 
spring  upwards  towards  the  dorsal  spines  ;  the  sternum  is  absent  or 
divided  throughout  its  length  {Schistocormus  Jisslstcrnalis,  Gurlt, 
Fig.  107),  with  evisceration  of  thoracic  organs — most  fre(]uently  the 
heart  {Ectopia  cordis,  Fig.  108)  ;  the  diaphragm   )s  not   present,   the 


Fig.  107. 
Ci  L3bOMi.vN  MoNSTRasiTY  (.*^.\int-Hil.\irk)  ;  Schiitocormiis  JUfivfnfralijt  (Gurlt)  :  Calk. 

chest  is  as  widely  open  as  the  abdomen,  and  the  viscera  of  both 
cavities  are  external  to  the  body  (.S.  Schistcpigastrico-steritalis).  At 
other  times  the  spine  is  twisted,  and  the  body  and  head  divided 
{Schistosotnus  contortiis)  ;  or  other  deformities  of  a  similar  kind,  and 
more  or  less  complex,  may  be  found.  The  skin  follows  the  displace- 
ment of  the  various  regions — the  external  surface  being  generally  in 
contact — while  the  lining  membrane  of  the  chest  or  abdomen,  or  both, 
becomes  external ;  sometimes  to  such  an  extent  is  this  inversion  of  the 


404 


FCETAL  DYSTOKIA. 


body  carried,  that  it  is  turned,  as  it  were,  outside  in  ;  tlie  skin  forming 
a  kind  of  internal  sac — the  hair  to  the  interior — and  containing  the 
head  and  limbs  of  the  foetus.  With  such  a  deformity,  of  course  other 
serious  malformations  or  displacements  co-exist :  distorted  pelvis, 
wasted  or  undeveloped  limbs,  atresia  of  the  anus,  more  or  less  complete 
absence  of  the  generative  organs,  etc. 


Fig.  108. 
Ectopia  Cordln  :  Schistocoi  mus  Jissisternalh. 

This  kind  of  monstrosity  will  have  to  be  specially  noticed  hereafter, 
the  eventration  of  the  viscera  of  the  foetus  often  considerably  baffling 
the  obstetrist ;  while  the  frequent  distortion  of  the  spine  and  limbs 
renders  delivery  very  difficult. 


Fig.  109. 
PsEUDENCEPHALiAN  MONSTROSITY  ;  Ptrocephalws  pseuclccephaUis  (Guult). 

The  Exenccphalian  monstrosities,  belonging  to  Gurlt's  third  Order  in 
the  first  Class,  are  those  which  have  the  brain  defective,  deformed,  and 
external  to  the  cranial  cavity — itself  more  or  less  imperfect. 

The  Pseiidencephaliau  monstrosities  belong  to  the  third  Order  of 
Gurlt's  first  Class,  the  encephalon  being  absent  and  replaced  by  a 
variable-sized  bright  red  tumour,  composed  of  a  multitude  of  small 


tr: 


MOXSTKOSiriKS. 


405 


bloodvessels ;  this  tumour  rests  on  the  base  of  the  cranium,  the  roof 
of   which  is  absent  (Fij^.  109). 

The  Ancnccphalian  monstrosities — Gurlt's  first  Order,  first  Class — 
are  destitute  of  the  encephalon  or  anything  to  represent  it,  and  the 
roof  of  the  cranium  is  entirely  absent. 


rig.  110. 

Cyclopean  Moxstuosity  :  R.am. 


The  CycZocc^j/irtZwin  monstrosities  (xi'x^o?)  circle,  Ke<l>dk),  head) — Order 
five,  Class  first  of  Gurlt — are  characterised  by  the  approximation,  or 
more  or  less  complete  fusion  of  the  eyes  into  one  organ,  with  absence, 
displacement,  or  deformity  of  the  nose  and  mouth  ;  but  the  ears  are 


rig.  111. 

CicLOPEA.v  Monstrosity  ;  Cyclops  megaloMomtu  archynchiut  (Gurlt)  :  A.ss. 

usually  in  their  natural  position,  or  perhaps  are  lower  than  usual.  Not 
unfrequently  the  nose  is  absent  and  the  mouth  greatly  enlarged,  while 
the  fusion  of  the  eyes  may  not  be  complete  (Figs.  110,  111). 

The  Acephalian  monstrosities — Gurlt's  first  Class  and  first  Order — 
are  more  or  less  destitute  of  head,  and  sometimes  of  neck,  thorax  and 
thoracic  organs  (Fig.  112). 


406 


FCE TAL  D  YSTOKIA 


The  Anidian  or  zoomylian  monstrosities,  we  have  ah'eady  described 
at  p.;_i78  ;  so  we  need  not  again  refer  to  them. 


Pig.  112. 
AcEPHALiAN  Monstrosity  ;  A.  perosomus  hemicephalicus  (Gurlt) 


"V 

Fig.  113. 
Schistocephalus  Jissislabr7is  or  labium  leporhium  (Hare-lip). 

The  Schistocephalian  monstrosities  (Gurlt)  have  the  head  or  face 
cleft :  most  frequently  the  face,  the  division  being  sometimes  limited  to 
the  nose  and  upper  lip. 


MoXSTJiOS/TIES. 


407 


Those  monstrosities  which  are  characterised  by  the  al)iioriiial  situa- 
tion and  form  of  dilTerent  parts  —  and  wliich  are  inckided  in  Class 
first,  Order  six,  of  Clurlt  —  are  not  exceedingly  rare,  and  in  some 
instances  are  probably  due  to  muscular  contraction,  or  malposition 
for  some  time  in  the  uterus  (Fif^.  114). 

Saint-Hilaire  divides  the  double  monstrosities  into  two  orders  :  Aiitu- 
sitaric  and  Pdrasilic ;  the  former  beinj^  constituted  by  individuals  more 
or  less  intimately  united  and  somewhat  ecjually  developed,  each  con- 
curring to  the  mutual  existence  :  while  the  second  is  made  up  of  those 
monstrosities  which,  though  united,  have  one  being  more  or  less  com- 
plete— being  reduced  in  fact  to  a  linil),  jaw,  or  other  fragment  of  a  body 
implanted  or  subsisting  on  an  individual  which  is  fully  developed. 
These  are  included  in  Gurlt's  second  Class. 

In  the  autositaric  order  we  have  the  Eusomphalian  and  Monomphalian 
monstrosities  :  these  have  the  common  character  of  two  heads  and  four 


Fig.  114. 
CamylorrhnrrhU  contortn. 

pairs  of  limbs  ;  the  first  have,  however,  a  distinct  umbilical  cord  to 
each  of  the  united  fcrtuses  ;  while  in  the  other — the  Monomphalian — 
there  is  only  a  single  umbilical  cord  and  umbilicus. 

The  Eusoniphalian  monstrosity  consists,  then,  of  two  pretty  equally 
developed  fcrtuses,  each  with  its  own  umbilical  cord,  the  two  being 
usually  joined  together  by  some  soft  part  at  any  region  of  the  body  ; 
so  that  they  may  be  separated  by  a  surgical  operation  without  the 
existence  of  either  beinu'  compromised.  This  is  included  in  the  third 
Order  of  Gurlt's  second  Class. 

With  the  Monomphalian  monstrosity,  on  the  contrary,  there  being 
only  one  umbilicus  and  one  cord,  the  foetuses  are  joined  at  the  ventral 
surface,  and  have  usually  several  organs  in  common — notably  the  liver, 
to  which  the  umbilical  vein  passes  (Fig.  115). 

The  Si/nccphalian  monstrosities  have  two  bodies  either  completely 
separated,  or  only  divided  above  the  umbilicus,  and  surmounted  by  a 


408 


FCETAL  DYSTOKIA. 


more  or  less  incomplete  double  head  :  the  two  heads  being  fused,  as  it 
were,  into  one  {Dicephalus  lieteroccphalus  of  Gurlt — Fig.  116). 


Fig.  115. 
MoNOMPHALiAN  MONSTROSITY  :  Cephalo-cormodidijmua  (Guklt). 


Fig.  116. 
Skull  of  Syncephaliax  Monstrosity. 


The  Monocephalian  monstrosities,  as  the  name  implies,  differ  from 


MOXSTJiOSJTIh'S. 


409 


the  last  in  havinf^  only  one  head,  but  a  double  body,  the  separation  of 
the  two  usually  takinj,'  place  below  the  umbilicus  (Fi^'.  117). 

The  Si/soniiaii  monstrosities  (Fij;.  US)  have  two  heads  on  apparently 
a  single  body,  though  a  closer  investigation  will  prove  tliat  the  unicity 
is  merely  superficial,  and  that  at  least  some  parts  are  double.  Gurlt 
describes  a  full-grown  Sysomian  lamb  he  examined,  and  which  had, 
apparently,  a  single  body  and  only  four  feet,  but  two  necks,  two  heads, 
and  two  tails,  and  the  skin  normally  covered  with  wool.  The  trunk, 
though  somewhat  small,  gave  no  indication  of  its  duplicity.  It  had, 
nevertheless,  two  vertebral  columns,  the  inner  ribs  attached  to  each 
being  shortened  and  fused  together,  while  the  external  ones  were  at- 
tached in  the  usual  way  to  the  single  sternum.  The  viscera  were 
generally  double,  though  they  were  confounded  at  certain  points.  A 
single  heart  suthced  for  two  pair  of  lungs,  one  pair  of  which,  however, 
were  onlv  rudimentarv.     The  two  livers  were  combined  into  one,  and 


Fig.  117. 

MO.NOCErH.\LIAN-  MoX- 

.sTROsiTT:  Corvw-Mf- 
lo'lidymi  (Gcrlt). 


Fig.  118. 

Syhcmian  Mon.strohity  :  Dicephalus 
bicollis  (UURLT). 


in  some  parts  the  intestines  merged  into  a  single  tube,  again  to  become 
double,  and  finally  to  terminate  in  one  rectum. 

The  Monosomian  monstrosities  have,  in  reality,  only  a  single  body, 
the  duplicity  generally  commencing  towards  the  neck,  in  the  cervical 
region,  not  un frequently  at  the  atlas,  and  sometimes  as  far  as  the  facial 
region  ^Fig.  119). 

Among  the  double  parasitic  monstrosities,  we  may  mention  Saint- 
Hilaire's  Hcterotn plans,  in  which  the  smallest  of  the  foetuses  is  attached 
to  the  anterior  part  of  the  body  of  the  other,  at  or  near  the  umbilicus ; 
the  Hctcralians,  in  which  the  parasitic  foetus  is  very  incomplete,  and 
perhaps  reduced  to  a  single  region — as  a  head  without  a  body — attached 
some  distance  from  the  umbiUcus ;  the  Pob/f/nathiayis,  in  which  the 
parasite  is  reduced  to  the  mere  fragments  of  a  fcrtus — the  jaws  and 
some  cephalic  remains  adhering  to  the  jaws  of  the  other  fcetus.     All 


410 


FCETAL  LYSTUKIA. 


these  are  included  in  Guiit's  classification,  which  we  would  advise  the 
veterinary  obstetrist,  as  a  rule,  to  employ. 

The  Polymelian  (/xeAo?,  limh)  monstrosities — Gurlt's  Melodidymi — 
comprise  those  creatures  which  are  so  frequently  exhibited  in  public, 
and  in  which  there  is  only  a  single  body  and  head,  but  supernumerary 


Fig.  119. 
MoNOSOMiAN  Monstrosity;  Dicephahts  bi-atlanticui  (Guklt)  :  Calk. 

limbs.  These  limbs  may  vary  in  number,  and  be  attached  to  various 
parts  of  the  complete  foetus ;  there  may  also  be  present,  in  addition  to 
the  supernumerary  members,  an  unformed  kind  of  tumour  resting  on 
the  back  or  shoulders,  which  in  one  case  has  been  recognised   to  be 


Fig.  120. 
Polymelian  Monstrosity  ;  Emprosthromelophorus  (Guklt)  :   Calk. 

composed  of  the  heart  and  lungs  of  a  second  foetus  (Fig.  121).  In 
other  instances,  the  tumour  is  alone  observed,  without  the  additional 
limbs. ^ 

^  It  is  not  improbable  that  the  "  Nadeah  "  bullock  of  India  is  an  animal  with  a 
parasitic  monstrosity  attached  to  it.  A  Bull  of  this  kind  has  been  described,  by  an 
amateur,  as  having  "an  excrescence  of  skin,  covered  with  white  hair,  hanging  from  the 
top  of  the  hump,  about  seven  inches  long  and  of  a  soft  nature,  in  appearance  resembling 


MoXSTlioSlTIEs. 


411 


The  Eiulociimian  monstrosities  are  those  double  foetuses  of  which 
one,  or  part  of  one,  is  inchuled  within  the  other.  They  are  the  Crypto - 
didiimi  of  Gurlt's  second  Class. 

Oriijin  of  Monstrosities,  and  the  Laws  of  Teratology . 

The  causes  which  operate  in  the  production  of  what  we  have 
designated  "  monstrosities  "  appear  to  be  numerous. 

Putting  to  one  side,  as  unworthy  of  notice,  the  superstitious  ideas 
which  long  prevailed  with  regard  to  the  formation  of  these  monstrosi- 
ties— because  they  can  all  be  explained  by  the  laws  of  teratology — we 
come  to  the  period  when  Regis  started  the  hypothesis  that  the  germs 
of  these  must  have  been  originally  produced  with  those  of  normal 
beings,  and  that  they  were  developed  in  i\\e  ordinary  course  of  genera- 
tion. This  hypothesis,  or  something  like  it,  was  accepted  by.Winslow, 
Duvernoy,  Haller,  and  others,   up  to  the  time  of  Meckel.     Geoffroy 


.^^^'# 


Fig.  121. 
DoiitLE  I'AR.v.'siTic  Monstrosity;  Polyintlian  notome/utt :  Cow. 

Saint-Hilaire,  however,  successfully  combated  it,  and  demonstrated 
that  these  anomalies  in  organization  are  not  primary,  but  accidental ; 
that  embryos  which,  had  they  been  placed  in  ordinary  circumstances, 
would   have  been  developed  in  a  normal  manner,  and  had,  in  fact, 


a  child's   stocking,  dangling   fn^ni   side   to  side   a.^   the  animal   moved,   but  in  no  wuy 
unsightly  or  repulsive  to  IcmjIc  at." 

Such  aninuals  are  worshipped,  :ind  not  put  to  any  work  ;  they  are  usually  exhibited 
covered  with  .1  kind  <>f  earth  coloured  cloth  trimmed  with  cowrie-shells,  and  the  owners 
derive  a  livelihood  by  exhibiting  them.  The  "  fakeers "  or  holy  mendicants  usually 
obtain  {xis.session  of  them.  The.se  double  or  pohmelian  monstrositie.s  receive  their  8acre<l 
designation  from  the  i^txl  Mahadeo,  who  is  bilieved  b\-  the  Hindoos  to  have  ridden  upon 
a  bull  called  "Nadeah,"  which  was  capable  of  changing  its  8ha]>e,  and  producing  a-s  many 
legs  or  horns  for  otfen.sive  or  defensive  purposes  as  it  might  find  necessary.  Thus  it 
happens  that  any  animal  with  unnatural  or  extraordinary  marks  is  supposed  t<>  hav«' 
some  affinity  to  the  great  "  Nadeah   '  of  Mahadeo,  the  founder  «f  Hindoo  teratology. 


412  F(ETAL  DYSTOKIA. 

begun  to  be  so  developed,  only  became  a,nomalous  and  monstrous 
because  their  development  was  disturbed.  Therefore  these  anomalies 
did  not  exist  previous  to  impregnation,  but  were  the  result  of  some  per- 
turbation occurring  during  the  development  of  the  embryos,  which  were 
at  first  perfectly  normal. 

The  opinion  which  at  present  prevails  with  respect  to  these  malforma- 
tions, is  to  the  effect  that  the  embryo  or  foetus  has  been  submitted  to 
some  kind  of  alteration  in  utero,  and  that  this  has  been  produced  during 
the  interval  between  conception  and  birth.  It  is  a  matter  of  ordinary 
observation  that  sometimes  a  fall,  blow,  sudden  fright,  or  a  powerful 
mental  impression  will,  in  woman,  disturb  the  ordinary  course  of  preg- 
nancy, and  give  rise  to  more  or  less  unusual  symptoms,  and  even  prema- 
ture birth  of  an  imperfect  foetus.  It  has  been  attempted  to  explain  the 
action  of  these  influences,  by  supposing  that  the  sudden  physical  or 
mental  shock  produces  an  abrupt  contraction  of  the  vascular  system 
and,  coincidentally,  of  the  uterus  ;  so  that  the  foetal  membranes  are 
thus  all  at  once  constricted  and  slightly  lacerated.  Consequently,  a 
part  of  the  liquor  amnii  escapes  (as  has  been  frequently  observed),  and 
this  is  succeeded  by  adhesion  of  the  margin  of  the  laceration  in  the 
membranes  to  the  corresponding  part  of  the  body  of  the  embryo  ; 
thus  are  formed  those  layers  or  bands  which,  whether  temporary  or 
permanent,  disturb  more  or  less  the  development  of  the  young  creature, 
either  by  preventing  organs  from  occupying  their  natural  cavities, 
hindering  the  union  or  fusion  of  parts,  or  opposing  or  delaying  the 
formation  of  those  which  should  afterwards  appear.  That  this  opinion 
is  not  improbable  may  be  at  once  conceded,  when  we  remember  that 
during  the  early  stages  of  development  the  ovum  is  little  more  than  a 
semi-fluid  mass,  and  that  its  constituent  parts  are  extremely  impres- 
sionable. 

But  the  formation  of  monstrosities  is  more  particularly  due  to  what 
has  been  designated  the  theory  of  retardation  or  arrested  develojmient ;  the 
deviations  from  the  normal  standard  being  the  effect  of  disturbance  and 
arrested  supply  of  nutriment  during  the  period  of  intra-uterine  growth. 
G.  Saint-Hilaire  has  proved  experimentally,  by  means  of  eggs  artificially 
hatched,  that  the  production  of  monstrosities  is  due  to  the  interruption 
or  accidental  suspension  of  development  which  had  commenced  in  a 
regular  manner  ;  while  Meckel  has  shown  the  striking  analogy  there 
exists  between  many  anomalies  and  various  transitory  conditions  of 
embryonic  organization. 

It  has  been  well  remarked  that  the  majority  of  the  malformations 
due  to  defect  in  the  higher  animals  represent,  in  a  more  or  less  perfect 
manner,  the  normal  conformation  of  the  inferior  classes.  For  instance, 
the  imperfection  or  absence  of  limbs  is  the  natural  condition  of  fishes 
and  some  reptiles  ;  the  heart  is  not  present  in  zoophytes  ;  when  it  has 
but  one  cavity  in  the  higher  mammalia,  it  only  resembles  the  single 
heart  of  crustaceae;  and  when  the  auricular  septum  of  the  heart  remains 
patent,  it  is  like  the  reptilian  heart.  All  this  is  explained  by  the  fact 
that  the  embryo  of  the  domesticated  animals,  in  arriving  at  its  ultimate 
development,  appears  to  pass  through  all  the  degrees  of  organization 
which  mark  the  different  types  in  the  zoological  series.  And  by  means 
of  the  knowledge  we  possess  of  the  organization  of  these  types,  we  are 
sometimes  able  to  say  when  a  particular  monstrosity  began  to  deviate 
from  the  normal  condition,  the  nature  of  the  deviation,  and  its  cause. 

An  excess  of  general  development  is  less  frequent  than  the  opposite 


MONS  THOSITIES.  1 1  :j 

condition,  and  partial  excess  of  an  organ  or  region  is  not  infrequent;  while 
excess  of  parts  is  far  from  rare,  and  may  be  noted  in  the  vasculai' 
system,  in  internal  organs,  and  externally  ;  more  particularly  is  it 
remarked  in  the  extremities,  when  we  iiave  in  some  species  "polydactyl- 
ism,"  and  in  others  "  hyperdactylism."  It  is  often  observed  that  an 
excess  in  development  in  one  part  coincides  with  defective  development 
in  another,  as  if  the  balance  in  formative  organization  must  be  main- 
tained throughout  the  body. 

With  regard  to  double  monstrosities — the  result  of  two  fcetuses  bein^ 
accidentally  joined  together,  and  fused,  as  it  were,  into  each  other — G. 
Saint- Ililaire  proposed  a  special  law  which  he  designated  the  laio  of 
similar  union  or  of  mutual  affinitij.  The  result  of  this  law  is  the  pro- 
duction of  symmetrical  development  in  a  double  monster  in  as  perfect 
a  manner  as  in  a  single  and  normal  individual ;  the  two  creatures 
which,  by  their  union,  form  either  a  partial  or  complete  double  mon- 
strosity, are  always  joined  by  the  homologous  faces  of  their  bodies — 
side  to  side,  front  to  front,  or  back  to  back.  And  not  only  are  they 
united  by  their  homologous  surfaces  externally,  but  internally  they  are 
allied  by  homologous  organs  :  each  part  or  viscus  of  one  corresponding 
to  a  similar  part  or  viscus  of  the  other  ;  so  that  each  vessel,  nerve,  or 
muscle  on  the  plane  of  union  of  one,  notwithstanding  the  apparent  com- 
plexity, is  joined  to  the  corresponding  vessel,  nerve,  or  nmscle  of  the 
other  :  just  as  the  two  moieties  of  a  single  and  central  organ,  originally 
distinct  and  lateral,  become  naturally  fused  together  at  a  certain  period, 
and  in  obedience  to  the  laws  controlling  their  formation  and  develop- 
ment. A  double  monster  is,  therefore,  only  a  being  composed  of  four  more 
or  less  complete  moieties  instead  of  two,  as  in  the  single  individual. 

"With  regard  to  more  complex  monstrosities,  we  lind  that,  instead  of 
two  moieties,  as  in  the  normal  condition  of  an  individual,  or  the  four 
moieties  as  in  the  double  monstrosity,  we  may  have  six,  eight,  or  even 
more  ;  but  yet  the  law  of  similar  union  prevails,  and  the  moieties  com- 
bine in  twos.  Therefore  it  is  that  a  triple  monstrosity  is  only  a  double 
monstrosity  doubled,  and  a  quadruple  one  a  triple  nionstrosity  doubled 
also — all  the  phenomena  of  the  compound  monstrosity  being  accounted 
for  on  the  same  general  principle. 

The  formation  of  double  monstrosities  has  given  rise  to  some  dis- 
cussion, and  at  present  there  are  two  chief  theories  which  are  worthy 
of  notice.  According  to  one  of  these,  there  have  been  originally  two 
ova,  which  may  have  been  derived  from  one  or  from  two  Graafian 
vesicles  or  follicles  rupturing  at  the  same,  or  nearly  the  same  time,  and, 
passing  down  the  oviduct  together,  towards  the  cornu,  becoming  fused  by 
pressure  in  their  passage.  The  other  theory  supposes  the  existence  of 
only  one  ovum,  by  whose  division  or  cleavage  the  double  monstrosity  is 
formed. 

The  first  view  is  that  which  has  found  most  favour,  though  recently 
it  has  been  considered  as  quite  exploded  by  Dittmer,'  who  is  in- 
clined to  adopt  the  latter  theory,  and  believes  that  the  double  monster 
is  only  an  instance  of  bilateral  symmetry  carried  too  far.  According 
to  him,  in  the  primitive  germ  of  the  normal  embryo  a  longitudinal 
gi-oove  is  formed,  which  afterwards  represents  the  middle  line,  the  two 
lateral  parts  developing  symmetrically.  But  if  this  groove  is  too  deep 
at  one  or  both  ends,  the  two  halves  will  there  be  separated  ;  and  the 
separated  extremities  have  the  power  of  producing  the  wanting  lateral 
*  Rtichert  and  Du  Bois-Rct/mond's  Archiv,  1875. 


414  FCETAL  DYSTOKIA. 

half  of  each.  The  separation  of  the  two  halves  may  occur  at  one 
extremity  or  at  both,  and  it  may  extend  to  any  depth.  According  to 
these  differences,  we  should  have  the  various  forms  of  double  monster — 
from  such  creatures  as  the  Siamese  twins  to  cases  of  a  small  super- 
numerary leg.  There  may  even  be  a  further  stage  of  this  process.  One 
of  the  separated  halves  may  present  a  similar  exaggeration  of  bilateral 
symmetry,  if  it  again  separate  into  two  halves  like  the  original  germ. 

Thus  may  be  explained  monsters  with  three  heads  or  three  tails. 

Some  objections  might  be  raised  to  this  theory,  but  this  is  not  the 
place  to  enter  upon  their  discussion.  "We  may,  however,  point  out 
that  it  will  scarcely  apply  to  included  monstrosities,  in  which  we  have 
one  creature,  more  or  less  perfectly  developed,  contained  within 
another.  We  can  scarcely  doubt  of  the  -existence  of  two  ova,  the 
included  one  being  the  oldest,  and  that  this  inclusion  has  probably  been 
effected  at  a  very  early  period  of  germ  development. 

To  return,  however,  to  the  long-accepted  theory.  If  wx  descend 
from  the  complex  phenomena  of  double  monsters  to  single  ones,  and 
from  these  to  simple  anomalies,  we  find  again  that  every  anomalous 
union  between  organs  takes  place  by  homologous  parts.  What  have 
been  designated  "  Symelian  "  monstrosities  are  characterized  by  the 
fusion  of  their  more  or  less  atrophied  abdominal  limbs  ;  in  the  "  Cyclo- 
cephalian  "  monsters  the  eyes  are  more  or  less  fused  into  one  organ  of 
vision ;  while  with  the  "  Otocephalians  "  tbe  ears  themselves  are 
joined,  and  often  intimately  confounded.  The  union  of  the  kidneys, 
testicles,  cerebral  hemispheres,  and  other  double  organs,  is  often 
observed  in  creatures  otherwise  normal  in  conformation  ;  and  all  these 
anomalies  occur  under  the  reign  of  the  same  law — that  of  "  similar 
union  " — which  for  organs,  as  for  entire  individuals,  operates  on  homo- 
logous parts. 

With  regard  to  the  remote  or  proximate  causes  which  lead  to  the 
production  of  monstrosities,  it  is  very  probable  that  the  most  pi'ominent 
are  irregularity  or  inequality  in  the  nutrition  of  the  foetus,  physical 
injury,  undue  pressure,  alterations  in  the  membranes,  or  diseased 
conditions  of  the  young  creature.  G.  Saint-Hilaire  and  Valentine,  by 
disturbing  the  development  of  the  embryo  of  the  fowl  during  the  early 
stage  of  incubation  of  eggs — through  shaking,  jarring,  and  pressing 
them,  perforating  the  shell,  or  covering  it  with  wax — could  almost 
create  monstrosities  at  will.  And  an  accident  during  gestation — a 
blow,  a  fall,  a  displacement  of  the  uterus — will  produce  the  same 
results  in  animals.  Lafosse  observes  that  it  is  perhaps  because  of 
the  pressure  to  which  the  foetus  of  Euminants  is  exposed,  owing  to 
the  accumulation  and  fermentation  of  food  in  the  rumen,  that  must 
be  attributed  the  greater  frequency  of  anomalies  in  the  species  of  this 
order  than  in  the  other  domesticated  animals.  The  quantity  and 
quality  of  the  food,  as  well  as  the  work  to  which  the  mother  is  sub- 
jected, have  an  undoubted  influence  on  the  nutrition  of  the  embryo. 

A  circumstance  which  appears  to  have  some  influence  in  the  pro- 
duction of  anomalies  in  animals,  is  the  great  disparity  in  size  between 
the  male  and  female.  Lafosse  endeavours  to  prove  this  by  showing 
that  the  frequency  of  certain  vices  of  conformation — such  as  hypo- 
spadias, umbilical  hernia,  want  of  proportion  between  the  jaws,  etc. — 
is  most  notable  in  the  mule. 

We  are  also  convinced  that  excessive  consanguinity  (breeding  "in 
and  in  ")  likewise  leads  to  the  frequent  production  of  monstrosities  ; 
we   have   witnessed   some   startling   instances   in   the  Cow  and  Pig. 


MOySTROSITIES.  \  1 5 

Weakness  of  the  procreativc  powers  may  also  tend  to  the  development 
of  monsters. 

A  too  small  uterus  may  likewise  act  mechanically  in  distorting  the 
foetus  ;  while  the  health  or  disease  of  the  organ,  or  of  the  foetal  mem- 
branes, must  exert  a  powerful  influence  on  its  development  and  con- 
formation. It  is  not  improbable  that  tlie  Celosomian  monstrosity 
{Schistosomiis  rcjlcxiis),  observed  only  in  the  Bovine  species,  is  due  to 
the  form  of,  or  pressure  in,  the  uterus  ;  and  to  the  same  cause  may  also 
be  ascribed  the  greater  frequency  of  double  and  triple  monstrosities  in 
this  species  than  in  any  other. 

The  amputation  of  limbs,  or  portions  of  them,  may  be  due  to  the 
action  of  the  umbilical  cord,  which,  in  the  Mare  at  least,  is  perhaps 
sutticiently  long  for  this  purpose. 

Hereditary  influence  is  here  undeniable.  In  the  human  species  it 
has  often  been  remarked,  and  scarcely  less  frequently  in  animals. 
Hornless  Cattle,  double-headed  Puppies,  tail-less  Cats,  and  other 
anomalies,  are  commonly  reproduced.  Franck'  mentions  the  case  of 
a  Mare  which  constantly  had  Foals  whose  lower  jaw  was  so  short  that 
they  could  not  suck  ;  consequently  they  died.  Gurlt  alludes  to  a 
Bitch  which  brought  forth  four  litters  of  Puppies  ;  the  first  litter  con- 
sisted of  six,  two  of  which  were  minus  their  fore-feet  and  were  hare- 
lipped  ;  there  were  five  in  the  second  litter,  four  of  which  were 
monstrosities  ;  in  the  third  litter  there  was  the  same  number,  and  the 
fifth  Puppy,  which  was  otherwise  normal,  had  a  hump  in  the  middle 
of  its  back  ;  four  Puppies  were  produced  in  tlie  fourth  litter,  three  of 
which  were  anomalous. 

A  psychical  or  mental  influence  has  often  been  invoked  to  account  for 
certain  monstrosities,  and  the  vulgar  opinion  since  Old  Testament 
times  is  certainly  entirely  in  favour  of  its  existence  ;  but,  on  the  other 
hand,  it  has  often  been  denied.  While  there  can  be  no  doubt  that  the 
popular  mind  has  greatly  exaggerated  this  influence,  yet  it  would 
appear  from  the  interesting  observations  collected  by  Trehonnais,  as 
well  as  the  curious  instances  recorded  by  Buhler,  Weber,  Herbst, 
Bagge,  Kueff.  and  others — and  which  we  regret  we  have  not  space  to 
quote — that  it  does  operate  to  some  extent  in  animals  ;  fear  especially, 
as  has  been  already  said,  will  react  on  the  embryo  or  fu'tus. 

Disease  of  the  fu'tus  itself,  or  maladies  transmitted  from  the  mother, 
may  play  an  active  part  in  the  production  of  anomalies  and  mon- 
strosities. 

Frequency  of  Monstrosities. 
Monstrosities  are  far  from  being  rare  in  the  domesticated  animals, 
but  they  do  not  occur  with  the  same  frequency  in    all  the  species. 
Gurlt-  tabulates  740,  which  shows  the  proportion   furnished   by   the 
different  animals.     This  is  as  follows  : — 

Ass  -  -  -  -         3 

Mule         ....         3 
Goat         -  -  -  -       24 

Mare         -  -  -  -       56 

Cat  -  -  -  -       71 

Bitch        -  -  -  -       78 

Sow  -  -  -  -       87 

Ewe  -  -  -  -     179 

Cow  ....     239 

'   Ilandfmch  iltr  Ihitrarztlichtn  Oehurtnliulfe,  p.  434. 
-  Pathol.  Anatomie,  vol.  ii.,  p.  5. 


416  FCETAL  DYSTOKIA. 

Baumeister  and  Eueff  mention  that  in  the  King  of  Wurtemberg's 
private  stud,  of  2,340  Foals  produced  there  were  only  nine  mon- 
strosities, or  one  abnormal  to  260  normal  Foals.  In  the  Hohenheim 
dairies,  among  the  Cows  the  monstrosities  were  only  one-half  per  cent. 
(1  per  200) ;  Swine  came  next  in  frequency,  then  Goats  and  Sheep. 
Among  the  latter  there  was  only  one  monster  in  768  Lambs. 

Saint-Cyr  collected  71  instances  (not  including  hydrocephalic  or 
synocephalic  monsters),  which  were  apportioned  in  the  following 
manner : — 

Calves 45 

Lambs  and  Kids  -         -         -       16 

Pigs 4 

Kittens        .         .         -         .         .         4 

Puppy 1 

Foal 1 

Though  monstrosities  are  not  rare  in  animals,  yet  all  do  not  give  rise 
to  difficult  parturition  ;  for  in  some  cases  the  deformity  does  not  inter- 
fere at  all  with  birth  ;  in  others  in  which  the  deformity  is  of  such  a 
nature  as  would  impede  delivery,  birth  often  occurs  prematurely  when 
the  foetus  or  foetuses  are  small  and  soft ;  while  even  when  fully 
developed,  double  and  triple  monstrosities  have  been  occasionally  born 
without  assistance. 

Nevertheless,  there  is  ample  proof  that  triple,  double,  and  even  single 
monstrosities,  often  require  to  be  removed  artificially,  and  may  be 
productive  of  serious  consequences  to  the  mother.  These  we  will  now 
allude  to. 

Distorted  Monstrosities. 

The  distorted  monstrosities  which  Gurlt  has  designated  Camylor- 
rhacchis  contorta,  and  which  are  characterised  by  abnormal  situation  and 
form  of  different  parts  (Fig.  114),  may  occasionally,  from  their  crooked 
shape,  prove  a  source  of  difficulty  during  birth.  The  distortion  may  be 
due  either  to  muscular  contraction  in  the  foetus,  or  to  extraneous  uterine 
pressure,  and  if  we  glance  at  the  figure  which  illustrates  one  variety  of 
this  malformation  at  p.  407,  w^e  will  readily  perceive  that  the  obstetrist 
may  indeed  have  a  serious  task  before  him  if  he  is  required  to  remove 
such  a  misshapen  foetus.  The  remarks  we  have  made  with  regai'd  to 
dystokia  from  muscular  contraction  are  applicable  to  this  form  of 
monstrosity  ;  and  in  the  majority  of  instances  it  will  be  found  that 
embryotomy,  or  even  the  Caesarian  section,  must  be  resorted  to. 

Cyclopean  Monstrosity. 

A  Cyclopean  monstrosity  would  not,  so  far  as  the  visual  deformity  is 
concerned,  give  any  trouble  to  the  obstetrist ;  but  in  conjunction  with 
this  condition  we  not  unfrequently  find  other  anomalies  existing,  which 
have  to  be  considered. 

Pseudencephalian  Monstrosity. 

The  head  of  the  foetus  may  prove  a  cause  of  protracted  or  difficult 
parturition,  as  we  have  seen  when  treating  of  hydrocephalus  as  a  source 
of  dystokia,  as  well  as  in  other  kinds  of  anomalies  when  it  is  either 
greatly  deformed  or  double.     We  are  cognisant  of  only  one  instance  in 


MoxsrnosiTiEs.  417 

which  a  pseudenceplialian   monstrosity  {Perocephalus  pseiidocephalns , 
Gurlt)  gave  rise  to  dilliculty  iu  birth. 

Double-headed  (Monosomian  and  Sysomian)  Monstrosities. 

The  occurrence  of  double-headed  monstrosities  is  more  common, 
perhaps,  than  any  other  anomaly  ;  they  are  observed  more  particularly 
in  Ruminants,  though  instances  are  recorded  of  their  appearing  in  the 
Pig,  and  even  in  the  Cat  species. 

We  have  collected  reports  of  some  three  dozen  cases,  the  large  majority 
of  which  refer  to  this  anomaly  in  the  Calf,  and  not  one  to  the  Equine  or 
Asinine  species.  Only  two  of  these  cases  appear  in  English  literature. 
We  have  alreadv  shown,  in  classification  of  monstrosities,  the  kind 


Fig.  122. 
Sy30mi.\n  Mo.vstrosity  :  Dicephalus  bkollis  (Gublt). 

and  degree  of  division  there  exists  between  the  heads,  and  we  have 
only  now  to  deal  with  this  anomaly  from  an  obstetrical  point  of  view. 

It  may  bo  obsened  that  many  of  these  creatures  have  been  born 
alive,  and  have  continued  to  live  for  some  time.  Canu  mentions  a 
double-headed  Calf  which  survived  its  birth  fifty  days,  and  Bert  gives 
a  good  description  of  another  which  he  examined  when  it  was  fifteen 
months  old ;  but  in  the  latter  instance  the  anomaly  was  limited  to  the 
lower  part  of  the  head,  the  jaws  only  giving  evidence  of  duplicity. 

The  existence  of  this  anomaly  renders  birth  more  or  less  difiicult,  or 
even  impossible,  according  to  the  size  of  the  heads,  their  point  of  junc- 
tion— whether  at  the  face  or  cranium,  or  towards  tlie  neck,  and  also 
according  as  the  presentation  of  the  fcttus  is  anterior  or  posterior.  In 
very  many  of  the  cases  recorded,  the  mother  died  or  had  to  be  killed, 
while  in  others  birth  occurred  without  assistance  and  with  but  little 

27 


418  FCETAL  DYSTOKIA. 

difficulty — rather  a  matter  for  wonder,  considering  the  width  of  two 
foetal  heads  joined  towards  the  upper  part  of  the  neck.  In  this  respect 
the  Monosomian  iiiust  prove  more  troublesome  sometimes  than  the 
Sysomian  monster.  In  the  majority  of  cases  the  presentation  is 
anterior. 

An  examination  will  reveal  the  existence  of  this  condition,  when  the 
obstetrist  will  adopt  the  measures  necessary  for  extraction.  In  very 
many  of  the  cases  embryotomy  will  have  to  be  resorted  to,  or  even  the 
Caesarian  section.  Decapitation  of  one  or  both  heads  may  sometimes 
suffice.  In  other  cases  judicious  manipulation  and  well-timed  traction 
will  effect  delivery.  When  the  heads  are  united  at  the  cranium  (as  in 
Figs.  116  and  119),  and  it  is  impossible  to  decapitate,  the  obstetrical 
saw,  chisel,  or  bone  forceps  may  be  usefully  employed  to  disunite  them 
at  their  junction. 

With  double  necks,  amputation  of  one  head  and  neck  should  be 
effected  as  low  down  as  possible. 

Celosomian  Monstrosities. 

Those  creatures  which  are  more  or  less  destitute  of  abdominal  and 
thoracic  parietes,  and  otherwise  deformed  in  various  degrees,  would 
appear  to  be  somewhat  frequently  met  with  by  the  veterinary  obstetrist. 
The  above  designation  for  them  will  be  recognised  as  that  bestowed  by 
G.  Saint-Hilaire,  the  name  proposed  by  Gurlt  being  Scliistosoinus  reflexiis 
or  contorUis  (Fig.  107).  They  also  are  found  more  often  in  the  Cow 
than  in  other  animals,  the  Sheep  being  next  in  order  of  frequency. 
Of  seventy-one  monstrosities  referred  to  by  Saint-Cyr,  twenty-three 
belonged  to  this  order,  and  of  these  twenty-one  were  Calves,  and  only 
one  Lamb  and  one  Kid.  Our  own  figures  place  the  proportion  of  Calves 
much  higher. 

Perhaps  this  relative  frequency  is  at  least  partly  due  to  the  fact,  that 
the  singularity  of  the  malformation  is  so  striking  that  observers  are 
more  ready  to  publish  cases  of  this  kind  ;  while  parturition  being  always 
more  or  less  laborious,  empirics  who  may  chance  to  be  called  in  cannot 
understand  the  anomaly,  and  the  veterinary  surgeon  has  at  last  to  be 
sent  for. 

Diagnosis. 

The  diagnosis  of  this  malformation  is  not  difficult  to  the  practised 
obstetrist.  If  the  foetal  intestines  are  apparent  at  the  genital  orifice  of 
the  mother,  their  small  size  indicates  at  once  that  they  are  those  of  the 
foetus  ;  while  an  exploration  of  the  vagina  and  uterus  will  discover  the 
distorted  body,  with  the  viscera  unprotected  and  floating  freely  about. 
When  nothing  is  visible  externally,  of  course  the  diagnosis  is  more 
difficult ;  and  this  difficulty  is  increased  with  certain  presentations  and 
positions  of  the  foetus.  When,  for  instance,  this  is  anterior,  and  the 
spine  is  greatly  distorted,  the  hand  will  first  meet  the  head,  and  around 
it  all  the  feet  (Fig.  123) ;  it  will  be  in  vain  for  the  obstetrist  to  attempt 
to  separate  these  and  push  back  the  posterior  limbs  in  order  to  put  the 
foetus  in  a  good  position,  as  the  rigidity  of  the  crooked  spine  prevents 
this  being  accomplished.  In  other  cases  the  presentation  may  be 
abdominal  or  posterior,  and  then  the  hand  encounters  a  confused,  soft, 
floating  mass  of  viscera,  the  nature  of  which  is  not  easily  ascertained. 
However,  the  feel  of  the  intestines  should  lead  to  a  suspicion  of  the  case, 
while  the  twisted  spine,  deformed  pelvis,  and  general  distortion  ought 


MONSTROSITIES. 


419 


to  lead  to  a  correct  diagnosis.  In  some  cases  the  exposed  heart  can  be 
seized  by  the  hand,  and  if  the  fcctus  is  ahve  the  contractions  of  this 
organ  will  be  distinctly  perceptible. 

Prognosis. 

The  prognosis  in  these  cases  of  dystokia  will  greatly  depend  upon 
the  distortion  and  size  of  the  fcctus,  as  well  as  upon  its  position.  In 
thirty -nine  observations  collected  by  Franck,  twenty-eight — or  72 
per  cent. — of  these  monstrosities  were  born  without  injury  to  the 
mother,  and  a  number  of  them  without  assistance  ;  the  remaining  eleven 
Cows  had  to  be  slaughtered.  In  thirty-two  instances,  twenty-eight — or 
93  per  cent. — of  the  foetuses  presented  by  the  abdomen ;  only  four  cases 
— 13  per  cent. — presented  anteriorly,  with  the  head  and  all  the  feet 
towards  the  genital  canal.  The  latter  were  the  most  serious,  as  in  three 
of  them  the  Cows  died.  Of  the  twenty-eight  abdominal  or  visceral 
presentations,  twenty-three  births  took  place  without  permanent  injury 
to  the  mothers,  the  other  five  being  killed.  One  was  delivered  by  the 
CsBsarian  section.  In  some  of  the  cases  in  which  birth  occurred  with- 
out assistance,  the  young  creature  was  born  alive. 


Fig.  vii. 
Cklosomian  Mo.nstuosity  :  L.\mb. 

1,  Hind  Foot  ;  2,  Fore  Feet  ;  3,  Tail  ;  4,  Tongue  :  5,  f:il>ow  of   Left  Fore 
Limb  ;  6,  Stifle  ;  7,  Kibs  everted  ;  8,  Viscera. 

Extraction. 

.\s  we  have  seen,  the  prognosis  in  the  large  majority  of  cases  is 
favourable,  and  particularly  when  the  presentation  is  abdominal.  Here 
careful  manipulation  will  elTect  delivery,  and  often  the  only  mutilation 
necessary  is  the  removal  of  the  ftctal  viscera.  These  being  got  rid  of, 
hand  or  cord  traction  made  on  the  most  convenient  parts,  or  the  inser- 
tion of  a  hook  behind  the  spine  into  the  pelvis  or  any  other  likely  and 
accessible  part,  with  gradual  pulling  will  effect  delivery;  if  not,  the 
vertebrtD  should  be  divided. 

But  when  the  head  and  all  the  feet  present,  then  the  case  is  much 
more  serious.  If  the  fcctus  is  only  moderately  developed,  even  in  this 
position  it  has  been  removed  by  traction.  But  in  nearly  all  these  cases 
embryotomy  must  be  adopted.  Some  practitioners  have  succeeded  in 
extracting  the  Calf  by  cording  the  head  and  fore-limbs,  and  pulling  at 
these,  while  the  hind-limbs  were  being  pushed  forwards  into  the  uterus, 
and  so  dislocating  the  spine  and  straightening  the  body.  If  the  spine 
does  not  give  way,  it  may  be  cut  or  sawn  through. 


420  FCETAL  DYSTOKIA. 

In  removing  the  body  of  the  foetus  by  instalments,  the  limbs  are 
amputated  one  after  the  other,  according  to  the  rules  to  be  prescribed 
for  this  operation  ;  and  it  may  be  necessary  to  excise  two,  three,  or 
all  of  the  legs,  and  even  the  head  of  the  foetus,  before  delivery  can  be 
completed. 

DoubijE  and  Tkiple  Monstrosities. 

We  have  already  alluded  to  monstrosities  which  have  the  head 
double  ;  we  now^  come  to  the  consideration  of  those  which  have  the  body 
more  or  less  double,  or  even  triple,  and  which  have  been  designated  by 
G.  Saint-Hilaire  Eusomphalian,  Monoinpkalian,  and  Monocejjhalian, 
according  to  the  degree  of  separation  of  the  bodies,  and  whether  two 
are  united  to  a  single  head — the  double-headed  creatures  being  desig- 
nated Synceplialian. 

From  an  obstetrical  point  of  view,  there  is  little  need  to  distinguish 
between  the  Eusomphalian  and  Monomphalian  monstrosities  ;  for,  as 
already  explained,  they  consist  of  two  distinct  foetuses  joined  together 
at  some  part  of  their  body,  the  character  distinguishing  them  being  the 
presence  of  a  double  or  single  umbilical  cord  (see  Figs.  115,  117,  118, 
119). 

The  occurrence  of  such  monstrosities  is  generally,  though  not 
always,  serious,  so  far  as  birth  is  concerned  ;  they  are  met  with  in  all 
the  domesticated  animals,  but  perhaps  most  frequently  in  the  Bovine 
and  Ovine  species.  Several  instances  are  mentioned  in  w^hich  birth 
has  taken  place  wathout  difficulty,  and  the  young  creatures  have  lived. 
Holzner  of  Erding,  quoted  by  Franck,  states  that  a  double  Lamb,  with 
eight  feet,  double  abdomen,  and  single  breast,  neck,  and  head,  was  born 
without  assistance.  But  in  other  cases,  unless  relief  is  afforded  the 
gravest  results  are  certain  to  ensue. 

Saint-Cyr  alludes  to  three  instances  in  w^hich  embryotomy  had  to  be 
practised,  and  in  two  of  these  the  mother  succumbed  ;  the  third,  how- 
ever— a  Mare — recovered. 

Diagnosis. 

The  diagnosis  of  these  monstrosities  is  often  very  difficult,  as  they 
may  be  mistaken  for  ordinary  twins.  Franck  has  drawn  attention 
to  the  circumstance  that  there  is  very  frequently  a  difference  in  the 
presentation  of  the  merely  double-headed  foetus  and  the  double  foetus, 
particularly  the  double  croup ;  the  first  being  mostly  in  the  anterior 
presentation,  the  latter  in  the  posterior. 

In  the  case  of  the  double  fcetus,  its  presence  may  be  suspected 
when  one  cannot  be  moved  without  moving  the  other  ;  w^hen  one  is 
brought  into  a  good  position  with  regard  to  passing  through  the  pelvic 
inlet,  and  it  cannot  be  advanced  beyond  a  certain  point,  though  the 
passage  appears  to  be  sufliciently  wnde  to  permit  easy  delivery,  because 
the  other  lies  across  the  inlet ;  when  the  hand  is  passed  between  the 
two  foetuses  and  is  stopped  at  the  point  where  the  skin  is  carried 
between  them  at  their  junction  ;  and  w^hen  they  are  united  by  homolo- 
gous parts,  as  already  explained.  With  regard  to  the  latter,  we  may 
be  positive.  If,  for  instance,  two  foetuses  lie  together  at  the  inlet  in  the 
same  presentation — anterior  or  posterior — there  is  nothing  to  be  inferred 
from  this  as  to  their  being  monstrosities  or  merely  twins,  as  the  pre- 
sentation may  be  the  same  for  these  latter  ;  but  if  one  is  in  the  anterior 


MONS  TROSI  TIES.  <*21 

and  the  other  in  the  posterior  presentation,  then  we  may  bo  certain  that 
they  are  not  united.     Heterologous  parts  do  not  unite. 

The  diagnosis  in  the  case  of  Monocephahan  monstrosities  is  com- 
paratively easy  when  the  head  presents.  But  much  care  and  attention 
are  necessary  in  forming  a  diagnosis  in  such  cases,  and  the  examination 
of  the  bodies  should  lead,  if  possible,  to  an  exact  notion  of  their  condition. 

Extraction. 

In  some  cases,  though  they  are  very  rare,  extraction  may  be  possible 
by  manipulation  and  judicious  traction  ;  but  as  a  rule,  embryotomy,  or 
even  the  Cicsarian  section,  has  to  be  practised.  If  it  were  possil)le  to 
separate  the  two  individuals  by  excising  the  parts  which  unite  them, 
then  birth  would  probably  be  as  easy  as  with  twins  ;  but  it  can  rarely 
be  practicable,  for  the  simple  reason  that  the  point  of  union  is  gener- 
ally beyond  reach  :  it  is  too  extensive  to  be  cut  through,  or  the  junction 
is  of  an  osseous  character.  Nevertheless,  cases  may  occur  in  which 
the  knife  and  the  obstetrical  saw  or  bone  forceps  may  be  most  effectively 
employed  in  accomplisliing  disunion. 

Wlien  the  monstrosity  is  in  the  anterior  presentation,  should  it  prove 
to  be  double-headed,  then  it  will  be  found  advisable  to  remove  one  of 
the  heads  as  low  down  the  neck  as  possible ;  after  this  is  done,  removal 
of  two  or  more  of  the  anterior  limbs  by  subcutaneous  section,  will  often 
diminish  the  diameter  of  the  body  to  such  an  extent  that  traction  on 
the  head  and  x-emaining  skin  of  the  limbs  will  sometimes  effect  delivery. 
If  not,  then  eventration  of  the  thorax  and  abdomen  will  be  necessary. 
When  the  two  croups  cannot  be  made  to  pass  through  the  pelvis  together, 
it  will  be  imperative  to  divide  each  across,  as  far  back  as  possible, 
extract  the  anterior  halves,  push  the  posterior  into  the  uterus,  turn 
them,  and  deliver  them  as  in  the  posterior  presentation.  Sometimes 
excision  of  one  or  more  of  the  hind  limbs,  in  order  to  diminish  the 
volume  of  the  double  croup,  will  be  necessary  before  the  operation  can 
be  completed.  With  Monocephalic  monstrosities,  of  course  the  head 
and  neck  are  not  interfered  with,  only  the  body  and  limbs  requiring 
attention. 

When  the  presentation  is  posterior,  the  procedure  must  be  carried 
out  in  a  similar  manner  ;  but  in  all  cases  the  task  is  a  long  and 
fatiguing  one,  and  the  tax  upon  the  endurance  and  sensibility  of  the 
mother  is  heavy  indeed. 


('II.\PT1:R  IV. 

Dystokia  from  Multiparity. 

At  p.  164  allusion  was  made  to  the  relative  position  of  the  young  in 
multiple  pregnancy,  and  at  p.  262  we  described  the  manner  in  which 
twin  births  take  place.  We  need  not  again  refer  to  these,  but  we  must 
notice  those  cases — rare,  it  is  true — in  which  difficulties  are  encountered 
from  pathological  conditions  in  twin  parturition.  As  has  been  shown, 
in  ordinary  cases  one  foetus  occupies  the  body  of  the  uterus,  the  other 
one  of  the  cornua,  or  both  may  be  in  thecornua  ;  and  both  may  present 
either  anteriorly  (Fig.  47),  posteriorly,  or  one  in  the  first  and  the  other 
in  the  second  presentation  (Fig.  66).  One  alone  must  pass  through  the 
genital  canal,  then   the  other,  as  there  is  not  space  for  both  at  once  ; 


422  F(ETAL  BYSTOKIA. 

and  birth  is  usually  quite  as  easy  as  if  there  were  only  one  foetus. 
Indeed,  it  is  sometimes  easier,  from  the  fact  that  parturition  either 
occurs  before  the  full  period  of  gestation  has  expired,  and  the  progeny 
are  therefore  not  so  largely  developed  ;  or  if  the  usual  term  has  been 
reached,  it  nearly  always  happens  that  the  twins  are  smaller  than  in 
uniparous  births.  When  the  most  advanced  foetus  is  expelled,  a  variable 
period  elapses  before  the  birth  of  the  second  takes  place.  During  this 
interval  the  uterus  is  accommodating  itself  to  its  altered  conditions, 
and  preparing  for  the  expulsion  of  the  remaining  foetus ;  while  the 
parent  remains  restless,  pays  little,  if  any,  attention  to  the  young 
creature  already  born,  and  manifests  a  particular  anxiety,  which  is  an 
almost  certain  indication  that  parturition  is  not  completed.  When  the 
uterus  has  got  rid  of  its  occupants,  the  mother  then  turns  its  attention 
to  the  offspring. 

This  is  the  ordinary  course  of  affairs  ;  but  it  is  not  always  so  fortunate. 
In  some  instances,  after  the  expulsion  of  the  first  foetus  the  uterus  is 
seized  with  a  kind  of  inertia,  and  labour  may  be  suspended  for  hours, 
even  for  days,  and  sometimes  more  than  a  week.^  During  this  suspen- 
sion the  parent  at  times  gives  indications  of  uneasiness  by  pawing, 
looking  at  the  sides  now  and  then,  straining  at  intervals  perhaps,  and 
not  infrequently  exhibiting  symptoms  of  colic,  while  the  milk  retains 
all  the  characters  of  colostrum  until  the  other  foetus  is  born. 

Eetention  of  the  second  foetus  after  a  certain  time  is  fatal  to  its  exist- 
ence ;  even  in  animals  with  a  multiple  placenta — such  as  the  Cow, 
whose  foetus  retains  its  vitality  much  longer  than  that  of  those  whose 
placenta  is  single,  like  the  Mare — the  retained  foetus  has  never,  accord- 
ing to  Saint-Cyr,  been  known  to  exist  forty-eight  hours  after  the  birth 
of  the  first. 

This  suspension  of  labour  in  twin  birth,  and  which  is  not  at  all  infre- 

^  This  uterine  inertia,  scarcely  noticed  by  veterinary  writers  as  occurring  in  mul- 
tiparous  animals,  we  have  often  observed.  One  of  these  cases  may  be  alluded  to.  A 
medium-sized  Bull-terrier  Bitch,  belonging  to  a  brother  officer,  required  my  assistance 
the  previous  year,  through  being  unable  to  pup.  The  animal  had  been  in  labour  for  some 
time,  and  the  head  of  a  Puppy  was  in  the  vagina.  This  was  easily  removed  by  an  instru- 
ment hereafter  to  be  described,  as  was  another  which  we  contrived  to  seize  immediately 
afterwards.  These  were  all  that  the  uterus  contained,  and  they  certainly  were  not  too 
large  for  the  genital  passage  ;  the  uterus  could  not  expel  them. 

Some  time  afterwards,  this  officer,  who  had  in  the  meantime  removed  to  Portsmouth, 
wrote  to  inform  me  that  the  Bitch  was  again  pregnant,  and  owing  to  my  having  made  him 
acquainted  with  its  uterine  peculiarity,  he  was  anxious  to  know  what  he  should  do  when 
its  time  was  due  for  pupping.  Recommending  certain  hygienic  precautions,  I  advised 
that  nothing  special  should  be  attempted  unless  birth  was  delayed,  as  on  the  previous 
occasion  ;  then  a  dose  of  tincture  of  ergot  of  rye  wa-<  to  be  administered,  followed  by 
another  if  necessary.  Subsequently,  I  had  a  letter  stating  that  on  the  Thursday  night 
the  Bitch  had  four  small  Pups,  but  there  was  no  sign  of  milk.  A  dose  of  castor  oil  was 
given,  as  symptoms  of  constipation  were  exhibited  (due,  in  all  probability,  to  fa;tal 
retention)  ;  the  following  day  the  animal  was  in  pain,  "and  as  she  was  strong  and  well 
in  herself,  I  did  not  like  to  give  the  ergot  of  rye  yet.  However,  on  Saturday  morning 
she  became  very  ill.  and  was  scarcely  able  to  stand  up,  and  yet  there  was  no  milk.  So 
about  ten  o'clock,  I  gave  her  a  drachm  of  tincture  of  ergot  of  rye  (our  prescription),  and 
about  five  p.m.  she  passed  a  dead  pup,  followed  shortly  hy  five  life  ones.  She  is  now 
(Tuesday)  all  right,  but  all  the  live  puppies  died,  save  two." 

This  case  is  interesting,  as  showing  the  tendency  in  some  animals  to  uterine  inertia  ; 
as  testifying  to  the  great  value  of  ergot  of  rye — at  least,  with  the  Carnivora — its  ecbolic 
action  on  animals  being  denied  by  many  veterinarians  ;  as  proving  that  the  death  of  one 
f cetus  i7i  utero  does  not  always  imperil  the  existence  of  the  others  ;  and  as  demonstrating 
that,  contrary  to  what  occurs  in  the  Mare  and  Cow,  foetuses  will  exist  in  the  uterus  of 
the  Bitch  for  forty-eight  hours  after  the  expulsion  of  others,  without  succumbing,  even 
when  one  of  their  number  is  dead. 


DYSTOKIA  FROM  MULTIPAniTV 


423 


quent,  is  ordinarily  due  to  malposition  of  the  second  footus ;  and  this 
cause  of  dystokia  is  one  which  nearly  always  demands  the  attention  of 
the  veterinary  obstetrist. 

This  malposition  of  the  single  foetus  will  be  noticed  presently ;  we 
have  now  to  consider  diiVicult  birth  due  to  multiparity.  Dystokia  from 
this  cause  always  happens  when  the  two  fcetuses  are  about  the  same 
distance  from  the  os  uteri,  and  both  present  together  at  the  pelvic 
inlet ;  the  uterine  contractions  carry  them  simultaneously  into  the 
opening,  but  of  course  they  cannot  possibly  pass  through  the  canal 
at  the  same  time ;  hence  the  dilliculty  in  birth — a  ditliculty  which 
varies  according  to  the  relative  situation  of  the  two  foetuses  to  each 
other. 

The  fcetuses  may  be  so  situated  that  when  the  hand  is  introduced 
into  the  vagina  or  os,  it  will  either  encounter  the  head  of  one  ftt'tus 


Fig.  124. 
Twin  ForrusEs,  in  Dikkerkxt  Puesestatioxs,  passino  into  the  (Jenital  Canal. 

with  the  fore-limbs  of  the  other  ;  four  anterior  or  posterior  limbsj  two 
hind  and  two  fore  limbs  (Fig.  124) ;  two,  four,  or  six  feet ;  a  headland 
a  tail,  etc. 

The  cause  of  this  malposition  is  in  all  probability  due  to  the  relative 
smallness  of  the  twins,  and  the  changes  which  occur  in  their  position 
during  birth  ;  and  it  will  be  apparent  that  the  obstetrist  must,  in  some 
cases  at  least,  find  it  difficult  to  distinguish  between  such  presenta- 
tions of  twins  and  some  of  the  monstrosities  or  deformities  we  have 
described. 

Diagnosis. 

In  such  cases  the  obstetrist  has  to  ascertain  : 

1.  Whether  individual  twins  are  present ;  2.  To  distinguish,  among 


424  FCETAL  DYSTONIA. 

the  parts  which  present,  those  which  belong  to  each  foetus.  This  can 
only  be  done  by  a  most  careful  manipulation,  and  even  then  at  times 
the  obstetrist  will  find  himself  embarrassed.  For  instance,  when  the 
fore-feet  of  one  foetus  present  along  with  the  head  of  the  other,  the 
operator  may  be  led  to  believe  that  there  is  only  one  animal  to  extract ; 
and  as  the  position  is  seemingly  favourable,  and  the  difficulty  only  due 
to  excessive  size  of  the  foetus,  powerful  traction  is  resorted  to  for  its 
removal.  This,  however,  fails  to  effect  its  object ;  and  when  another 
exploration  is  made,  it  is  discovered  that  the  attempt  has  so  fixed  the 
foetal  parts  in  the  pelvis,  that  the  most  energetic  and  skilful  manipula- 
tion will  scarcely  move  them  in  order  to  alter  their  position. 

In  other  instances,  we  find  the  limbs  of  the  foetuses  so  interlocked 
{locked  fcetiises)  tbat  they  are  with  the  greatest  difficulty  disengaged. 

Extraction. 

It  is  evident  that,  if  delivery  is  to  be  effected,  one  foetus  must  be 
extracted  at  a  time.  They  must,  therefore,  be  disengaged,  and  one 
pushed  forward  into  the  uterus,  while  the  other  is  carried  towards  the 
vulva.  When  the  latter  has  been  born,  then  the  second,  if  in  a  wrong 
position,  must  be  adjusted  and  removed. 

This  is  easily  written  ;  those  who  have  had  to  carry  it  out  in  practice 
are  alone  competent  to  say  how  difficult  it  is  to  execute  in  the  majority 
of  cases.  It  must  be  remembered  that,  as  in  nearly  every  other  case, 
the  veterinary  obstetrist  is  only  called  in  when  the  foetuses  have  been 
for  some  time  wedged  in  the  pelvic  entrance  by  the  uterine  contractions, 
and  most  likely  also  by  the  injudicious  manipulations  of  amateurs  or 
empirics.  If  he  had  the  advantage  of  attending  the  animal  before 
matters  had  proceeded  so  far,  and  the  foetuses  were  still  in  the  abdomen, 
then  the  difficulties  would  be  greatly  diminished. 

Eecognising  the  presence  of  twins,  he  w^ould  select  that  which  is  in 
the  most  favourable  position,  cord  the  head  and  fore-limbs,  or  the  hind- 
limbs  if  they  presented;  place  them  in  a  good  direction  for  extraction, 
and  by  the  aid  of  assistants  draw  it  towards  the  outlet,  while  the  other 
foetus  was  pushed  deeper  into  the  uterus.  When  the  first  foetus  is  well 
into  the  passage,  and  the  other  behind  and  clear  of  it,  the  operation 
may  be  said  to  be  completed.  It  may  be  noted,  however,  that  owing 
to  the  obstacle  offered  by  the  first  foetus,  the  one  remaining  in  the 
uterus  is  very  often  in  a  wrong  position,  and  the  uterus  contracting 
upon  it  after  removal  of  the  other,  may  fix  it  in  that  position,  and  thus 
necessitate  adjustment  and  other  assistance  being  rendered.^ 

^  It  is  often  astonishing  how  multiparous  animals  bring  forth  their  young  under  extra- 
ordinary circumstances.  Cases  are  on  record  of  Cats  having  Kittens  attached  to  each 
other  in  such  an  unusual  manner  that  the  space  allowed  each  for  birth  seemed  too 
limited  to  permit  this  to  take  place.  Morot  alludes  to  six  Kittens,  for  instance,  which  were 
born  alive,  and  all  of  which  were  joined  by  the  end  of  their  umbilical  cords,  owing,  it  was 
surmised,  to  the  placenta,  chorion,  amnion,  and  allantois  being  single. 


.VA/J'/:k'SKXT.lT/itX  on  MA/J'OSITW.V  OF  THE  FiETU^.  42.') 

GROUP  II. 

DYSTOKIA  FROM  MALPRESKXTATION  OR  MAr.roSITIOX  OK  THK 

Fa<:Tus. 

Though  the  impediments  to  birth  in  the  human  female  are  not  infre- 
quently due  to  the  fcutus  being  in  sucli  a  position  that  it  cannot  pass 
through  the  pelvic  canal,  yet  it  is  very  questionable  whether,  in  animals, 
this  cause  of  dystokia  is  not  much  more  common,  much  more  com- 
plicated, and  very  much  more  dillicult  to  be  rectified.  In  woman  the 
ditiiculty  in  this  case  chiefly  occurs  when  the  axis  of  the  foetus  does 
not  coincide  with  that  of  the  uterus — when,  for  instance,  the  head  or 
the  breech  cannot  pass  through  the  pelvic  inlet,  and  the  presentation 
is  more  or  less  oblique  or  transverse.  It  is  exceedingly  rare  "indeed 
that  the  neck  or  limbs  offer  an  obstacle  to  birth. 

With  the  Calf  and  Foal  the  case  is  very  different.  These  creatures 
have  the  neck  and  limbs  long  and  very  flexible,  and  even  the  body 
itself  is  comparatively  long  and  readily  curved  in  any  direction.  The 
consequence  is  that  the  limbs  or  neck  may  be  bent  under,  to  one  side, 
or  above  the  trunk  ;  while  the  latter  may  be  flexed  in  such  a  manner 
AS  to  become  quite  distorted. 

The  Cow  is  the  animal  of  all  others  which  suffers  most  frequently 
from  dirticult  parturition,  and  several  of  the  causes  which  give  rise  to 
this  dirticulty  are  not  met  with  in  the  females  of  other  species ;  this  is 
no  doubt  chiefly  owing  to  the  fact  that,  among  uniparous  creatures,  this 
has  proportionately  the  narrowest  pelvis,  and  therefore  deviations  of 
the  head  and  limbs,  or  any  unusual  presentation  or  position  of  the 
body,  which  would  be  of  little  moment  in  the  case  of  Solipeds,  lead  to 
trouble.  As  for  multiparous  animals,  the  young  are  generally  so  small 
when  compared  with  the  genital  canal,  that  they  can  generally  pass 
through  it  in  presentations  and  positions  which  would  be  most  difficult, 
if  not  impossible,  in  Solipeds,  and  more  so  in  Bovines. 

For  these  reasons,  we  have  a  great  number  of  more  or  less  com- 
plicated malprcsentations  and  positions,  wliich  give  rise  to  varying 
degrees  of  dystokia,  some  of  them  of  a  very  formidable  kind. 

It  will  therefore  be  readily  understood  that,  even  when  the  axis  of 
the  young  creature's  body  coincides  with  that  of  the  uterus  and  pelvic 
canal,  and  the  latter  is  normal  in  dimensions,  birtli  may  not  be  possible 
without  assistance ;  and  this  establishes  a  wide  difference  between  the 
obstetrics  of  the  human,  and  the  Equine  and  Bovine  species.  Added 
to  this,  the  veterinary  surgeon  has  the  difliculties  before  mentioned  to 
contend  with — powerful  and  often  irritable  animals  ;  a  long  genital 
canal  and  deep  uterus ;  uterine  contractions  so  energetic  that  they 
fatigue  and  paralyse  the  hand  and  arm  ;  the  disadvantages  of  position 
in  the  parturient  animal ;  the  late  period  at  which  professional  assist- 
ance is  sought  for ;  and  the  damage  that  may  have  been  inflicted  by 
amateurs  and  empirics. 

Considering  the  frequency  of  the  causes  of  dystokia,  and  their  often- 
times serious  character,  they  deserve  the  most  careful  study  in  order 
that  they  may  be  successfully  overcome. 

The  following  synoptical  table  shows  the  various  causes  of  fcetal 
•dystokia  dependent  on  abnormal  presentations  and  positions  : 


426 


FCETAL  DYSTOKIA. 


rXATCRAI. 


Obstacles  due  to  the 
Hind-Limbs 


Causes  which  may  be 
met    with    in     all^ 
Positions   ... 


Obstacles  due  to  the 
Head        


rDorso-pubic. 
Abnormal  Positions  -  Dorso-supra-cotyloidean    (right  or 
[     left). 
/The  hind -limbs  are  extended  and 

retained  at  the  stifles. 
-  The  hind-limbs  are  flexed  beneath 

the  body  and   enter   the  pelvis 

with  it. 
TThe  limbs  are  on  the  neck. 

Obstacles  due  to  the    '^\^   ^V^}"'    ^^    i°,^°."^Ple*ely    ^^- 
T'        J  •    ,  -,      tended  in  the  pelvis. 

The  limbs  are  flexed  at  the  knees. 

The  limbs  are  completely  retained. 

The  head  is  flexed  downwards. 

The   head   is  flexed   beneath   the 

chest. 

The  head  is  turned  to  one  side  of 

body. 

The  head  is  extended  on  the  back. 

/The  head  is  retained  with  one  or 

Combined   Obstacles        both  fore-limbs. 

due  to  the    Head  -|  The  head  is  retained,  or  one  of  the 

and  Limbs  ...  I      fore  or  hind  limbs  has  entered 

'      the  pelvis. 

fLumbo-pubic. 

Abnormal  Positions  -]  Lumho-(*upra  -  cotyloidean    (right 

y     and  left). 

^,    .     1      J       i.     iv     /The  neck  is  contracted. 
Obstacles  due  to  the    mu       r  v    u  ^       ai, 

I  The    fore  -  limbs    are    under    the 

j      chest,  and  enter  the  pelvis  with 
••  I     it. 

/  The  limbs   are    incompletely   ex- 
Causes  to  be  met  with  f  Obstacles  due  to  the        tended  in  the  genital  canal. 
in  ALL  Positions   ...\     Hind-Limbs       ...    The  limbs  are  flexed  at  the  hocks. 

I,  The  limbs  are  completely  retained. 
(dorso    tt-mear   positions/^^P^*^°"^^^*^  ("S^t  and  left). 
TRANSVERSE     '  ^^^^°  '  ^^  ^'^^^   position  s  ^  Cephalo-sacral. 
PRESENTATION. "  Sterno  -  abdominal    Posi-  /  CephaloUial  (right  and  left). 
[     TiONS       ...         ...         ...\Cephalo-sacral. 


P-( 


f^- 


Natural 


Head 
Limbs 


Fore- 


CHAPTEE  I. 
Dystokia  depending  on  the  Anterior  Presentation. 

It  will  be  seen  from  the  preceding  table,  which  is  that  followed  by 
Saint-Cyr — the  tables  of  Franck  and  other  veterinary  obstetrists  differ- 
ing somewhat — that  the  causes  of  dystokia  due  to  the  foetus  are 
numerous  and  varied.  In  each  of  the  presentations  there  may  be 
difficulties,  as  well  as  in  the  positions,  many  of  which  may  be  more 
or  less  vicious  and  complicated,  whether  as  regards  the  whole  mass  of 
the  body  or  only  parts  thereof — as  the  limbs,  head  and  neck,  etc. 

In  this  presentation  the  obstacles  are  somewhat  numerous  ;  for 
while  it  may  be  normal  the  position  may  be  reversed,  or  the  hind-limbs 
may  impede  birth  ;  or  the  presentation  itself  may  be  abnormal  and 
combined  with  one  of  the  positions  described. 

Eainard,  looking  at  the  subject  from  an  obstetrical  point  of  view, 
considered  the  head  and  hmbs  of  the  foetus  as  appendages  which,  from 
their  wrong  direction,  may  more  or  less  hinder  its  expulsion.  Thus 
the  head,  one  or  both  of  the  fore-limbs,  or  even  the  posterior  limbs  in 
the  anterior  position,  may  cause  the  most  varied  complications,  one  or 
more  of  which  may  be  found  in  the  same  animal,  and  even  compli- 


DYSTOKIA  FROM  ABNORMAL  POSITION.^'.  427 

eating  each  other.  Thus,  with  a  vicious  position  of  the  head  we  may 
have  a  wrong  direction  of  the  fore,  and  perhaps  also  of  the  hind,  hinbs. 
But  as  the  double  or  triple  complications  are  ditVicult  to  describe,  and 
as  the  practical  value  of  the  descriptions  might  consequently  suffer,  it 
is  deemed  the  best  course  to  study  each  complication  separately  :  the 
complex  cases  arising  from  their  combination  being  then  easily  under- 
stood, and  the  indications  for  overcoming  them  being  also  simplified. 

These  complications  are  very  often  found  in  the  Mare  and  Cow,  less 
frequently  in  the  Sheep  and  Goat,  and  rarely  in  the  Bitch,  Sow,  or  Cat. 
"We  have  no  means  of  arriving  at  a  knowledge  of  their  relative  frequency 
in  any  species.' 

A.  Normal  Anterior  Presentation. 

In  this  presentation  the  extended  head  and  the  outstretched  fore- 
limbs  are  towards  the  genital  canal. 

SECTION  I.— DYSTOKIA  FROM  ABNORMAL  POSITIONS. 

Here  we  have  three  abnormal  or  reversed  positions — a  dorso-puhic,  and 
two  durso-supra-colyloidean. 

Dorso-Pubic  Position. 

This  position  is  difficult  when  the  depth  of  the  fcetal  chest  exceeds 
the  vertical  diameter  of  the  pelvic  inlet  of  the  mother — a  circumstance 
more  frequent,  evidently,  in  the  Cow  than  the  Mare — being,  according 
to  one  practitioner,  as  twenty  to  one.  In  the  natural  or  dorso-sacral 
position,  the  foetus  readily  accommodates  itself  to  the  canal,  but  when 
it  lies  on  its  back  its  shape  does  not  lend  itself  readily  to  enter  the 
pelvis,  it  having  a  tendency  to  jam  against  the  upper  surface,  and  the 
feet  to  penetrate  the  soft  tissues  there.  On  exploration  the  hand  detects 
the  position  by  the  fore-feet  being  upwards,  and  the  fetlocks  bending  in 
the  same  direction  as  the  knees  ;  while  if  the  head  is  within  ruach,  the 
nose  and  lower  jaw  can  be  distinguished. 

To  rectify  this  position,  rotation  of  the  ftetus  must  be  practised. 
The  lower  jaw  and  fore-feet  should  be  corded,  the  head  pushed  away 
from  the  pelvic  inlet,  and  the  body  turned  withers  upwards  by  the 
hand  ;  then  gentle  traction  is  to  be  made  on  the  cords,  so  as  to  ))ring  the 
head  and  feet  into  the  pelvis,  the  hand  guiding  them  into  the  canal  in 
the  first  position,  when  delivery  can  be  effected. 

'  Zippelius,  ((unted  by  Franck,  in  108  cases  of  dystokia  found  them  to  be  due  to  the 
several  causes  in  the  following  proportions  : 

Abortions           ...         ...          ...          ...          ...          ...  ...  ...  31 

Occlusion  of  the  os  uteri         ...          ...          ...          ...  ...  ...  30 

Torsion  of  the  uterus     ..          ...          ...          ...          ...  ...  ...  10 

Lateral  inclination  of  the  head  and  neck  of  the  foetus  ...  ...  16 

Lateral  inclination  of  thf  hrad  and  n>i.<Klirection  of  the  fore-limbe  4 

Head  and  neck  under  the  fore-limbs             ...          ...  ...  ...  3 

Head  bent  up  on  the  back       ...          ...          ...          ...  ...  2 

Torsion  of  the  uterus  with  posterior  presentation  ...  ...  ...  1 

Posterior  presentation  with  misdirection  of  the  hind-feet ...  ...  2 

Limb  over  neck             ...          ...          ...          ...          ...  ...  ...  1 

Lumbo-pubic  position  ...         ...          ...          ...         ...  ...  ...  3 

Posterior  and  tran.sverse  presentation            ...          ...  ...  ...  1 

Rachitis  affecting  the  pelvis  of  Cow  and  Calf          ...  ...  ...  1 

Hydrops  amnii  ...          ...          ...          ...          ...          ...  ...  ...  1 

Mummification  of  the  foetus   ...                      ...          ...  ...  ...  2 


428  FCETAL  DYSTOKIA. 

In  the  Mare  and  other  animals  there  is  more  room  for  the  passage 
of  the  foetus  in  this  position,  and  with  the  first-named  deHvery  may  be 
accompHshed  in  some  cases  by  guiding  the  limbs  through  the  genital 
canal,  so  as  to  prevent  injury  to  its  walls. 

Dorso-supra-Cotyloidcan  Positions. 

In  these  positions  the  foetus  lies  on  its  right  or  left  side,  and  they 
must  be  altered  to  the  dorso-sacral  position  before  birth  can  be  com- 
pleted. This  change  is  effected  in  the  same  manner  as  in  the  pre- 
ceding position. 

SECTION  II.— DYSTOKIA  DUE  TO  THE  HIND-LIMBS. 

As  Saint-Cyr  remarks,  it  is  somewhat  surprising  to  find  the  hind- 
limbs  an  obstacle  to  birth  in  the  anterior  presentation.  The  difficulty 
may  arise  from  the  hind-limbs  being  retained  by  the  stifles,  the  irre- 
ducible mass  of  which  is  greater  than  the  inferior  bis-iliac  diameter  of 
the  inlet ;  or  the  hind-limbs  may  be  bent  under  the  body  and  enter  the 
pelvis  along  with  it,  instead  of  being  extended  and  following  it.  In 
both  conditions  the  anterior  part  of  the  body  presents  in  a  normal 
manner,  and  nearly  always  in  the  dorso-sacral  position ;  and  birth 
appears  to  be  progressing  favourably — the  fore-limbs,  head,  neck,  and 
even  the  chest  and  body  as  far  as  the  flanks,  may  have  cleared  the 
vulva — and  when  the  act  is  apparently  almost  completed,  all  at  once 
there  is  a  check,  and  notwithstanding  the  most  vigorous  straining  of 
the  mother  no  more  of  the  foetus  can  be  expelled,  neither  can  external 
traction  remove  it.  As  has  been  stated  above,  the  retention  may  be 
due  to  one  of  two  causes. 

The  Extended  Hind-Limhs  are  retained  by  their  Stifles. 

This  kind  of  dystokia  has  been  hitherto  supposed  by  writers  and 
practitioners  to  be  due  to  the  hind-legs  of  the  foetus  being  in  a  state 
of  extreme  abduction  ;  but  more  careful  study  has  shown  it  to  occur 
when  these  limbs  are  in  a  state  of  extension,  and  their  stifles  so 
voluminous  as  to  check  progress.  This  occurrence  should  be  rare  in 
the  Mare,  unless  the  pelvis  is  unusually  narrow  or  the  foetus  is  very 
large ;  but  in  the  Cow  it  must  be  more  frequent,  as  the  pelvis  is  not 
so  wide  and  the  shafts  of  the  ilia  are  more  parallel  than  in  the  Mare, 
so  that  these  joints  are  more  likely  to  be  retained  when  arrested  in  this 
way.  It  is  remarked,  also,  that  they  are  large  calves  which  are  being 
born  slowly  and  with  difficulty,  that  are  so  fixed  when  the  greater 
part  of  their  body  has  got  beyond  the  vulva. 

This  cause  of  difficult  birth  can  be  ascertained  by  exploration  with 
the  hand,  but  the  almost  complete  expulsion  of  the  foetus  and  the 
sudden  check  to  its  progress,  which  no  amount  of  traction  can  alter, 
should  give  rise  to  suspicion  of  its  existence.  The  obstacle  is  a  serious 
one  to  overcome,  and  it  not  infrequently  happens  that  the  young  creature 
is  lost — sometimes  the  mother  also.  A  successful  result  depends  not 
only  upon  the  skill  and  patience  of  the  practitioner,  but  also  upon  the 
size  of  the  foetus  when  compared  with  the  dimensions  of  the  pelvic 
inlet,  and  whether  amateurs  have  been  previously  at  work  attempting 
delivery. 

Indications. — When  both  stifles  are  together  they  form  too  large  a 
mass  to  pass  through  the  genital  canal,  and  must  therefore  be  brought 
into  the   inlet   separately — one  after  the  other.     With  this  object  in 


DYSTOKIA   UUE  TO  THE  IIIXDLIMBS.  429 

view,  Saiut-Cyr  recommends  very  oblique  traction  on  the  fcutus — to  the 
right  or  left  side,  so  as  to  force  one  stifle  farther  into  the  canal  than 
the  other ;  and  this  has  always  proved  successful  when  the  creature 
had  not  been  already  too  mucli  pulled  at,  as  when  such  has  been  the 
case  the  stifles  are  firmly  and  immovably  wedj,'ed  in  the  inlet.  Then  it  is 
necessary  to  push  the  fu'tus  forward  into  the  uterus,  if  this  be  possible, 
or  at  least  one  of  the  stifles,  and  if  this  be  effected,  then  have  recourse 
to  oblique  traction,  so  as  to  get  one  stifle  into  the  passage  in  advance 
of  the  other. 

If  the  Cow  is  lying  on  one  side  and  exhausted,  the  same  authority 
advises  that  the  practitioner  take  the  body  of  the  calf  in  his  arms,  and 
pull  it  up  vertically  ;  if  not  successful  on  this  side,  have  the  Cow  turned 
on  the  other  side,  and  again  try  vertical  traction.  On  every  occasion 
in  which  this  procedure  was  adopted  the  result  was  satisfactory. 

Another  method  of  overcoming  the  difficulty  is  by  slightly  rotating 
the  body  of  the  fcetus.  This  can  be  accomplished  by  passing  a  double 
cord  around  its  loins,  as  near  to  the  maternal  vulva  as  possible,  and 
passing  a  strong  stick  through  the  loop,  so  as  to  give  the  cord  two 
turns  and  make  it  tight  round  the  body  ;  the  foetus  is  held  up  on  a 
level  with  the  vulva,  and  on  the  word  being  given  its  body  is  twisted 
from  left  to  right,  simultaneously  with  a  turn  of  the  lever  in  the  same 
direction,  when  the  obstacle  is  overcome  and  delivery  can  be  com- 
pleted. 

When  it  happens  that  unskilful  people  have  been  exercising  great 
force  before  the  arrival  of  the  practitioner,  and  the  hind-limbs  are  so 
firmly  fixed  that  it  is  impossible  to  move  them,  then  embryotomy  nmst 
be  had  recourse  to ;  the  body  being  divided  at  the  loins  and  the  posterior 
portion  pushed  into  the  uterus,  where  it  can  be  turned,  and  the  stifles 
carried  into  the  genital  canal  one  after  the  other. 

The  Ilind-Limhs,  flexed  wider  the  Body,  pass  tvitJi  it  into  the  Genital 

Canal. 

This  malpresentation,  known  to  the  German  veterinary  obstetrists 
as  the  "  vertical -abdominal "  or  "dog-sitting  position"  (Bauch- 
Vcrtikallaije,  Hunde-Sitziije  Lar/c),  is  not  very  common,  and  is  one  of 
the  most  formidable,  perhaps,  which  can  be  encountered.  First 
described  by  Canu  in  1837,'  it  has  been  alluded  to  by  a  numl)er  of 
veterinary  surgeons,  and  it  has  also  been  mentioned  in  every  work  on 
veterinary  obstetrics  published  on  the  Continent. 

Since  that  time  it  has  been  met  with  in  the  Mare,  as  well  as  the 
Cow,  and  consists  essentially  in  the  advance  of  the  hind-limbs  of  the 
foetus  into  the  pelvic  canal,  at  the  same  time  as  the  anterior  part  of 
the  body,  the  position  of  the  young  creature  being  consequently  more 
or  less  vertical,  the  body  being  posteriorly  bent  at  the  loins.  How  it 
gets  into  this  position  is  not  accurately  known,  but  the  hind-feet  must 
be  closely  applied  to  the  abdomen  as  the  chest  is  entering  the  inlet ; 
and  probably  the  compression  the  fu'tus  then  experiences  causes  it  to 
struggle  with  the  posterior  limbs  to  free  itself  from  the  discomfort. 

As  in  the  preceding  deviation,  nothing  is  at  first  known  of  the 
existence  of  the  displacement.  Paiturition  commences  and  appears  to 
be  going  on  favourably  ;  the  foetus,  in  the  dorso-sacral  position,  arrives 
at  the  inlet,  the  head  and  fore-limbs  in  advance  as  in  normal  birth.  Pro- 
gressive expulsion  may  continue  until  the  head  of  the  young  animal  is 
'  RecufU  dt  if'decint  VtUrinaire,  1837,  p.  -145. 


430 


FCETAL  DYSTOKIA. 


beyond  the  inlet,  and  as  far  as,  or  even  external  to,  the  vulva — some- 
times the  head,  fore-limbs,  neck,  and  even  half  of  the  body  hanging 
outside  the  vagina.  But  further  progress  is  checked,  and  neither  the 
most  energetic  straining  on  the  part  of  the  animal,  nor  the  most  violent 
traction  by  those  persons  who  may  be  with  it,  can  advance  the  foetus 
beyond  this  point. 

The  obstetrist  has  great  difficulty  in  ascertaining  the  cause  of  delay 
in  birth — the  difficulty  varying,  and  depending  upon  the  volume  of  the 
foetus,  and  whether  its  body  more  or  less  completely  fills  the  pelvic 
canal.  The  hand  can  generally  only  be  introduced  after  much  trouble 
and  tact  into  the  passage,  and  having  got  to  a  certain  distance  it 
encounters  either  under  the  body  or  head  (Fig.  126),  to  one  side  of  the 
neck  or  head,  or  even  projecting  upwards  above  the  head  (Fig.  125), 
first  one,  then  a  second  foot  or  limb,  which  are  recognised  by  a  careful 
examination  to  be  those  of  the  hinder  part  of  the  body.  Sometimes  the 
feet  and  metatarsal  bones  have  alone  entered  the  pelvis,  the  other  parts 


Fig.  125. 
Deviation  of  the  Hind-Limbs  in  the  Pelvis  in  the  Anterior  Presentation. 


of  the  limbs  being  in  the  uterus  (Fig.  126) ;  in  other  cases  the  hocks 
may  be  in  the  inlet,  or  even  well  through  the  passage — depending  upon 
the  size  of  the  foetus  and  the  capacity  of  the  maternal  pelvis  ;  more 
rarely  the  stifles  have  cleared  the  inlet,  and  the  hind-feet  are  at  the 
vulva.  The  more  advanced  the  hind-limbs  are  the  more  are  they  flexed, 
and  so  the  more  is  the  body  of  the  foetus  bent  on  itself,  until  it  is  like  a 
dog  in  a  sitting  posture.  It  is  needless  to  remark  that  unless  the  foetus 
is  exceptionally  small  in  proportion  to  the  pelvic  capacity,  it  cannot  be 
extracted  in  this  position,  when  the  hind-limbs,  and  especially  the 
stifles  and  hocks,  add  so  largely  to  the  volume  of  the  body  ;  traction 
will  probably  kill  the  creature,  and  in  all  likelihood  injure  the  mother. 
Some  cases  are  recorded  in  which  delivery  was  effected,  however,  but 
then  circumstances  were  favourable,  both  as  to  time  and  the  position 
of  the  foetus.  The  greatest  care  is  therefore  necessary,  in  order  to 
ascertain  the  exact  state  of  afl'airs  ;  indeed,  in  all  cases  of  dystokia  it 
cannot  be  too  often  impressed  on  the  mind  of  the  young  practitioner, 
that  a  careful  examination  is  absolutely  essential  before   attempting 


DYSTOKIA  DUE  TO  THE  HIXDLIMHS. 


431 


extraction.  In  this  particular  fonn  of  dystokia,  the  life  of  the  mother 
may  be  preserved  by  timely  and  rational  intervention  ;  while  violent  and 
improper  interference,  even  iit  the  earliest  period,  may  be  followed  by 
serious,  if  not  fatal,  consequences. 

The  distinction  between  this  form  of  dystokia  and  tlie  last  is,  accord- 
ing to  Saint-Cyr,  not  ditlicult.  When  the  fcctus  is  expelled  as  far  as 
the  loins,  then  it  is  the  stifles  whicli  arc  the  cause  of  obstruction  ;  but 
when  only  the  anterior  part  of  the  thorax  appears  at  the  vulva,  we  may 
be  certain  it  is  not  these  articulations.  When  the  feet  are  not  visible, 
then  a  manual  exploration  is  necessary. 

With  regard  to  preserving  the  foetus,  the  prognosis  must  generally  be 
unfavourable.  The  Foal  is,  in  nearly  every  case,  certain  to  perish  at  an 
early  period,  from  compression  of  its  body  or  the  umbilical  cord  ;  and 
though  the  Calf  is  more  tenacious  of  life,  and  may  continue  to  exist  for 


Trrrrrm 


Fig.  126. 
HiND-LiMn  Dkviation  :  .Vstehior  Preskntation. 


some  time,  yet  in  the  majority  of  cases  it  succumbs,  or  it  has  to  bo 
sacrificed  to  save  the  mother,  which,  if  the  practitioner  can  render  aid 
sufficiently  early,  may  survive. 

Indications. — In  nearly  every  case  the  preservation  of  the  mother  is 
the  first  object  to  be  attained,  the  life  of  the  foetus — if  it  be  living  when 
the  veterinary  surgeon  is  called  in — being  quite  a  secondary  considera- 
tion ;  though  it  must  be  admitted  that  if  he  is  present  when  it  is  still 
vigorous  and  not  much  engaged  in  the  pelvic  cavity,  there  is  no  reason 
why  it  should  not  be  extracted  alive.  The  indication  is,  of  course,  to 
rectify  the  deviation  of  the  hind-limbs  ;  and  if  the  fatus  is  not  too  far 
advanced  in  the  genital  canal,  this  maybe  accomplished  by  pushing  it,  if 
need  be,  towards  the  uterus,  and  introducing  the  hand  between  it  and  the 
wall  of  the  vagina  (often  a  most  difficult  matter),  to  carry  the  hind-feet 
back — one  after  another — into  the  uterine  cavity,  either  by  the  hand  or 


432  POSTAL  DY8T0KIA. 

with  the  aid  of  the  repeller  ;  then  the  head  and  fore-limbs  being  in  a 
good  position,  birth  can  readily  be  effected.  In  this  manner  Carsten 
Harms  has  extracted  a  Foal.  But  in  carrying  the  limbs  into  the  uterus, 
care  must  be  taken  to  lift  the  feet  off  the  floor  of  the  pelvis,  one  after 
the  other,  by  flexing  the  hock  and  holding  the  hoof  in  the  hand  while  it 
is  carried  beyond  the  inlet.  "When  the  front  part  of  the  foetus  has  not 
advanced  far  into  the  pelvis,  and  the  deviation  has  been  ascertained  in 
good  time,  the  anterior  presentation  has  sometimes  .been  successfully 
converted  into  a  posterior  one,  so  that  birth  could  take  place. 

But  such  cases  are  rarely  met  with  in  practice ;  and,  as  a  rule,  the 
veterinary  obstetrist  finds  that  parturition  has  made  much  progress,  the 
foetus  being  fixed  in  the  genital  canal  and  occupying  its  entire  diameter, 
and  its  hind-limbs  well  forward  under  the  body,  each  labour-pain 
wedging  it  more  firmly;  and  the  case  is  perhaps  complicated  and 
aggravated  by  the  indiscreet  manipulation  of  amateurs.  In  such  cir- 
cumstances, it  is  needless  attempting  to  push  the  foetus  towards  the 
uterus,  neither  can  the  hind-limbs  be  thrust  into  the  uterine  cavity  ;  as 
no  sooner  are  they  carried  from  under  the  body  for  ever  so  short  a  dis- 
tance, than  a  succeeding  pain  brings  them  into  their  former  position. 
Indeed,  it  is  sometimes  most  difiicult  to  reach  the  hind-limbs  to  apply 
cords  to  them,  and  so  by  straightening  to  bring  them  parallel  to  the 
body.  In  some  cases  it  has  been  possible  to  effect  delivery  by  cord- 
ing the  hind-limbs  if  they  are  not  advanced  very  far,  and  then  imlling 
llicm  upwards  until  the  feet  reach  below  the  wings  of  the  atlas,  but  not 
beyond  ;  traction  now  being  made  simultaneously  on  all  the  limbs  and 
the  head,  the  foetus  may  be  extracted.  With  one  hind-limb  engaged, 
the  same  procedure  can  be  adopted.  In  a  case  of  this  description  in 
the  Mare,  Obichi  succeeded  in  extracting  the  Foal  by  cording  the  hind- 
feet  (which  were  under  the  body),  and  pulling  at  them  as  well  as  the 
head  and  fore-feet. 

Donnarieix  recommends  pulling  the  posterior  limbs  forward  beneath 
the  body,  the  contents  of  the  abdomen  and  chest  having  been  previously 
removed  to  facilitate  the  operation ;  then  cording  the  hind-pasterns,  to 
draw  first  one,  then  the  other,  towards  the  vulva.  He  admits,  however, 
that  this  is  difficult,  and  one  of  his  cases  treated  in  this  way  occupied 
four  hours  ;  he  was  even  compelled  to  excise  one  of  the  limbs  at  the 
hock,  before  he  could  straighten  it.     The  Mare,  however,  lived. 

Canu,  in  1837,  gives  another  method  in  which  embryotomy  may  be 
carried  out.  The  illustrative  case  was  that  of  a  Mare,  the  Foal — which 
was  dead — being  born  as  far  as  the  half  of  the  chest.  As  it  was  not 
possible  to  push  it  back,  the  body  of  the  young  creature  was  divided  as 
near  the  hind-quarters  as  possible,  by  making  an  incision  from  the 
sternum  to  the  spine,  behind  the  last  rib  on  each  side  ;  then  the  abdo- 
men was  emptied  of  its  contents,  and  the  spine  cut  through  between  the 
last  dorsal  and  first  lumbar  vertebra,  the  amputation  being  facilitated 
by  an  assistant  holding  the  lips  of  the  vulva  as  far  apart  as  possible. 
The  Mare,  which  was  very  exhausted,  did  not  offer  much  opposition 
when  the  croup  was  pushed  into  the  uterus,  and  the  hind-limbs  being 
corded,  version  was  easy,  and  the  operation  soon  finished.  The  Mare 
was  at  work  within  twenty  days  afterwards. 

Canu's  method  of  extraction  has  often  been  practised,  both  in  the 
Mare  and  Cow,  by  veterinary  sui'geons  ;  and  it  has  been  proved  to  be 
both  rational  and  successful — so  far  as  the  mother  is  concerned-  Iii 
^    Wochtnsch.rift  fiir  Thierheilkuv.de  luid  Viehr.ucht. 


DYSTOKIA  DUE  TO  THE  FORELIMHS.  433 

practising  it,  the  following  directions  have  been  given,  and  their  obser- 
vance is  important : 

1.  Find  the  hind-limbs  and  secure  them  by  cords  around  tlie  pasterns ; 
2.  Cord  the  head  and  fore-limbs,  and  pull  these  out  as  far  as  possible 
beyond  the  vulva ;  8.  Remove  the  abdominal  viscera,  and  divide  the 
spine  as  near  the  lumbar  region  as  possible,  taking  the  precaution  to 
leave  a  good  piece  of  skin  attached  to  the  loins,  so  as  to  cover  the 
exposed  bones  and  prevent  the  maternal  organs  being  injured  during 
the  subsequent  steps  in  extraction  ;  4.  Obtain  a  solid  bearing  on  the 
divided  spine,  either  with  the  hand  or  the  repeller,  and  push  steadily 
and  firmly  against  it  so  as  to  direct  it  into  the  uterus,  when  the  cords 
on  the  hind-pasterns  being  pulled  by  assistants,  guided  by  the  hand  of 
the  operator,  the  remains  of  the  fci'tus  can  be  removed.  This  part  of 
the  operation  is  the  most  difficult  and  fatiguing  for  the  obstetrist,  as 
well  as  the  most  dangerous  for  the  mother,  and  requires  both  strength 
and  dexterity  to  push  back  the  loins  and  pelvis  of  the  foetus  while 
advancing  the  hind-limbs,  thighs,  and  croup  towards  the  outlet ;  5. 
Nothing  now  has  to  be  done  but  to  exercise  moderate  traction,  and  ter- 
minate, in  the  lumbo-pubic  position  of  the  posterior  presentation,  a 
birth  commenced  in  the  dorso-sacral  position  of  the  anterior  presenta- 
tion. 

Dietrich  recommends  eventeration  of  the  fa-tus,  removal  of  one  of 
the  hind-limbs,  and  the  adjustment  of  the  hinder  parts  through  the 
abdominal  opening ;  if  this  cannot  be  effected,  then  these  parts  are  to 
be  drawn  into  the  vacant  cavity  of  the  abdomen. 

When  only  one  hind-leg  is  in  the  pelvis,  retropulsion  of  the  body 
may  be  tried,  the  fore-legs  and  head  being  corded,  and  the  misplaced 
hind-limb  finally  extended  backwards  in  the  uterus.  If  this  cannot 
be  accomplished,  the  hind-leg  must  be  drawn  forward  and  amputated 
at  the  hock  or  beyond,  and  the  thigh  then  carefully  pushed  towards 
the  uterus. 

Removal  of  the  abdominal  viscera  favours  these  manoeuvres. 

When  this  malpresentation  occurs  in  the  Sheep  or  Goat,  embryotomy 
will  generally  be  necessary,  as  there  is  not  suflicient  room  to  attempt 
delivery  in  any  other  way. 

B.    AUNOHMAL    AnTERIOH    PRESENTATION. 

In  dystokia  accompanying  the  anterior  presentation,  the  obstacle 
may  be  due  to  the  fore-limbs  or  head,  or  to  both,  as  well  as  to 
the  hind-limbs  ;  and  it  may  be  met  with  in  any  position  the  foetus  can 
occupy  in  this  presentation,  though  it  is  most  frequent  in  the  dorso- 
sacral  position,  which  we  will  commence  with. 

SECTION  I.— DYSTOKIA  Dl'E  TO  THE  FORE-LIMBS. 

In  the  anterior  presentation,  and  what  we  have  designated  the 
"  normal  position,"  the  two  fore-limbs  of  the  foetus  are  extended  in 
front  towards  the  pelvic  inlet,  the  head  being  also  extended  and  resting 
either  upon  or  between  the  legs,  the  distal  extremities  of  which  extend 
beyond  its  nose — the  whole  forming  a  wedge-shaped  mass.  Con- 
sequently, the  fore-feet  should  be  the  first  parts  to  pass  through  the 

28 


434  FCETAL  DYSTOKIA. 

genital  canal ;  and  if  only  one  appears  along  with  the  head,  or  if  the 
latter  alone  offers,  then  one  or  both  of  the  anterior  limbs  are  in  a  wrong 
direction,  and  birth  may  be  hindered  if  they  are  not  adjusted.  The 
directions  they  may  assume  are  generally  four  :  1.  They  may  he  in- 
completely extended  in  the  loelvis ;  2.  They  may  be  crossed  over  the  neck; 
3.  They  may  he  hent  at  the  knees  ;  4.  They  may  he  extended  covipletely 
under  the  fcet^is.  Each  of  these  misdirections  may  be  met  with  in  the 
four  principal  positions  of  the  anterior  presentation,  and,  as  has  been 
mentioned,  one  or  both  limbs  may  be  involved  ;  if  the  latter,  then  the 
direction  may  be  the  same  or  different. 

The  cause  of  misdirection  of  the  limbs  is  not  well  ascertained.  In 
many  cases  it  may  be  due  to  insufficient  dilatation  of  the  os  uteri, 
which  hinders  their  advancing  with  the  head :  the  joints  of  the  limbs 
readily  flexing  when  the  feet  come  in  contact  with  the  cervix,  while 
the  uterine  contractions  propel  the  more  rigid  head  and  neck  into  the 
vagina.  The  misdirection  may  also  primarily  occur  during  intra-uterine 
existence,  and  before  parturition  sets  in,  and  particularly  if  the  foetus 
dies  before  birth,  when  its  position  is  not  the  same  as  at  that  period. 
There  can  be  no  doubt,  however,  that  the  accident  generally  happens 
during  parturition. 

One  or  Both  Fore-Limbs  crossed  over  the  Neck. 

This  complication  is  not  very  uncommon  in  the  Mare,  but  is  less 
frequent  in  the  Cow ;  it  usually  occurs  when  the  foetus  is  in  the  dorso- 
sacral  position.  One  or  both  limbs  may  be  carried  over  the  neck,  but 
it  is  generally  only  one. 

It  is  undoubtedly,  in  many  instances,  an  obstacle  to  parturition,  as 
the  shoulders  are  no  longer  lodged  in  the  hollow  space  at  each  side  of 
the  neck,  but  are  fixed  at  the  side  of  the  chest,  the  transverse  diameter 
of  which  they  increase.  The  obstacle  is  still  greater  if  one  or  both  of 
the  limbs  should  chance  to  cross  towards  the  summit  of  the  head.  At 
all  times  the  complication  is  more  serious  if  the  labour  pains  are 
violent  and  irregular — as  they  generally  are  in  the  Mare  when  there  is 
any  impediment  to  birth  ;  then  there  only  too  frequently  results  lacera- 
tion of  the  roof  of  the  vagina,  perforation  of  the  rectum,  rupture  of  the 
perinseum,  etc.  In  the  most  favourable  cases,  labour  is  protracted  and 
more  severe,  and  contusions  of  the  genital  canal  are  almost  unavoidable. 
In  some  cases  birth  may,  and  does,  take  place  without  assistance. 
Eainard  alludes  to  the  case  of  an  Ass  in  which  spontaneous  delivery 
occurred,  notwithstanding  the  existence  of  this  complication. 

The  obstacle  is  discovered  by  exploring  the  genital  canal,  when  the 
hand  will  encounter  in  the  vagina  the  head  of  the  foetus  and  one  limb 
in  the  usual  situation  (if  only  one  be  misplaced),  and  the  other  limb 
feeling  as  if  shorter,  higher  up,  and  crossing  the  neck  towards  the 
fetlock-joint.     This  is  the  usual  state  of  affairs. 

Indications. — When  only  one  limb  is  crossed,  reduction  is  not  difficult, 
and  may  be  effected  in  the  pelvis.  The  leg  is  seized  a  little  above  the 
fetlock,  raised,  drawn  to  its  proper  side,  and  extended  in  the  genital 
canal.  Delivery  may  then  take  place  without  help,  or  gentle  traction 
on  the  head  and  limbs  may  be  necessary. 

"When  both  fore-limbs  are  crossed,  and  the  foetus  is  not  too  far 
advanced  in  the  pelvis,  cords  should  be  fixed  to  the  pasterns,  and  the 


DYSTOKIA  DfE  T"  TIIK  FoRKLIMliS. 


435 


trunk  pushed  into  the  uterus ;  assistants  then  pull  moderately  at  the 
cords,  and  in  such  a  manner  as  to  bring  each  limb  to  its  own  side,  if 
the  hand  of  the  operator  cannot  effect  this  in  the  uterine  cavity.  In 
this  way  a  kind  of  rotation  of  the  limbs  is  effected,  and  they  are  brought 
each  to  its  proper  side,  and  a  little  beneath  the  head. 

"When  the  faHus  is  firmly  fixed  in  the  pelvis,  and  retropulsion  is 
impossible,  the  limbs  must  be  amputated,  one  after  the  other.  Such 
an  operation  must,  however,  be  very  exceptionally  required  in  this 
complication. 

Fore-limbs  incompletchj  extended. 

This  accident  would  appear  to  be  most  frequent  in  the  Cow,  and  is 
due  to  the  legs  not  advancing  with  the  head  in  the  ordinary  way,  after 


Fig.  127. 
Anterior  Pi'.e.><entation  :  Fork-Limb  crossed  ovku  the  Nkck.' 


they  have  entered  the  inlet ;  so  that  the  elbow-joints,  instead  of  being 
in  front  of  the  thorax,  are  alongside  of  it,  and  they  and  the  chest  are 
intercepted  at  the  inlet.  It  occurs  when  the  fa-tus  is  in  the  vertebro- 
sacral position,  and  should  not  be  considered  serious  if  the  case  has 
not  been  tampered  with.  Its  occun-ence  is  recognised  by  the  nose  and 
the  feet  being  together,  or  the  former  may  even  be  in  advance  of  the 
latter. 

Indications. — To  bring  the  legs  straight  into  the  vagina  is  the  object 
to  be  attained  ;  and  if  the  body  and  limbs  are  not  firmly  fixed  in  the 
maternal  pelvis,  this  can  be  accomplished  without  much  trouble.  But 
when  they  are  tightly  wedged   in  the  passage,  then  there  is  more 

'  In  thia  fi^ire  the  anterior  limbs,  especially  the  right  one,  are  inaccurately  drawn  bv 
the  artist.  They  are  too  long,  and  the  right  leg  should  be  shown  as  crossing  the  neck  at 
the  fetlock  joint. 


436  FCETAL  DYSTOKIA. 

difficulty  in  releasing  them.  In  any  case,  the  lower  jaw  and  feet  should 
be  corded  ;  this  being  done,  the  chest  is  pushed  forward  into  the 
uterus,  when  the  upper  parts  of  the  limbs  accompany  it.  The  hand 
can  now  fully  extend  the  legs  and  bring  them  into  the  vagina  along 
with  the  head,  and  traction  will  complete  the  delivery. 

One  or  Both  Fore-Limbs  flexed  at  the  Knees. 

The  fore-limbs  flexed  at  the  knees,  and  fixed  under  the  neck  and  chest, 
are  a  very  frequent  and  often  troublesome  comphcation.  It  is  generally 
foimd  in  the  Mare  and  Cow ;  when  it  occurs  in  the  Sheep  and  Goat  it  is 
rarely  of  any  importance,  as  delivery  can  usually  take  place  without 
assistance  ;  in  the  young  of  Carnivora,  the  metacarpal  bones  are  too 
short  to  offer  any  obstacle  when  the  knee  is  flexed. 

This  misdirection  of  the  fore-hmbs  may  occur  in  all  the  positions  of 
the  anterior  presentation,  but  chiefly  in  the  dorso-sacral  position.  One 
or  both  hmbs  may  be  flexed,  and  the  comphcation  is  not  unusually 
accompanied  by  a  misdirection  of  the  head ;  hence,  there  are  several 
varieties  of  the  complication,  the  most  important  being  those  due  to  the 
general  position  of  the  foetus.  It  may  occur  in  three  positions — the 
dorso-sacral,  dorso-pubic,  and  dorso-ilial. 

Dorso-Sacral  Position  of  the  Foetus. — If  at  the  moment  when  the 
limbs  of  the  foetus  enter  the  pelvic  inlet,  they  are  not  quite  extended 
and  the  feet  are  slightly  below  the  level  of  the  anterior  border  of  the 
pubis,  the  uterine  contractions  push  them  against  this  border,  and  there 
they  remain  ;  at  the  same  time  the  head  enters  the  inlet,  and  as  it  pro- 
ceeds the  limbs  become  flexed,  the  knees  are  bent  and  advance  with  it, 
but  the  metacarpals  and  phalanges  are  directed  backwards  beneath  the 
forearms,  and  the  hmbs  thus  doubled  are  applied  against  the  neck.  We 
have  therefore  the  head,  fore-arms,  and  metacarpals  in  one  mass, 
entering  or  being  propelled  into  the  limited  space  afiorded  by  the  inex- 
tensible  pelvic  circle,  and,  according  to  circumstances,  the  hand  of  the 
obstetrist  will  meet  with  these  parts  in  varying  relative  positions, 
depending  on  the  stage  of  labour.  When  parturition  has  only  recently 
commenced,  the  head  has  entered,  or  is  about  to  enter,  the  inlet,  and 
the  limbs  placed  beneath  it  are  still  somewhat  free  in  the  uterine  cavity, 
while  the  foetus  itself  is  not  immovably  fixed  if  the  waters  have  not  long 
escaped.  But  when  labour  has  been  progressing  for  some  time,  the 
head  is  well  advanced  in  the  passage — sometimes  as  far  as  the  vulva  ; 
but  considerably  behind  it  are  the  limbs,  imbedded  on  each  side  of  the 
jieck — the  knees  towards  the  head,  the  feet  at  the  elbows. 

With  the  smaller  Euminants,  as  already  remarked,  birth  may 
take  place  spontaneously  even  now,  as  they  often  have  more  than 
one  fcetus,  and  these  comparatively  small,  compared  with  the  pelvic 
diameter;  while  the  bones  are  elastic  and  yielding.  But  with  such 
animals  as  the  Cow  and  Mare  the  foetus  is  nearly  always  single  and 
voluminous,  and  its  skeleton  is  rigid  and  unaccommodating,  and  can 
only  undergo  a  very  small  reduction  in  size  during  its  passage  through 
the  pelvis. 

Therefore  it  is  that,  in  the  larger  domesticated  animals,  such  a  devia- 
tion of  the  limbs  is  always  a  serious  cause  of  dystokia — not  so  much 
from  the  increased  volume  that  the  doubled-up  limbs  gives  to  the  neck, 
as  because  the  arms,  incompletely  extended  on  the  shoulders,  retain 


DYSTOKIA  ItlK  Tn  THE  FnllKlAMliS. 


437 


the  latter  against  the  thorax,  and  prevent  their  being  lo(l{::;ed  in  the 
depression  at  the  base  of  the  neck — thus  augnientin<^  the  vertical  and 
transverse  diameter  of  the  chest,  while  at  the  same  time  the  projecting 
elbows  press  against  the  border  of  the  pelvis. 

It  may  happen  tliat  only  one  limb  is  tlexed  at  the  knee,  and  then,  of 
course,  the  case  is  not  so  serious. 

Indications. — The  indications  are  in  this  case  also  obvious :  Find 
the  retained  limbs,  extentl  the  fore-arm  of  each  on  the  arm,  and  ex- 
tend them  in  the  pelvic  cavity,  as  in  normal  parturition. 

These  indications  are  not  so  ditticult  to  carry  out  when  the  obstetrist 
is  called  in  sutliciently  early,  and  the  head  has  made  but  little  advance 
into  the  pelvis. 

We  will  suppose  both   fore-legs  partially  retained   in  the  abdomen. 


Fig.  128. 
.A.NTEBIOR  Presentation,  Dorso-Sacral  Position  :  FoiiKLisiits  klexku  at  the  Knee.s. 


and  flexed  at  the  knees.  The  exploration  which  has  led  to  this  discovery 
has  perhaps  also  indicated  that  one  limb  is  not  so  much  flexed  as,  or  is 
more  accessible  than,  the  other.  If  this  is  the  left  limb,  then  the  left 
hand  and  arm  must  be  employed  ;  if  it  is  the  right  leg,  then  the  right 
hand  and  arm  will  be  most  convenient  ;  but  if  both  limbs  are  alike 
implicated  and  accessible,  then  it  is  immaterial  which  is  first  manipu- 
lated, so  long  as  the  corresponding  hand  and  arm  are  employed.  The 
same  directions  are  applicable  to  both,  keeping  in  mind  that  the  right 
and  left  hands  are  opposite.  The  object  is  to  adjust  the  direction  of  the 
fore-limbs,  so  that  delivery  can  be  accomplished.  This  adjustment  is 
effected  in  four  movements  : — 1.  The  hand  is  passed  alongside  the  neck 
of  the  fcctus,  the  fore-arm  is  seized  in  the  middle,  the  radial  border  of 
the  hand  being  upwards,  the  cubital  downwards ;  then  bending  the  hand. 


^>Mk«%/  /  th«  k9%m  Mi^  IhnMl 

M,  or 
w.^  fool  lo 
thr  b&od. 

o  ovikl.  Md  i( 
u^bOT  hmb^  if  tJso 


tuuUUUKMI. 
:b«  PMltra  vim  And 


'W, 


CO     p<M.' 

-*nn  oi 


rif,  Lai 

nu  Fobs  Lan. 

hnntiy  mar  the  oelvui  \:  be  easily  arece^srhle     the  method  by  pn>- 
nrr«  aztuiB;  :  is  cha  e  gcoerklly 

■nf»«f      T  ^..•.  ^rt  r^ ^w  . ,  bat  in  the 

-■:i  eiLsy  HT-t^iigh  when  the 

tit  when  it  is  eompietely 

Retropolson  m*y  be 

•<  ocly  poawble  when 

ag  oat  tfast  ::  :s 

ace  for 


xi.':    3iw»c    ..x.. c  X  i.r: 


4S  fior  nmc  tune,  the  "  w&ten  "  hsve 

iflypraipfled  eowarda  the  ▼oIt^  th« 

.ppiied  dosciy  to  the 

^  attonpti  at  retro 


«- 


« 


V  Ij-. 

luii-; 

iorv  . 
aT»pi 


•rrfl    in    r-- 


-Mi,  ittrf 


Life  tiin^T 

J-      ' 


iuu;£^ 


art  recDTtKJL     TTitt  iffitm  & 
TiRjBfinK  a'  ine  mist,  or  js  hj 
imt  ioK-iimjK   occinrr  -tot  mi 

11   TIl?^    T(i- 


nxotiarr,  ::fl 


xnv,-ar»  iiK  Titerc-Tt^rrrKK   „_-_--     —    -_       _     — 

nufc-crnei     istmctiuL  finouii-  'tiieESioEe  tk  3sat  ^axaooit  ^aartj.  aaaui-a 

^'"-? —  presanttoi. 


nicrre  drfiicutT  aa.aa&.'g:'  tmnv  titt  imima^:aE!  igraaaE       vgTRTOU 

iu/,:     or  JMti  JHnrra^Jual  ^josiumi  of  ^im  3Jtaat^ — ~ 

xioi    c   tiK   I:..        .     '-^BEB  :qd '-JK*  3Bee.  sat   "    ""    "~     -^^    -- 


440 


FCETAL  DYSTOKIA. 


of  the  foetus,  in  order  to  bring  it  into  a  more  favourable  position — the 
dorso-sacral,  if  possible — before  proceeding  to  the  adjustment  of  the 
other  leg,  which  is  to  be  effected  in  the  manner  already  indicated. 

One  or  Both  Fore-Limhs  completely  retained. 

The  complete  retention  of  one  or  both  fore-limbs  of  the  foetus  in  the 
uterine  cavity  is  often  met  with  in  the  domesticated  animals,  but 
perhaps  more  frequently  in  the  Mare  than  the  Cow  or  other  creature. 
It  is  always  a  serious  cause  of  dystokia,  and  may  occur  in  either  of 
the  four  anterior  positions,  though  it  is  usually  observed  in  the  dorso- 
sacral  position.     It  is,  no  doubt,  produced  during  birth,  and  in  the 


Fig.  130. 
Anterior  Presentation,  Dorso-Sacral  Position  :  One  Fore-Limb  completely 


same  manner  as  knee  flexion ;  its  more  frequent  occurrence  with  the 
Foal  than  the  Calf  is,  in  all  probability,  due  to  the  former  having  longer 
limbs  than  the  latter.  Under  exceptionally  favourable  circumstances, 
as  Franck  remarks,  the  Foal  or  Calf  may  be  born  with  the  fore-limbs 
under  the  chest  and  abdomen,  and  without  injury  to  the  mother  or 
offspring.  This  is  much  more  likely  to  occur  when  the  foetus  is  small, 
the  maternal  pelvis  roomy,  and  only  one  limb  misplaced. 

But  when  the  foetus  is  large  and  the  pelvis  narrow,  then  birth, 
especially  of  the  Foal,  is  impossible.  Not  only  this,  but  unless  ex- 
traction is  soon  accomplished,  the  foetus  runs  great  risk  of  dying  from 
asphyxia — indeed,  the  Foal  is  nearly  always  delivered  dead  in  this  com- 
plication ;   so  that  death  of  the  foetus  may  be  said  to  be  the  rule  in 


DYSTOKIA  DUE  TO  THE  FoUELIMm^. 


441 


shoulder  presentations.  With  the  smaller  Ruminants,  owing  to  the 
formation  of  the  pelvis,  birth  is  not  often  impeded.  With  the  Sow 
and  Garni vora — multiparous  animals — this  might  almost  be  designated 
a  normal  presentation. 

It  will  readily  be  perceived  how  one  or  both  of  the  anterior  members 
bent  back  under  the  body  will  prove  an  obstacle  to  the  passage  of  the 
foetus,  after  what  has  been  said  with  regard  to  the  relative  dimensions 
of  the  young  creature  and  the  pelvis  of  the  mother.  The  shoulder  or 
shoulders,  and  the  muscles  in  this  region,  are  the  cause  of  dystokia — 
more  especially  the  flexor  brachii,  which  constitutes  a  thick  and  some- 
what tendinous  elastic  mass  between  the  scapula  and  upper  end  of  the 
fore-arm.     This  muscular  mass  forms  a  very  prominent  obstacle  on 


Fig.  131. 

A.STBBIOB   PRtSKSTATION,  D0R80-SaCR.\L  PoSITIO.V  :    BoTH  FoEK-LlMUa  OOMPLKTKLY 

RETAINED. 


the  side  of  the  chest  when  the  limb  is  thrown  back.  There  is  also  the 
large  levator  humeri  muscle  adding  to  the  increased  volume  of  the 
thoracic  region,  as  well  as  the  elbow  and  fore-arm. 

On  exploration  in  this  complication,  the  head  is  found  to  be  in  a 
good  direction,  the  hand  encountering  it  either  in  the  pelvis  or  towards 
the  inlet,  or  it  may  even  protrude  into  the  vulva,  according  to  circum- 
stances. The  fcetus,  if  a  Calf,  may  be  yet  alive  ;  if  a  Foal,  it  is  nearly 
always  dead.  If  only  one  limb  is  completely  retained,  the  other  will 
be  in  a  normal  position — alongside  or  under  the  head  (Fig.  130).  If 
both  limbs  are  retained,  though  the  head  may  appear  in  the  genital 
canal  or  at  the  vulva,  yet  nothing  can  be  discovered  of  them  in  the 
pelvis,  they  being  entirely  lodged  in  the  uterus.      At  each  pain  the 


442  FCETAL  DYBTOKIA. 

head  of  the  foetus  is  propelled  outwards,  but  as  soon  as  this  ceases  it 
recedes  again,  as  if  thrown  back  by  a  spring. 

With  small-sized  Cows,  the  hand  introduced  deeply  into  the  uterus 
may  find  the  extremity  of  the  fore-limb  ;  but  in  large  Cows,  and  in  the 
Mare,  particularly  if  the  abdomen  be  pendulous,  this  is  rarely,  if  ever, 
the  case  ;  indeed,  sometimes  the  limbs  can  only  be  reached  with  the 
greatest  difficulty,  though  there  is  generally  no  trouble  in  introducing 
the  arm.  When  the  limbs  can  be  felt,  they  are  usually  found  to  be 
in  one  of  three  positions  :  directed  nearly  vertically  downwards,  the 
fore-arms  resting  against  the  brim  of  the  pubis ;  lying  beneath  the 
abdomen  (Fig.  131) ;  or  closely  applied  against  the  walls  of  the  chest 
and  the  flanks.  In  many  of  these  cases,  the  head  is  also  in  a  vicious 
position. 

In  the  larger  animals,  when  the  two  limbs  are  retained  birth  is 
nearly  always  impossible ;  it  may  certainly  be  sometimes  effected  by 
violent  means,  but  then  these  are  the  resort  of  brute  force,  and  not  of 
humane  and  intelligent  device,  and  nearly  always  entail  the  death  of 
the  mother.  With  the  smaller  animals,  when  this  complication  is  a 
cause  of  dystokia,  delivery  can  generally  be  effected  by  simple  measures 
and  gentle  force. 

Indications. — The  indications  are  to  reach  the  limb  or  limbs  with 
the  hand — resorting  to  retropulsion  if  necessary,  to  gradually  raise  and 
bring  them  forward,  joint  by  joint,  into  the  pelvis,  and  then  to  extract 
the  foetus  by  judicious  traction.  These  indications  are  not  attended 
with  difficulty  in  those  cases  in  which  the  head  is  yet  in  the  abdomen, 
or  only  at  the  pelvic  inlet,  and  are  easier  carried  out  in  the  Cow  than 
the  Mare.  The  method  of  rectifying  the  direction  of  the  limbs  will  be 
referred  to  hereafter. 

It  sometimes  happens,  especially  with  the  Mare,  and  with  Heifers 
which  have  been  rudely  manipulated  before  the  arrival  of  the  veterinary 
surgeon,  that  the  foetus  is  so  engaged  in  the  genital  canal  that  retropul- 
sion is  impossible.  In  such  circumstances  some  authorities  have  re- 
commended forced  extraction,  traction  being  exerted  on  the  head  of 
the  foetus  either  by  assistants  or  mechanical  means ;  others  have 
advised  decapitation — skinning  the  head  and  removing  it  at  the  first 
or  second  cervical  vertebra,  taking  care  that  the  ends  of  the  bones 
are  covered  by  the  skin  of  the  skull,  to  prevent  laceration ;  then 
retropulsion  is  possible,  the  limbs  can  be  extended,  and  extraction  may 
be  effected. 

With  regard  to  forced  extraction,  there  can  be  no  doubt  that  if  both 
fore-limbs  are  retained,  the  life  of  the  foetus  is  endangered,  and  that  of 
the  mother  also  ;  though  it  may  be  successfully  practised  with  the 
Sheep,  Goat,  and  other  small  animals.  When  only  one  limb  is  retained 
in  the  Mare  or  Cow,  forced  extraction  may,  nevertheless,  succeed  ;  and 
Eueff,  Harms,  Darreau,  and  other  practitioners,  have  proved  that  it  is 
possible,  traction  being  employed  on  the  head  and  normally-presented 
leg.  Amputation  of  the  head  will  not  always  prove  advantageous 
in  retropulsion ;  indeed,  it  will  often  be  found  that  it  is  a  dis- 
advantage. 

The  most  rational  and  hopeful  operation  is  detaching  the  shoulder  from 
the  trunk  ;  or  the  flexor  brachialis  muscle  may  be  cut  through  by  means 
of  the  curved  finger-knife  (to  be  hereafter  described)  in  its  thickest  part  at 
the  shoulder-joint,  or  above  the  elbow-joint.     Then  extraction  may  be 


DYSTOKIA  DUE  T<>  THE  HEAD.  443 

afjain  attempted.  If  the  fcetus  does  not  come  away,  evisceration 
of  the  chest  and  abdomen  may  be  practised.  Should  dehvery  be  still 
impossible  (which  is  unlikely),  the  limb  must  be  detached  at  the 
shoulder  and  tlie  trunk  withdrawn  from  the  uterus,  the  leg  being 
extracted  afterwards. 

When  one  limb  protrudes  with  the  head,  it  may  be  removed  subcu- 
taneously  at  the  shoulder,  as  it  is  easier  accomplished  than  amputation 
of  the  retained  limb. 


SECTION  II.— DYSTOKIA  DUE  TO  THE  HEAD. 

Obstacles  to  parturition  from  a  wrong  direction  of  the  head  are 
<iuite  as  frequent  as,  and  more  serious  than,  those  due  to  misdirection 
of  the  fore-limbs.  It  is  stated  that  they  occur  oftener  in  the  Mare  than 
the  Cow,  but  this  is  questionable  ;  though  in  the  former  animal  they 
are  more  embarrassing,  as  in  consequence  of  the  longer  neck  of  the 
ftt-tus  the  head  can  be  carried  back  much  farther — even  as  far  as  the 
riank,  while  with  the  Calf  it  seldom  goes  much  beyond  the  shoulder.^ 
The  complication  is  all  the  more  serious  in  the  Mare  from  the  fact,  as 
has  so  often  been  stated,  that  obstetrical  manoeuvres  in  this  animal  are 
much  more  difficult  than  in  the  Cow  :  the  straining  being  far  more 
violent — paralysing  arms  and  hands — while  the  impatience  and  restless- 
ness are  generally  so  great,  that  it  is  often  necessary  to  throw  it  down 
before  anything  can  be  done  in  the  way  of  adjustment. 

Misdirection  of  the  head  usually  takes  place  immediately  preceding 
or  during  parturition,  under  the  influence  of  irregular  and  energetic 
uterine  contractions  before  the  os  is  sulliciently  dilated ;  it  is  supposed 
sometimes  to  be  due  to  premature  escape  of  the  "  waters,"  to  injudicious 
manipulation  of  the  fore-limbs,  maltraction,  etc.  Some  of  the  cases, 
however,  have  doubtless  occurred  long  before  the  period  of  parturition, 

'  Since  allusion  was  made  to  dystokia  from  excess  in  volume  of  the  head  of  the  fa-tus 
(p.  374),  Cv  lin,  of  Wassy,  has  puhliwhed  an  instnictive  jiaper  on  the  subject  (Journal  dt 
Mid.  Veterinnire  tt  df  Zooftc/iuii,  Nov.,  1876,  p.  5".i0),  which  deserves  notice  here. 
Observing  that  in  very  bony  Cows  the  size  of  the  Calf's  head  is  often  an  obstacle  to  par- 
turition— especially  in  primiparre  and  in  the  jHra.t.iii/iif  breed  of  cattle — while  it  is  rare 
in  improved  breeds,  in  which  the  head  i.s  small,  he  describes  the  nature  of  the  obstacle, 
and  remarks  that,  if  traction  is  ventured  u]>on  to  extract  the  fatus,  it  must  be  very 
violent,  and  therefore  likely  to  j)roduce  serious,  if  not  irreparable  injury.  To  avert  this, 
he  insists  <>n  putting  Schaack's  head-collar  on  the  fotus,  or  a  cord  placed  l)ehin(l  the  ears, 
then  each  side  looj)ed  roimd  the  lower  jaw,  to  answer  the  same  ptirpose.  The  head  being 
thus  secured,  the  protruding  limbs  are  pushed  forward  into  the  uterus,  after  a  cord  has 
been  fixed  U>  each  p.'istem.  If  the  genital  j)assage  is  dry,  oil  is  jilentifully  injected  into 
it  Traction  being  then  exerted  on  the  head,  this  readily  clears  the  inlet  of  the  maternal 
pelvis,  its  fiiniensions  being  no  longer  increa-ned  by  the  addition  of  the  limbs  ;  it  is  drawn 
well  into  the  j>elvic  cavity,  and  then  the  fore-limbs  are  easily  brought  through  the  inlet, 
now  only  occupied  by  the  neck  of  the  fcttus.  The  head  and  feet  are  afterwards  simul- 
taneousl}-  drawn  towards  the  vulva,  and  it  is  rare,  if  the  traction  is  judicious,  that  delivery 
is  not  promptly  effected. 

Through  having  neglected  the  precaution  of  first  pushing  the  fore-limbs  into  the  uterus, 
Colin,  at  the  commencement  of  his  career,  in  1853,  lost  two  Cows.  Since  that  time,  in 
more  than  two  hundred  ca-ses,  he  has  been  succes-sful  in  delivering  the  Calf  without 
resorting  to  embryotomy.  Success  is  always  certain,  pronded  incomjH't'-nt  persons  have 
not  previously  rendered  it  imjwssible.  He  recommends  the  same  procedure  in  spasm  of 
the  cervix  uteri,  after  reduction  of  torsion  of  the  uterus,  and  in  fcetal  hydrocephalus.  In 
the  latter,  puncture  of  the  cranium  is  easier  if  the  fore-limbe  have  been  previously 
poshed  into  the  utems. 


444 


FCE  TA  L  D  YS  TOKIA . 


and  are  of  the  nature  of  deformity  of  the  neck  or  head,  or  both  ;  we 
have  alluded  to  them  when  treating  of  "  Contractions,"  at  p.  392. 

It  will  readily  be  understood  why  misdirection  of  the  head  should 
prove  a  serious  obstacle  to  delivery,  when  we  remember  the  part  the 
nose  and  cranium  play  in  dilating  the  os  and  genital  canal,  and  how 
largely  this  voluminous  region  must  add  to  the  bulk  of  the  neck,  and 
render  expulsion  impossible. 

Deviations  of  the  head  may  be  met  with  in  the  four  principal  positions 
of  the  anterior  presentation  ;  and  they  may  occur  alone,  or  be  com- 
plicated with  misdirection  of  the  fore-limbs.  These  will  not  again  be 
referred  to,  but  the  head  will  be  studied  in  three  different  deviations 
from  the  normal  direction  :    1.    Doivmvard  deviation,  the  nose  being 


■^-#^ 


Fi?.  132. 


Anterior  Presextation,  Dorso-S.vcral  Position  :  Downward  Deviation  of  the 

Head. 

towards  the  trachea,  and  the  "  poll  "  or  upper  ridge  of  the  neck  present- 
ing ;  2.  Bent  under  the  body,  the  neck  being  flexed ;  3.  Lateral  devia- 
tion to  the  right  or  left  side,  the  head  being  carried  towards  the  shoulder 
or  flank  of  that  side,  the  side  of  the  neck  presenting  ;  4.  Upicard  devia- 
tion, the  head  being  bent  upwards  and  backwards  in  the  direction  of 
the  withers,  or  twisted  to  the  right  or  left  side  of  the  chest,  with  the 
throat — either  straight  or  twisted — presenting. 


Doivmvard  Deviation. 

This  is  usually  the  deviation  of  the  head  met  with  in  hydrocephalus, 
though  it  is  not  very  uncommon  when  the  cranium  is  normal  and  the 
foetus  well  formed.  It  is  usually  met  with  in  the  dorso-sacral  position, 
though  it  is  not  infrequent  in  the  dorso-pubic  ;  it  perhaps  occurs  oftenest 
in  the  Cow, 

The  cause  is  usually  ascribed  to  premature  rupture  of  the  foetal 
membranes,  the  deviation  occurring  when  the  foetus  is  entering  the 
pelvis.  If  the  head  is  not  exactly  in  the  axis  of  the  inlet,  but  inclines 
a  little  downwards  and  is  at  the  same  slightly  flexed,  the  nose  comes 
in  contact  with  the  brim  of  the  pubis,  and  is  retained  there  ;  while  the 


DYSTOKIA  ]>VE  To  THE  HEAD.  445 

uterine  contractions,  pushing  on  the  body,  propel  the  fore-hmbs,  if  they 
are  in  a  favourable  direction,  into  the  genital  canal.  Thus  it  will  be 
understood  that,  if  the  expulsive  efforts  continue,  the  head  becomes 
more  and  more  tlexcd  as  the  fietal  mass  is  carried  towards  the  vulva  (as 
is  delineated  in  the  shaded  and  unshaded  fcetuses  in  Fig.  132),  until, 
from  vortical  and  oblique,  the  face  becomes  horizontal,  and  rests  on 
the  floor  of  the  pelvis  of  the  mother,  the  lower  jaw  against  the  trachea ; 
the  neck  becomes  proportionately  flexed,  and  as  laliour  goes  on  the 
head  is  retained,  as  well  as  the  cervical  portion  of  the  former  ;  so  that 
when  the  obstetrist  introduces  his  hand  into  the  genital  canal,  the  feet 
are  found  presenting  towards  the  vulva,  but  far  in  front  of  them  (or 
behind  them,  as  the  explorer  stands)  ;  this  may  be  designated  a  neck  or 
poll  presentation  {unshaded  fcetus  in  Fig.  132). 

The  diagnosis  of  this  deviation  is  not  ditlicult.  When  the  anterior 
limbs  are  in  a  proper  direction,  the  feet  and  upper  part  of  them  are 
readily  found,  and  their  inclination  should  be  noted  ;  but  in  a  slight 
complication  the  whole  of  the  head  cannot  be  discovered — only  the  ears, 
eyes,  nape  of  the  neck,  and  the  forelock  and  mane  if  a  Foal.  With  the 
Calf,  which  has  a  shorter  neck,  it  may  be  possible  to  reach  the  head 
or  nose.  The  upper  ridge  of  the  neck  is  always  a  safe  guide  to  follow 
in  discovering  the  direction  of  the  head. 

Indications. — There  is  no  difViculty  in  adjusting  the  head,  if  the  ob- 
stetrist is  called  in  time,  and  it  is  movable  towards  the  pelvic  inlet,  but 
not  engaged  in  that  opening.  It  is  merely  necessary  to  glide  the  hand 
along  the  floor  of  the  vagina  into  the  uterus,  pass  it  between  the  maternal 
pubis  and  the  forehead  of  the  foetus,  downwards  to  the  nose,  which  is 
to  be  received  into  the  hollowed  palm  and  raised  above  the  pubic  brim, 
by  flexing  the  wrist  and  drawing  it  towards  the  vulva.  When  the  nose  is 
brought  into  the  genital  canal,  nothing  more  is  to  be  done  than  to  pull 
the  head  into  the  passage  and  complete  delivery  in  the  usual  way. 
W'ith  the  Calf,  whose  muffle  is  wider  and  cannot  be  so  readily  received 
into  the  palm  of  the  hand,  it  is  better  to  introduce  the  lingers  into  its 
mouth,  using  them  like  a  blunt  hook,  or  to  seize  the  nose  l)y  pushing 
the  index  finger  and  thumb  into  the  nostrils,  so  as  to  throw  the  lower 
part  of  the  head  upwards. 

When,  however,  through  delay  or  unskilful  attempts  at  delivery,  the 
nape  of  the  neck  is  firmly  engaged  in  the  inlet,  there  is  no  room  to 
adjust  the  head,  the  lower  part  of  which  is  jammed  against  the  mater- 
nal pubis  below,  and  the  vertex  against  the  sacrum  above.  In  such  a 
case  delivery  has  been  etTected  by  passing  the  running  noose  of  a  cord 
round  the  nose  or  the  upper  jaw  of  the  fa^tus,  and  while  an  assistant 
pulled  at  this,  the  operator,  by  pressing  strongly  against  the  top  of  the 
head,  made  this  swing  backwards,  the  nose  rising  into  the  passage ; 
birth  was  then  accomplished  in  a  few  minutes. 

.\nd  even  with  this  degree  of  head  deviation,  delivery  of  the  Foal 
without  adjustment  is  not  impossible  ;  for  Lecoq  gives  an  instance  in 
which  the  upper  part  of  the  head  and  poll  were  so  firmly  fixed  in  the 
pelvis,  that  it  was  impossible  to  push  the  fcctus  into  the  uterus.  This 
was  attempted,  however,  by  squeezing  the  head  closer  to  the  neck,  the 
hand  being  passed  alongside  the  cheek  and  the  nose  gradually  raised  ; 
at  the  same  moment  the  Mare  strained  doubly  hard,  and  gentle  traction 
being  applied,  the  Foal  was  expelled  with  its  head  in  this  position,  but 
without  injuring  the  perinicum  of  the  mother.    The  latter  soon  recovered, 


446 


FCETAL  DYSTOKIA. 


but  the  Foal,  as  is  usual  in  such  cases  in  the  Equine  species,  was 
dead. 

In  this  degree  of  deviation,  as  well  as  in  the  others,  great  assistance 
will  be  afforded  by  raising  the  hinder  parts  of  the  mother  to  the  extent 
of  one,  two,  or  more  feet.  Lecoq,  Eueff,  and  others  have  recommended 
placing  the  animal  on  its  back.  It  is  perhaps  better,  however,  to 
elevate  the  hind-quarters,  and  resort  to  retropulsion  either  by  the 
hand  or  the  crutch ;  then,  after  injecting  warm  water  or  oleaginous 
fluids,  to  either  extend  the  head  or  to  attempt  forced  extraction.  The 
blunt  hooks  fixed  firmly  in  the  orbits  of  the  foetus,  will  be  found  most 
useful  in  the  latter  operation. 

In  the  dorso-pubic  position,  propulsion  is  necessary  to  adjust  the 


Fig.  133. 
Antekior  Presentation  :  Extreme  Downward  Deviation  of  the  Head. 

body  for  extraction  ;  the  head  being  pushed  into  the  uterus,  efforts  must 
be  made  to  place  the  foetus  in  the  dorso-sacral  position,  which,  being 
accomplished,  renders  delivery  possible. 

The  same  procedure  is  necessary  with  the  Sheep  and  Goat  ;  while 
with  the  Bitch  and  Cat  delivery  must  be  effected  by  means  of  forceps. 

Head  bent  under  the  Body. 

This  is  an  exaggerated,  but  much  more  serious  form  of  head  and  neck 
flexure,  especially  in  the  Mare,  and  it  occurs  in  a  similar  manner  to  the 
preceding — the  foetus  in  the  anterior  presentation  advances  to  the  inlet 
with  the  neck  flexed,  and,  consequently,  the  lower  part  of  the  head 
below  the  floor  of  the  pelvis  ;  this  misdirection  increases  as  the  uterine 
contractions  force  the  foetus  backwards,  and  the  head  is  pushed  lower 


nVSToKIA  Dl'K  TO  THK  UKAD.  \\1 

and  more  under  the  neck  until  it  gets  beneath  the  chest,  and  even  tlie 
abdomen  (Fig.  133),  where  it  may  deviate  to  one  side.  The  fore-limbs 
are,  of  course,  in  the  genital  canal. 

The  accident  is  discovered  by  manual  exploration  ;  the  fore-limbs 
being  followed  by  the  hand,  the  crest  of  the  neck  is  found  pressed 
against  the  pubis,  while  the  head  can  be  traced  by  the  ears  and  the 
orbits,  the  face  being  towards  the  Uoor  of  the  uterus  ;  or  the  hand  may 
discover  the  nose  and  mouth  inclined  upwards  at  one  side  of  the  chest, 
behind  the  elbow.  In  this  condition  birth  is  impossible,  as  straining 
and  traction  only  make  matters  worse. 

Indications. — When  the  upper  part  of  the  neck  alone  presents, 
reduction  is  still  possible,  provided  no  great  delay  has  occurred,  nor 
mismanagement  by  unskilful  people  has  been  allowed.  But  when  the 
"waters"  have  been  long  expelled,  the  legs  pulled  at  by  amatem-s, 
and  the  uterus  closely  applied  to  the  body  of  the  foetus,  the  case  is 
most  ditticult ;  as  then  manipulation  and  retropulsion  cannot  effect 
much  in  many  instances. 

The  doubled  neck  is  too  voluminous  to  enter  the  pelvis,  and  the 
longer  the  pains  continue,  so  the  farther  is  the  head  pushed  forward 
from  the  inlet,  and  therefore  away  from  the  reach  of  the  obstetrist. 

The  contractions  of  the  closely  applied  uterus  also  render  attempts 
at  delivery  almost  impossible,  by  their  paralysing  the  hand  and 
arm. 

Large  quantities  of  warm  lubricating  fluids  must  be  injected,  retro- 
pulsion attempted  by  one  or  two  crutches  applied  to  the  shoulders  of 
the  fcetus — not  to  the  neck ;  while  the  hand  manipulates,  aided,  if  need 
be,  by  the  finger-hook.  A  blunt  hook  inserted  on  each  side  of  the  lower 
jaw — when  this  can  be  reached,  towards  the  root  of  the  ear,  or  into  the 
orbits  ;  a  cord  round  the  neck — if  it  can  be  passed  ;  and  other  devices, 
may  be  tried.  If  they  all  fail,  then  the  animal  should  be  thrown  on  its 
back  ;  indeed,  the  success  which  has  attended  this  change  of  attitude  in 
80  many  recorded  instances,  should  induce  the  obstetrist  to  adopt  it 
without  much  delay.  Very  often  the  altered  position  of  the  mother  at 
once  disengages  the  head  of  the  fcetus  from  its  deviation  ;  if  this  does 
not  happen,  then  the  other  means  may  be  tried  as  in  the  standing 
position.  Pelvic  version  may  be  resorted  to  in  some  cases,  the  anterior 
presentation  being  converted  into  a  posterior  one. 

When  reduction  cannot  be  effected,  and  delivery  of  the  entire  foetus 
cannot  be  accomplished,  then  the  obstetrist  has  no  other  course  left 
open  to  him  but  the  adoption  of  embryotomy.  Indeed,  it  should  be 
resorted  to  early  if  the  fcetus  is  dead,  which  is  nearly  always  the  case 
in  the  Mare.  The  head  maybe  amputated  through  the  presenting  part 
of  the  neck,  or  the  fore-limbs  removed  subcutaneously  at  the  shoulders 
— the  latter  is  to  be  preferred  in  the  majority  of  cases,  at  least  before 
incision  of  the  neck  is  begun.  This  gives  more  room  for  manipulating 
the  body  and  etlecting  extraction. 

In  many  cases  the  removal  of  one  fore-limb  will  permit  delivery. 
"Whether  one  or  both  be  removed,  it  is  generally  necessary  to  pass  a 
cord  round  the  bend  in  the  neck  and  pull  it  so  as  to  bring  the  head 
nearer  the  inlet,  where  it  may  be  possible  to  turn  it  into  the  genital 
canal,  or  at  least  to  amputate  it  more  easily. 


448  FCETAL  DYSTOKIA. 

Lateral  Deviation  to  the  Right  or  Left. 

The  lateral  deviation  of  the  head  to  the  right  or  left  side  of  the  body, 
whereby  the  left  or  right  side  of  the  neck  presents  at  the  pelvic  inlet,  is 
a  very  serious  obstacle  to  birth,  and  is  only  too  frequently  one  of  the  most 
difficult  to  be  overcome.  It  is  also  one  of  the  most  frequent  deviations, 
Saake  observing  it  in  394-  per  cent,  of  his  cases  of  dystokia ;  it  occurs 
much  more  often  in  the  Mare  than  the  Covp  or  other  animals.  With 
regard  to  its  origin,  as  well  as  to  its  adjustment,  a  wide  distinction 
must  be  drawn  between  it  as  it  exists  in  the  Foal  and  other  young 
creatures. 

The  cause  of  lateral  deviation  of  the  head  is  not  well  ascertained  in 
all  cases.  It  is  not  improbable  that,  in  very  many  instances,  it  is  due 
to  precipitate  or  tumultuous  birth,  when  the  os  is  either  imperfectly  or 
not  at  all  dilated.  In  such  circumstances,  the  uterine  contractions 
propel  the  head  of  the  foetus,  otherwise  in  a  good  direction,  towards  the 
pelvis  ;  but  as  the  os  is  not  open,  and  as  the  impelling  force  continues, 
the  body  pushes  the  nose  against  either  the  pelvis  or  the  occluded  os, 
and  it  turns  to  one  side  ;  then  the  deviation  becomes  increased  with 
every  contraction.  Premature  rupture  of  the  fcBtal  membranes  and 
escape  of  the  "  waters,"  spasm  of  the  cervix  uteri,  torsion  of  the  uterus, 
and  other  anomalous  conditions,  may  all  more  or  less  occasion  it.  As 
with  the  downward  deviation,  if  the  nose  is  not  in  the  axis  of  the 
pelvis,  or  indeed  of  the  os — even  though  the  latter  is  partially  dilated, 
misdirection  may  occur,  and  all  the  more  rapidly  should  the  fore-limbs 
chance  to  pass  into  the  vagina. 

The  accident  appears  to  be  most  frequent  with  primiparae.  In  108 
cases  of  lateral  deviation  of  the  head,  Saake  found  84 — or  78  per  cent. 
— in  animals  pregnant  for  the  first  time.  The  remainder  were  noted  in 
animals  which  had  previously  bred,  but  in  which  labour  was  protracted 
through  imperfect  or  tardy  dilatation  of  the  os. 

This  deviation  is  more  serious  when  the  foetus  is  dead  than  when  it 
is  alive  ;  and  when  the  deviation  is  only  slight,  the  head  fitting  into  the 
concavity  on  the  side  of  the  neck,  birth  may  even  -though  indeed  rarely 
— occur  without  assistance,  particularly  with  the  Foal,  which  has  a 
longer  and  thinner  head  than  the  Calf.  Some  authorities  have  remarked 
that  the  deviation  is  more  frequently  to  the  right  than  the  left  side, 
and  others  the  contrary. 

In  some  instances  there  can  scarcely  be  any  doubt  that  the  deviation 
has  taken  place  some  time  before  gestation  is  completed,  and  is  the 
result  of  a  long-continued  malposition  of  the  foetus.  In  many  Foals  at 
birth  the  neck  cannot  be  straightened,  and  the  head  is  distorted  from 
being  pressed  against  the  neck  or  side  of  the  body  (Fig.  103) — bones, 
muscles,  and  ligaments  being  involved.  We  have  referred  to  these  in 
describing  "  Contractions  "  of  the  foetus  as  a  cause  of  dystokia. 

It  is  not  difficult,  as  a  rule,  to  distinguish  the  existence  of  lateral 
deviation.  Usually  both  fore-feet  are  in  the  genital  canal,  but  birth 
does  not  progress.  But  an  important  fact  to  remember  is  that  one  limb 
— that  belonging  to  the  side  to  which  the  head  is  bent — seems  to  be 
shorter,  or  less  advanced,  than  the  other.  The  hand,  on  being  passed 
beyond  these  towards  the  inlet,  comes  in  contact  with  a  convex  mass, 
more  or  less  occupying  the  whole  of  it,  and  rendering  access  to  the  uterine 
cavity  difficult.  Patient  exploration,  however,  discovers  this  to  be  the 
bent  neck ;  and  if  it  be  a  Calf,  owing  to  the  shortness  of  this  part,  the 


DVSTOKIA  DUE  TO  THE  IIEAIK 


419 


head  is  soon  found,  and  recognised  by  the  ears,  eyes,  and  often  the 
muffle  turned  towards  the  shoulder  (Fig.  13-i) — with  this  Bovine  foetus, 
in  fact,  the  greater  part  of  the  head  in  the  majority  of  cases  lies  against 
the  shoulder. 

With  the  Foal,  it  is  only  too  often  otlierwise.  The  much  longer 
neck  of  this  creature  and  the  more  violent  uterine  contractions  of  the 
Mare,  generally  result  in  the  head  being  pushed  towards  the  side  of  the 
thorax,  the  altdomen,  or  even  the  Hank  or  croup,  where  it  cannot  be 
reached.  This  ditliculty  is  greatly  increased  if  the  abdomen  of  the 
mother  is  very  pendulous.  Occasionally  this  is  also  the  case  with  the 
Cow,  though  it  is  i-are  that  in  this  animal  the  ears,  or  even  the  eyes, 
cannot  be  reached  by  a  fairly  long  arm  (Fig.  13o).  If  the  animal,  be  it 
Mare  or  Cow,  chances  to  be  lying,  and  the  deviation  is  only  to  the 


Fig.  134. 

ANTKHIOR    PBE3EXTATIOX,    DoRSO-SaCK.VL    POSITION:    LaTEKAL    DEVIATION    OK    THK 

Head  towakds  the  Shoulder. 


shoulder,  it  is  most  difficult  to  reach  the  nose  of  the  foetus  should  it  be 
inclined  to  the  side  on  which  the  parent  lies — i.e.,  if  the  Mare  is  on  the 
left  side  and  the  deviation  of  the  Foal's  head  is  to  the  right. 

The  head  may  be  raised  as  high  as  the  back,  or  lie  as  low  as  the  under 
part  of  the  chest  or  abdomen.  The  fcetus  is  usually  in  the  first  (or 
dorso  -  sacral)  position,  though  the  deviation  may  also  occur  in  the 
second  (dorso-pubic)  or  third  (dorso-ilial)  positions ;  in  the  latter  posi- 
tion the  neck  may  be  bent  upwards — the  head  towards  the  maternal 
sacrum,  or  doicnnards — the  head  resting  on  the  floor  of  the  uterus. 

This  complication  is  not  only  a  very  frequent,  but,  as  has  been  said, 
a  very  serious  one  for  the  obstetrist,  and  it  may  be  truthfully  asserted 
that  birth  is  not  possible  without  his  assistance ;  indeed,  it  has  been 
well  remarked  that  "  it  taxes  all  his  strength,  patience,  and  ingenuity." 

29 


450 


F(ETAL  DYSTOKIA. 


With  the  Calf,  the  neck  of  which  is  comparatively  short,  the  head  is 
in  most  cases  no  farther  back  than  the  shoulder,  though  it  may  be  as 
high  as  the  withers  or  as  low  as  the  sternum.  It  is,  therefore,  possible 
to  reach  it ;  and  though  its  relatively  large  size  is  a  great  obstacle  to 
reduction,  yet  in  the  majority  of  instances  this  adjustment  can  be 
accomplished,  and  especially  if  the  young  creature  is  alive,  as  its  spon- 
taneous movements  aid  the  operation ;  for  this  and  other  reasons 
ah'eady  alluded  to,  the  Calf  is  more  frequently  extracted  alive  than  the 
Foal. 

As  a  rule,  reduction  of  the  displacement  is  indispensable  in  delivery, 
the  head  and  neck,  or  shoulder,  forming  too  voluminous  a  mass  to  pass 
through  the  pelvic  canal ;  though  rare  instances  are  recorded  in  which 
birth  took  place  with  the  neck  bent. 


Anterior  Peesentation 


Fig.  135. 

Lateral  Deviation  of  the  Head  towards  the 
Abdomen. 


With  the  Foal  the  head  may  also  not  go  beyond  the  region  of  the 
shoulder,  and  the  case  is  then  generally  not  so  serious  as  with  the 
Calf,  the  head  being  smaller  and  the  displacement  more  easily  reduced. 
But,  as  has  been  pointed  out,  owing  to  the  long  and  flexible  neck  of 
this  creature,  the  head  is  most  frequently  deeper  in  the  uterine  cavity — 
towards  the  side  of  the  chest,  abdomen,  flank,  or  even  the  croup. 
Here  the  hand  cannot  reach  it,  and  reduction  is  nearly  always  impos- 
sible ;  besides,  the  foetus  succumbs  soon  after  the  commencement  of 
the  labour-pains — death  being  due  in  many,  if  not  in  all,  cases  to  pre- 
mature separation  of  the  maternal  and  foetal  placentae.  However, 
owing  to  the  thinner  and  more  flexible  neck  and  the  smaller  head, 
when  the  latter  was  lodged  in  the  flank  the  foetus  has  been  delivered 
by  energetic  traction. 


DYSTOKIA  DUE  TO  TUE  HEAD.  451 

Indications. — The  principal  indication  in  this  deviation  is,  of  course, 
to  get  hold  of  the  head,  if  possible,  adjust  and  bring  it  into  a  favour- 
able position  in  the  genital  canal,  and  then  etVect  delivery.  This  is  on 
the  supposition  that  the  head  is  accessible ;  but  when  such  is  not  the 
case,  then  it  is  dillicult,  if  not  impossible,  to  straighten  the  neck,  and 
especially  if  the  curvature  is  due  to  contraction.  When  we  come  to 
treat  of  obstetrical  operations,  reference  will  be  made  to  this  straighten- 
ing of  the  neck. 

When  it  is  found  impossible,  or  not  advisable,  to  attempt  adjustment 
of  the  head  and  neck,  then  recourse  must  be  had  to  forced  extraction 
or  cmhriiotomii. 

With  regard  to  forced  extraction  in  the  Cow,  though  instances  are 
recorded  in  which  it  has  been  successfully  practised,  yet  it  should 
never  be  resorted  to  by  the  humane  pi-actitioner.i  The  gi*eat  length 
and  essentially  bony  structure  of  the  Cow's  pelvis,  and  the  large 
volume  and  shape  of  the  Calf's  head,  prove  such  an  obstacle  to  forced 
extraction  in  this  lateral  deviation,  that,  if  persisted  in,  it  will  not  only 
cause  the  death  of  the  mother,  in  all  probability,  but  also  that  of  the 
foetus,  unless  it  is  unusually  small  and  the  pelvis  of  the  Cow  very 
wide.  In  fact,  those  who  have  attempted  it  testify  to  its  barbarity 
and  fatality. 

With  the  Mare,  the  case  is  somewhat  different.  When  the  head  of 
the  Foal  is  deeply  buried  towards  its  flank  or  croup,  i-eduction  is  most 
difficult,  and  requires  long  and  laborious  manipulations,  which  so  irritate 
the  organs  and  exhaust  the  strength  of  the  mother,  that  death  not 
infrequently  results.  In  most  cases,  too,  the  obstetrist  is  called  in 
when  the  Foal  is  dead,  so  that  there  is  no  necessity  for  scruples  with 
regard  to  it.  On  the  other  hand,  as  we  have  previously  said,  the  long, 
thin,  and  flexible  neck  and  narrow  and  tapering  head  readily  allow 
the  latter  to  become  embedded  in  the  flank,  and  thus  to  offer  much  less 
resistance  than  with  the  Calf ;  while  the  wider  pelvis  of  the  Mare 
offers  further  facilities.  Numerous  instances  are  given  in  which  forcible 
extraction  of  the  Foal  with  the  head  so  deviated,  has  been  attended 
with  complete  success — Darreau  had  eight  out  of  ten  cases — and  with- 
out much  suffering  on  the  part  of  the  Mare.  Indeed,  so  successful  and 
prompt  is  it,  that  Donnarieix,  who  has  devoted  much  attention  to  this 
procedure,  says  it  should,  as  a  rule,  be  adopted  in  these  cases,  as  it  is 
not  possible  to  restore  the  head  to  its  normal  position  ;  delivery  by 
vigorous  traction  is,  if  not  easy,  at  least  most  frequently  followed  by 
success. 

Donnarieix  operates  as  follows  :  The  Mare  is  thrown  down  near  the 
stable  door,  the  thighs  pi'opped  against  the  threshold,  and  a  breeching 
and  side-line,  fixed  to  the  wall  or  held  by  assistants,  may  be  employed 
to  keep  the  animal  in  position.  Each  fore-limb  of  the  foetus  is  corded 
at  the  pasterns,  the  cords  being  confided  to  assistants,  the  number  of 
which  will  vary  according  to  the  amount  of  resistance — four  at  least 
are  necessary,  and  sometimes  six  or  eight.  On  the  word  being  given, 
these  men  pull  slowly,  steadily  and  gradually,  without  jerking,  but 

'  Franck  (op.  cit.,  p.  373)  gives  an  instance  in  which  two  empirics  attempted  to 
deliver  a  Cow  that  could  not  calve.  They  mistook  this  deviation  for  a  breech  presenta- 
tion, as  they  could  not  find  the  head,  and  they  thought  the  fore-feet  in  the  vagina  were 
hind  ones.  They  c<insequently,  other  means  failing,  set  about  extracting  the  Calf  by 
force,  and  eight  men  pulled  at  the  cords  attached  to  the  feet ;  the  young  creature  was 
removed,  but  it  was  dead.  The  Cow  was  unable  to  get  up  for  eight  days,  but  eventually 
recovered. 


452  FCETAL  DYSTOKIA. 

Strongly  and  equally  on  both  cords.  The  Foal  enters  the  inlet,  but  it 
often  happens  that,  at  a  given  moment,  it  stops  there,  owing  to  the 
uterus  forming  a  double  or  ring  at  this  part  and  opposing  progression. 
Traction  must  then  cease,  but  the  fcetus  is  to  be  held  firmly  in  the  posi- 
tion to  which  it  has  been  advanced ;  the  hand  is  to  be  introduced 
between  the  latter  and  the  uterus — the  back  of  the  hand  to  the  foetus, 
palm  to  the  mucous  membrane — the  fold  sought  for,  and  dispersed  by 
raising  the  back  of  the  hand.  Then  the  tractions  are  to  be  renewed, 
and  in  the  course  of  fifteen,  ten,  or  even  fewer  minutes,  the  Foal  is 
extracted.  It  is  well  to  empty  the  rectum  before  commencing 
extraction. 

When  practised  with  care  and  discretion,  this  forced  removal  of  the 
Foal  may  certainly  be  commended,  especially  if  it  is  of  small  size 
and  the  Mare  is  not  exhausted  ;  but  when  the  foetus  is  large  and  the 
mother  has  suffered  much,  then  there  is  certainly  danger,  and  embry- 
otomy should  be  performed.  But  we  should  prefer,  when  circumstances 
will  permit,  to  give  a  trial  to  the  methods  already  enumerated  ;  seeing 
that  this  procedure  is  not  always  successful,  and  may  be  followed  by 
untoward  consequences.  Eberhard  gives  an  instance^  in  which  forced 
extraction  was  attempted  in  a  Mare,  and  was  followed  by  rupture  of 
the  abdominal  muscles,  through  the  powerful  traction  resorted  to. 

With  regard  to  embryotomy,  this  must  be  looked  upon  as  preferable 
to  forced  extraction — even  in  the  Mare,  but  particularly  in  the  Cow ; 
nevertheless,  it  must  always  be  considered  as  an  extreme  measure. 
The  operation  will  be  described  hereafter,  but  we  may  note  in  this 
place  that  the  head  or  presenting  limbs,  or  even  both,  may  be  re- 
moved. Decollation  is,  however,  a  most  difficult  business  when  the 
head  cannot  be  reached ;  if  it  is  accessible  the  operation  can  scarcely  be 
necessary.  The  limbs  should  be  removed  subcutaneously,  the  most 
advanced  being  first  excised,  and  with  the  shoulder  if  possible.  Not 
infrequently  removal  of  one  limb  will  be  sufficient  to  allow  the  foetus 
to  be  adjusted — especially  in  the  Mare  ;  or  it  may  permit  forced  extrac- 
tion, without  adjustment,  to  be  easily  accomplished. 

With  the  Calf,  both  limbs  have  usually  to  be  removed.  In  this  opera- 
tion, the  long  sharp  crotchet  will  be  of  service. 

The  parturient  animal  in  which  this  head-deviation  of  the  foetus 
occurs,  has  sometimes  a  very  pendulous  abdomen,  and  manipulation  is 
greatly  retarded  by  this  conformation.  Placing  it  on  its  back  will 
generally  give  greater  facilities  for  obstetrical  operations  of  this  kind. 

Lateral  deviation  of  the  head  is  usually  encountered  when  the  foetus 
is  in  the  first,  or  dorso-sacral,  position.  It  may  nevertheless  be  met 
with,  though  rarely,  in  the  dorso-pubic  position,  or  in  the  right  or  left 
dorso-ilial  position,  which  is  still  more  rare. 

These  positions,  however,  do  not  modify  the  indications  for  extraction 
to  any  considerable  extent,  except  that  in  the  last,  after  correcting  the 
deviation  of  the  head,  rotation  should  be  practised,  and  the  foetus  placed 
in  the  dorso-sacral  position,  if  possible,  before  delivery  is  attempted. 
When  the  head  is  doubled  beneath  the  body  of  the  foetus  in  these  lateral 
positions,  it  will  be  found  most  advantageous,  in  order  to  reach  it,  to 
throw  the  mother  down  on  the  side  that  will  ensure  the  head  of  the 
young  creature  being  uppermost.  Version  may  be  advisable  in  some  of 
these  positions. 

1  Gurlt  and  Hertwig's  Magazin  Jili-  Thurhtilkunde,  1S51,  p.  269. 


DYSTOKIA  DUE  TO  THE  HEAD.  453 

This  lateral  deviation  of  the  head  is  liable  to  be  complicated  by  mis- 
direction of  one  or  both  of  the  foro-linibs,  which  may  be  Hexed  at  the 
knee,  entirely  retained,  or  crossed  on  the  sternum.  Such  a  complica- 
tion of  course  greatly  adds  to  the  gravity  of  the  case,  and  renders  it 
much  more  formidable. 

Here  it  will  be  necessary  to  adjust  the  limbs  before  interfering  with 
the  head  ;  though  the  latter,  if  it  can  be  reached,  and  there  is  any  benefit 
to  be  derived  from  doing  so,  should  be  secured  by  either  a  head-collar, 
or  a  cord  round  the  neck  or  jaw.  The  feet  should  always  be  secured  by 
cords,  so  that  if  it  is  requisite  to  push  them  into  the  uterus,  they  may 
readily  be  withdrawn  again. 

In  one  instance  of  this  kind,^  the  sacro-sciatic  ligament  of  a  Cow  was 
divided,  and  the  dead  faHus  removed  through  the  opening.  There  was 
very  little  hicmorrhage,  and  the  Cow  soon  recovered. 

With  the  smaller  animals — such  as  the  Sheep  and  Goat — this  devia- 
tion must  be  remedied  by  forced  extraction  with  the  short  blunt  hook  or 
finger-hook,  the  fore-limbs  of  the  foetus  being  manipulated  so  as  to  push 
away  the  unencumbered  shoulder  into  the  uterus,  and  bring  forward 
that  round  which  the  neck  bends.  The  smallness  of  the  genital  passages 
in  these  creatures  is  an  obstacle  to  manipulation,  but  an  intelligent  boy 
with  a  small  hand  may  be  of  much  sei^vice  when  acting  under  the  direc- 
tion of  the  obstetrist. 

With  the  Bitch  and  Sow  these  deviations  are  extremely  rare.  When 
they  do  occur  it  will  be  found  that  forceps  will  generally  effect  forced 
extraction  ;  or  a  piece  of  strong  catgut,  or  brass  or  copper  wire,  may  be 
passed  round  the  bend  of  the  neck.  Traction  on  this  will  either  re- 
move the  fa^tus,  or  by  cutting  through  the  neck  permit  it  to  be  ex- 
tracted by  the  forceps  hereafter  to  be  described.  Placing  the  Bitch  in 
a  warm  bath  for  a  few  minutes,  and  then  laying  it  on  the  side  opposite 
to  that  to  which  the  head  of  the  puppy  is  inclined,  will  be  found 
advantageous. 

Deviation  Upicanl  and  Backward. 

The  deviation  of  the  head  more  or  less  upward  and  backward — the 
inferior  borders  of  the  lower  jaw  being  vertical  or  turned  towards  the 
maternal  sacrum — appears  to  be  an  extremely  rare  complication,  and  is 
chiefly  met  with  in  tlie  Mare,  in  which  it  has  led  to  rupture  of  the 
uterus  and  rectum,  and  delivery  by  the  latter. 

The  cause  is  probably  the  same  as  in  the  other  deviations  of  this 
region. 

On  exploration,  if  the  foetus  is  in  the  dorso-sacral  position,  the  fore- 
limbs  may  be  found  more  or  less  advanced  in  the  vagina,  and  beyond 
them,  at  the  inlet,  the  hand  meets  the  sternum,  while  above  it  is  the 
front  part  of  tlie  neck,  with  the  trachea  leading  upwards  to  the  head, 
which  may  be  bent  more  or  less  back  on  the  withers  or  loins  (Fig.  136), 
or  inclined  to  one  or  other  side  of  the  fatus,  the  lower  jaw  always 
facing  the  lumbo-sacral  region  of  the  mother,  or  twisted  slightly  round 
(Fig.  137). 

Indications. — Retropulsion  is  the  first  indication,  and  this  alone  will 
often  bring  the  head  into  its  normal  position  ;  it  should  be  practised  on 
the  sternum.     Should  the  head  not  drop  down  to  the  pelvic  inlet,  then, 

'   Velerinarian,  vol.  xxx.,  p.  20, 


454 


F(ETAL  DYSTOKIA. 


still  continuing  the  retropulsion,  the  hand  may  be  introduced,  the  lower 
jaw  seized  and  brought  towards  the  os,  in  carrying  it  downwards  and 
a  little  to  one  side  if  necessary,  by  a  slightly  screwing  motion,     k  cord 


rig.  136. 

Anterior  Presentation,  Dorso-Sacral  Position  :  Deviation  of  the  Head  Upwards 

AND  Backwards. 

on  the  lower  jaw,  or  around  the  head,  may  be  useful  if  it  can  be 
applied.      Eueff  recommends   compression  in  the  rectum,  previously 


Fig.  137. 
Anterior  Presentation     Deviation  of  the  Head  Upwards  and  Laterally. 

emptied,  by  the  hand  of  an  assistant,  while  the  operator  manipulates 
in  the  uterus.     If  the  animal  is  lying,  it  must  be  made  to  stand. 

When  this  deviation  has  been  found  in  the  Cow,  placing  the  animal 
on  its  back  has  been  found  of  great  service  in  rectifying  the  displace- 
ment. 


DYSTOKIA  DUE  To  TIIK  UKAD  AXD  FORE  OK  IIIXIJ  LIMBS.       455 

Embryotomy  is  rarely  necessary. 

In  the  smaller  animals— at  least  in  the  Bitch — delivery  has  been 
etlected  without  reduction  of  the  deviation. 

SECTION  III.— DYSTOKIA  DUE  TO  THE  HEAD  AND  FOIiE  OlC  HIND 

LIMBS. 

Saint-Cyr  speaks  of  complicated  cases  of  dystokia  in  the  anterior  pre- 
sentation, due  to  the  head  and  fore  or  hind  limbs,  which  are  sometimes 
met  with,  and  the  principal  of  which  are  the  following. 

Ilead  retained,  and  xcith  it  One  or  Both  of  the  Fore-Limbs. 

No  matter  what  the  abnormal  direction  and  position  of  the  head  and 
neck  may  be,  the  ditliculty  may  be  complicated — and  very  frequently  is 
— by  retention  of  one  of  the  fore-limbs,  which  may  be  either  Hexed  at 
the  knee  or  detained  in  the  abdominal  cavity ;  the  detention  of  both 
fore-limbs,  though  very  rare,  yet  is  not  impossible. 

In  such  a  case  the  deviated  parts  are  successively  rectified,  usually 
commencing  with  the  limbs,  as  their  presence  in  the  genital  canal  does 
not  interfere  with  the  manipulation  of  the  head  ;  but  it  sometimes 
happens  that  it  is  more  advantageous  to  begin  with  the  head — for 
instance,  when  it  is  much  forward  in  the  uterus.  But  it  is  really  of  no 
great  moment  which  part  is  first  dealt  with,  so  long  as  the  precaution  is 
taken  first  to  cord  those  which  are  deviated.  How  they  are  to  be 
rectified  will  be  explained  presently — but  it  may  be  remarked  that  such 
rectifications  succeed  most  frequently  in  the  Cow,  from  which  the  Calf 
may  be  extracted  alive  ;  but  the  fcctus  of  the  Mare  usually  dies  so  soon 
that  there  is  no  time  for  their  adoption,  so  that — putting  forced  extrac- 
tion aside  as  dangerous — version  should  be  tried  if  circumstances  will 
admit,  before  resorting  to  embryotomy. 

Head  or  One  of  the  Fore-Legs  retained^  and  One  or  Both  of  tJie 
Hind-Legs  in  the  Genital  Canal. 

It  may  happen  that  one  or  more  of  the  anterior  parts  of  the  body  are 
retained,  and  yet  one  or  both  of  the  hind-legs  enter  the  genital  canal, 
this  depending  upon  the  manner  in  which  the  fcctus  originally  presented 
itself — the  presentation  being  generally  sterno-abdominal,  with  either 
hind  or  fore  limbs,  or  both,  in  the  inlet,  and  a  change  occurring  in  the 
position  subsequently. 

When  a  fore-limb  is  retained  and  a  hind  one  is  in  the  passage,  the 
former  may  be  bent  at  the  knee  or  be  under  the  chest.  If  possible,  it 
should  be  straightened  and  brought  into  the  passage,  and  the  hind- 
limb  also  pulled  towards  the  head  of  the  futus,  the  foot  as  high  as  the 
ear,  and  traction  made  on  the  head  and  feet.  If  delivery  cannot  be 
accomplished,  then  propulsion  may  be  attempted,  and,  if  successful,  the 
position  rectified — though  this  attempt  is  likely  to  prove  futile.  Then 
it  will  be  necessary  to  remove  one  of  the  fore-limbs  at  the  scapula,  or 
cut  through  the  trunk  of  the  fuitus. 

When  the  head  is  retained  and  one  of  the  hind-legs  has  entered  the 
genital  canal,  in  the  dorso  sacral  position,  an  endeavour  should  be  made 
to  push  the  hind-leg  into  the  uterus,  and  even  the  head  may  be 
pushed  forward.  But  if  for  certain  reasons  this  cannot  be  done,  it  may 
be  advisable  to  proceed  to  embryotomy  —  removing  both  fore-limbs 
entirely,  which  will  then  admit  of  retropulsion  of  the  trunk  and  adjust- 
ment of  the  head  and  neck. 


456 


F(ETAL  BYHTOKIA. 


There  are  other  complications  of  a  similar  kind  in  this  presentation,  to 
remedy  which  the  practitioner  must  exercise  his  judgment  by  resorting 
to  rectification  of  the  misplaced  parts,  so  as  to  effect  delivery  in  the 
anterior  presentation  ;  to  version,  so  as  to  bring  about  a  posterior  pre- 
sentation and  then  deliver  ;  or  to  embryotomy,  in  order  to  reduce 
the  size  of  the  foetus,  and  thus  have  more  room  for  manipulation  and 
removal  of  the  body. 


CHAPTEE  II. 
Dystokia  in  the  Posterior  Presentation. 

Though  parturition  may  take  place  spontaneously  and  terminate 
favourably  w^hen  the  foetus  presents  posteriorly  and  in  a  normal  posi- 
tion, yet  as  in  the  anterior  presentation  so  in  this — the  presentation 


Fig.  138. 
Lumbo-Sacral  Positiox. 

may  be  natural  but  the  position  abnormal ;  or,  though  both  be  normal, 
yet  delivery  may  be  interfered  with  by  deviation  of  some  part-  such  as 
the  fore-limbs  or  head.  Not  only  may  this  be  the  case,  but  the  pre- 
sentation itself  may  be  unnatural. 

Several  authorities  alluded  to  by  Saint-Cyr  mention  deviation  of  the 
tail  of  the  foetus  as  ofi'ering  an  obstacle  to  birth  in  this  presentation, 
lumbo-pubic  position  ;  and  it  is  admitted  that  such  may  be  the  case  if 
that  organ  gets  below  the  thin  margin  of  the  pubis,  and  becomes  bent 
down  towards  the  croup  ;  but  this  should  be  easily  remedied. 

When   treating   of   the   mechanism   of   parturition  (p.  250),  it  was 


DVSroKIA  FROM  Jj:yn/:MJL  POSITIONS.  457 

remarked  that  of  the  positions  in  the  breech  or  posterior  presentation, 
only  one  is  compatible  with  spontaneous  and  natural  delivery — the 
lumbosacral ;  but  this  is  only  possible  when  the  hind-limbs  are  fully 
extended  backwards,  and  are  the  first  to  enter  tlie  genital  canal,  so  as 
to  gi-adually  dilate  the  channel  for  the  passa^'e  of  the  voluminous  and 
rounded  croup.  Birth  in  this  position,  and  without  assistance,  is  more 
frequent  in  the  Bovine  than  the  Equine  species,  and  the  youn<^  creature 
is  nearly  always  born  alive.  With  the  Mare,  parturition  is  always 
longer  and  more  laborious,  and  the  Foal  quickly  perishes  after  rupture  of 
the  membranes.  It  therefore  results  that,  even  when  the  latter  is  in 
the  lumbo-sacral  position,  and  everything  is  favourable,  delivery  should 
be  hastened  if  it  is  desired  to  preserve  the  life  of  the  young  creature. 

The  other  three  posterior  positions — lumbo-pubic  and  right  and  left 
lumbo  supra-cotyloidean — are  unnatural,  and  demand  the  intervention 
of  the  obstetrist. 

Besides,  these  positions,  as  well  as  the  lumbo-sacral,  may  be  compli- 
cated by  a  vicious  direction  of  the  limbs  or  neck,  which  may  lead  to 
as  great,  if  less  varied  ditliculties,  as  those  encountered  in  the  anterior 
presentation. 

A.    NOKM.\L    PoSTEltlOK    PRESENTATION. 

We  have  just  referred  to  this  presentation  and  described  what  it 
implies. 

SECTION  I.— DYSTOKIA  FROM  ABNORMAL  POSITIONS. 

As  has  been  mentioned,  these  are  three  in  number— the  lumbo-picbic 
and  two  lumbo-sitpra-cotyloidcaii  positions. 

Lwnbo-jncbic  Position. 

In  this,  the  posterior  reversed  position,  the  foetus  is  lying  on  its  back, 
its  croup  and  loins  towards  the  tioor  of  the  abdomen  or  the  pubis  of 
the  mother,  with  its  feet  and  belly  towards  the  sacrum. 

As  a  consequence,  the  hind-limbs,  which  soonest  enter  the  pelvis,  are 
inclined  upwards  and  backwards  into  the  genital  canal,  and  are  there- 
fore the  parts  that  first  meet  the  hand  in  exploration.  Saint-Cyr  points 
OQt  what  might  be  a  cause  of  error  in  this  exploration,  in  the  following 
terms:  "  As  the  anterior  face  of  the  hoof  or  claws  is  directed  upwards 
and  the  plantar  surface  (sole)  downwards,  the  explorer  might  be 
inchned  to  think  that  it  was  an  anterior  vertehro-sacral  presentation  ; 
but  in  pushing  the  exploration  further,  and  following  the  cannon-bone 
with  the  hand,  the  hock  is  met  with — recognisable  by  its  jlatimss  on 
each  side,  the  point  of  the  calcis  downwards,  the  hend  being  upwards  in 
the  same  direction  as  the  wall  of  the  hoof ;  whereas  the  bend  of  the 
knee  is  in  the  same  direction  as  the  sole  of  the  foot.  Beyond  the  hock 
the  hand  also  comes  in  contact  with  the  croup  and  the  tail,  lying 
towards  the  maternal  pubis." 

The  obstacle  to  birth  lies  chiefly  in  the  thighs  and  buttocks,  while 
the  hind-feet  project  against  the  mother's  sacrum,  and,  in  addition  to 
increasing  the  resistance,  threaten  to  lacerate  the  organs  interposed 
between  them — the  vagina  or  rectum,  or  both — and  that  bony  mass. 
Besides  this,  the  body  of  the  fcetus  itself  forms  a  curve  exactly  the 


458  FCETAL  DYSTOKIA. 

reverse  of  that  of  the  pelvis ;  so  that  it  cannot  readily  accommodate 
itself  to  the  bony  canal  through  which  it  should  pass.  From  all 
these  causes,  this  position  is  not  only  unfavourable  to  birth,  and  must 
be  remedied,  but  it  may  also  lead  to  serious  accidents. 

The  position  appears  to  be  more  frequently  met  with  in  the  Mare 
than  the  Cow,  Donnarieix  having  witnessed  it  at  least  a  score  of  times 
in  the  first-named  animal.  This  authority,  however,  is  of  opinion  that 
it  is  altogether  a  secondary  position  ;  the  foetus  at  the  commencement 
being  in  a  normal  position  (lumbo-sacral),  and  still  alive,  is  retained  at 
the  pelvic  inlet  by  its  croup,  and  soon  dies  ;  then  obeying  the  laws  of 
gravity,  at  a  moment  when  the  uterus  is  relaxed,  it  turns  upside  down. 
And  he  gives  what  he  considers  a  proof,  in  the  fact  that  breeders,  in 
consequence  of  what  he  was  always  telling  them — to  the  effect  that  in  the 
posterior  presentation  the  Foal  does  not  live  for  longer  than  half  an  hour 
— -were  always  successful  in  bringing  the  young  creature  forth  alive 
when  they  at  once  resorted  to  traction  in  such  cases,  all  informing  him 
that  the  croup  was  above  and  the  belly  beloio  ;  while  in  all  the  instances 
in  which  he  had  to  interfere,  the  belly  was  uppermost  and  the  bach  doivn- 
wards.     In  the  latter  cases  Donnarieix  never  found  the  Foal  living. 

Saint- Cyr,  however,  thinks  this  explanation  is  not  quite  satisfactory, 
that  the  opinion  is  too  absolute,  and  that  in  the  Mare,  as  well  as  in  the 
Cow,  the  lumbo-pubic  position  of  the  foetus  may  very  well  be  pjrimary. 
Donnarieix  himself  admits  as  much,  from  a  case  recorded  by  Eochard, 
in  which  a  living  Foal  was  extracted— an  extremely  rare  event  in  the 
Equine  species. 

Indications. — The  majority  of  authorities  recommend  that  rotation 
of  the  foetus  should  be  practised  in  this  position,  so  as  to  convert  it 
into  a  luvibo-ilial  or  even  a  himbo-sacral  position  ;  while  others,  and 
notably  the  French  veterinary  obstetrists,  do  not  think  of  changing  the 
position,  but  readily  effect  delivery  when  other  causes  of  dystokia  do 
not  complicate  it — indeed,  they  look  upon  these  cases  as  the  easiest 
to  remedy,  and  rarely  requiring  more  than  a  quarter  of  an  hour. 

"With  the  Cow,  however,  and  especially  if  the  Calf  is  of  large  size, 
version  is  necessary  before  delivery  can  be  effected  ;  and  this  may  be 
also  required  with  the  Mare,  though  the  comparatively  larger  pelvis  of 
this  animal  may  permit  delivery  without  changing  the  position.  In 
attempting  this,  the  most  important  matter  for  attention  is  the  direction 
of  the  hind-feet  during  delivery  ;  these  should  be  carefully  guided 
through  the  genital  canal  until  they  are  external  to  the  vulva,  so  as 
to  avoid  those  lacerations  and  ruptures  which  are  only  too  readily 
produced. 

In  order  to  accomplish  delivery,  the  pastern  of  each  hind-limb  should 
be  corded ;  then  the  hand  must  be  passed  along  the  flexor  tendons 
until  the  point  of  the  hock  is  reached,  this  part  usually  jamming 
against  the  brim  of  the  pubis  ;  the  hock  is  now  raised,  and  at  the  same 
time  the  corresponding  cord  is  pulled  gently  backward  and  slightly 
downward,  so  as  to  bring  the  calcis  into  the  vagina  ;  this  operation  is 
to  be  repeated  on  the  other  limb,  and  then  both  feet  are  to  be  directed 
by  the  hand  through  the  canal.  This  being  accomphshed,  the  cords 
should  then  be  pulled  upwards,  so  as  to  raise  the  croup  and  facilitate 
its  entrance  into  the  inlet ;  after  which  steady  traction,  proportioned  to 
the  amount  of  resistance,  must  be  employed  during  the  labour-pains 
until  the  young  creature  is  completely  extracted. 


JjysTiiKLi   IHE  To  TllK  IIK.U)  (ill  I-'ollKLlMHS.  469 

L  iimbo-supra-Co ty lo Ulean  Pos  it  io7is . 

These  positions — ri-^ht  and  left — are  so  like  the  corrcsponclinf:;  posi- 
tions in  the  anterior  presentation,  that  the  same  remarks  are  applicable 
to  them.  When  simple,  the  hind-limbs — perfectly  extended — first  enter 
the  ^'enital  canal.  Such  positions  are  very  rare,  and  they  do  not  offer 
anything  very  noteworthy  ;  they  are  recognised  in  the  same  way  as  the 
lumbo-pubic  position,  and  the  indications  are  the  same.  As  a  rule, 
parturition  is  easier  in  these  positions  than  in  the  lumbo-pubic,  as  only 
one  haunch  is  jammed  against  the  brim  of  the  pubis  ;  the  other,  being 
in  contact  with  the  mother's  sacrum,  can  enter  the  inlet  without  much 
dirticulty.  Judicious  traction  on  the  hind-pasterns  is  all  that  is  needed 
after  the  position  has  been  rectified. 

The  same  observations  apply  to  the  lumho-ilial  positions,  which  are 
sometimes,  though  rarely,  met  with,  and  are  a  cause  of  dilViculty. 

SECTION  II.— DYSTOKIA  Dl'K  TO  THE  HEAD  OR  FORE-LIMBS. 

Obstacles  occasioned  by  the  head  and  fore-limbs  in  this  presentation 
are  less  frequent,  and  not  so  serious  as  in  the  anterior  presentation  when 
the  hind-legs  enter  the  genital  canal.  The  head,  when  not  hydro- 
cephalic, is  usually  a  cause  of  dilliculty  when  the  neck  is  contracted  and 
brings  it  round  to  the  side  of  the  body. 

Head  and  Contracted  Neck. 

The  head  itself  does  not  so  readily  constitute  an  obstacle  to  birth, 
though  in  the  posterior  presentation,  being  the  last  portion  of  the  foetus 
to  enter  the  passage,  its  widest  part  may  become  faxed,  either  in  the 
pelvic  inlet,  or  be  retained  by  the  cervix  uteri  when  this  has  happened 
to  contract  earlier  than  usual.  This  sometimes  occurs  with  the  Calf 
and  some  of  the  smaller  animals,  but  more  especially  Puppies.  Indeed, 
it  is  not  very  uncommon  to  witness  Bitches  with  the  hind  part  of  the 
body  of  a  Puppy  hanging  from  the  vulva,  the  head  being  firmly  wedged 
in  the  passage. 

Very  few  instances  of  contracted  neck  are  recorded,  and  they 
occurred  in  the  Mare,  with  other  complications — such  as  a  transverse 
presentation,  or  a  misdirection  of  the  limbs.  The  head  is  bent  round 
towards  the  haunch,  and  rigidly  maintained  there  by  the  crooked  neck; 
so  that  it  is  fixed  against  the  border  of  the  pelvis  and  cannot  enter  the 
inlet,  which  is  already  occupied  by  the  hind-quarters.  In  these  cir- 
cumstances birth  is  impossible. 

Care  is  necessary  in  arriving  at  a  conclusion  as  to  the  nature  of  this 
difficulty,  but  in  repelling  the  hind-quarters  from  the  inlet  the  head  will 
be  found  at  one  side  ;  nothing  else  abnormal  being  discovered,  it  may 
be  inferred  that  contracted  neck  is  the  cause  of  obstruction. 

Indications. — When  the  head  alone  is  the  obstacle,  traction  will  re- 
move it  from  the  genital  canal,  the  body  of  the  fa-tus  being  at  the  same 
time  moved  from  side  to  side  and  up  and  down,  so  as  to  engage  the 
head  in  the  passage  by  all  its  diameters.  With  small  animals,  such  as 
the  Bitch,  an  emollient  hip-bath  is  very  useful;  as  are  also  injections  of 
warm  water,  oil,  or  glycerine  into  the  vagina. 

When    the  neck  is  bent  or  contracted,    the  hind-Umbs  should   be 


460  FCETAL  DYSTOKIA. 

corded,  placed  straight  in  the  genital  passage,  and  traction  made  on 
them  by  the  cords  and  the  hand  ;  if  there  is  difficulty  in  moving  the 
foetus,  traction  should  be  made  on  one  side,  then  on  the  other,  by  which 
means  progress  will  be  made,  and  delivery  ultimately  completed. 

Fore-Limhs. 

In  the  posterior  presentation  it  may  happen  that  the  fore-limbs  olTer 
an  obstacle  to  birth,  by  entering  the  inlet  along  with  the  chest  of  the 
foetus.  Donnarieix  alludes  to  this  accident  in  a  presentation  which 
he  designates  as  mixed,  and  characterised  by  the  entrance  into  the  os 
of  the  four  legs  at  the  same  time  ;  this  may  occur  in  the  anterior  pre- 
sentation, when  the  hind  extremities  are  flexed  beneath  the  abdomen 
and  jammed  in  the  pelvis,  as  well  as  when  these  are  the  first  to  enter 
the  OS.  Other  authorities  also  speak  of  this  accident,  which  is  not 
frequent.  Sometimes  the  two  hind-limbs  and  a  fore  one  are  found  in 
the  passage.  It  is  probable  that  the  presentation  is  secondary,  and 
probably  it  was  originally  sterno-abdominal,  with  the  feet  engaged  in 
the  canal. 

The  hind-legs  are  found  in  the  passage,  perhaps  projecting  from  the 
vulva,  one  or  both  of  the  fore  ones  being  in  the  vagina,  and  probably 
towards  the  maternal  sacrum  ;  while  the  body  of  the  foetus  may  be 
parallel  to  that  of  the  mother,  but  more  frequently  it  is  oblique. 

Indications. — According  to  Donnarieix,  retropulsion  is  impracticable 
in  the  Mare  in  this  difficulty,  as  the  limbs  are  jammed  against  the 
maternal  pubis,  ihums,  or  sacrum,  and  traction  will  lead  to  rupture  of 
the  uterus.  He  therefore  advises  amputation  of  the  fore-limb  or  limbs 
at  the  humero-radial  joint,  after  they  have  been  withdrawn  to  near  the 
vulva ;  he  has  always  been  successful  in  his  cases  by  such  treatment. 
With  the  Cow,  however,  he  admits  that  the  fore-limbs  may  be  pushed 
forward  into  the  uterus,  and  delivery  then  effected. 

Dieterich  and  Darreau  advise  retropulsion  of  the  fore-limb  or  limbs 
by  means  of  the  repeller. 

Amputation  of  these  limbs  being  a  long  and  troublesome  operation, 
Donnarieix's  advice  should  not  be  followed  until  other  measures  have 
been  tried.  These  should  be  :  propelling  the  fore-limbs  into  the  uterus, 
and  if  this  cannot  be  effected,  pushing  the  upper  joints  beyond  the 
inlet.  Canu  recommends  cording  the  hind  extremities,  grasping  the 
fore  ones  above  the  knee  and  carrying  them  into  the  uterus,  while  the 
assistants  pull  the  cords.  If  these  attempts  fail,  then  the  fore-legs  can 
be  drawn  as  near  the  vulva  as  possible,  and  amputated  either  at  the 
shoulder  or  scapula. 

B.  Abnormal  Posterior  Presentations. 

The  abnormal  posterior  presentations  are  chiefly  due  to  deviation  in 
the  direction  of  the  hind-limbs,  and  this  is,  in  many  instances,  a  very 
serious  complication.  Instead  of  being  extended  backwards  into  the 
passage,  one  or  both  may  be  bent  at  the  fetlocks  or  the  hocks — the  leg 
against  the  thigh,  these  joints  presenting ;  or  they  may  be  carried 
straight  forward  under  the  body,  the  buttocks  alone  resting  against  the 
inlet.  So  that,  instead  of  a  wedge-shaped  mass  offering  its  thinnest 
portion  to  gradually  dilate  the  genital  canal,  the  foetus  presents  a  large 
rounded  mass — the  croup  and  thighs — which  is  not  at  all  adapted  for 


ABXOUMAL  POSTERIOR  PRESEXTATIOXS.  4G1 

effecting  a  passage  through  the  Hinited  space.  When  to  tliis  bulk  is 
ailded  tlu'  Hexed  portion  of  the  hnibs,  it  will  be  seen  that  this  cause  of 
dystokia,  generally  most  formidable  in  all  cases,  must  be  more  so  with 
primiparip,  and  especially  if  some  time  has  been  allowed  to  elapse  since 
the  commencement  of  parturition,  if  the  "  waters  "  have  esca])ed,  and 
if  amateurs  and  empirics  have  been  interfering.  With  I'egard  to  this 
interference,  however,  it  must  be  admitted  that  it  is  less  to  be  dreaded 
in  this  presentation  than  perhaps  in  any  other  ;  incompetent  people  are, 
fortunately,  at  a  loss  how  to  act,  as  there  is  nothing  to  lay  hold  of,  and 
the  nature  of  the  malposition  or  the  manner  of  remedying  it  is  obscure, 
perhaps  unknown  to  them. 

In  the  diverse  complicated  positions  of  the  posterior  limbs  in  this 
presentation,  it  may  be  remarked  that  they  are  more  frequent  and 
difficult  in  the  Mare  than  in  the  Cow — the  increased  difficulty  being 
doubtless  due  to  the  gi'eater  length  of  the  limbs  in  the  Foal  than  the 
Calf. 

The  malposition  of  the  hind-limbs  may  be  of  three  kinds  :  1.  Limbs 
incompletely  extended  in  the  genital  canal ;  2.  Flexed  hocks,  the 
doubled  limbs  engaged  more  or  less  deeply  in  the  passage  ;  3.  Ilind- 
limbs  completely  retained  in  the  uterus,  and  applied  more  or  less  closely 
against  the  abdomen  of  the  fujtus,  the  back  part  of  the  thighs  and  the 
croup  presenting  at  the  inlet. 

We  have  mentioned  that  one  or  both  limbs  may  be  in  a  vicious  posi- 
tion ;  even  when  the  two  are  misdirected  they  may  not  be  in  the  same 
deviation — one  leg  being  perhaps  Hexed  at  the  hock  and  the  other  ex- 
tended forward  towards  the  chest,  one  Hexed  at  the  fetlock  while  the 
other  is  bent  at  the  hock,  etc. 

This  presentation  is  somewhat  rare,  and  though  differing  little  from 
the  natural  one,  yet  frequently  leads  to  death  of  the  Foal,  as  birth 
cannot  take  place  without  assistance  ;  though  the  Calf,  having  more 
vital  tenacity,  can  live  longer,  and  therefore  has  more  chance  of  being 
born  alive,  even  if  help  be  not  afforded  for  some  time.  It  is  generally 
due  to  the  prominent  stiHes  being  arrested  at  the  inlet  by  the  thin 
margin  of  the  pubis  in  the  Mare,  or  the  inclined  plane  this  part  forms 
in  the  Cow.  When  the  hind-limbs  become  fixed  the  body  of  the  fa'tus 
continues  to  pass  outwards,  so  that  the  fenuu-s  become  more  vertical, 
and  this  causes  the  croup  to  be  raised  against  the  lumbar  region,  and 
finally  to  be  jammed  there.  The  accident  is  much  less  frequent  in  the 
Cow  than  the  Mare,  probably  because  of  the  sloping  border  of  the 
pubis. 

Exploration  discovers  the  soles  of  the  hind-feet  uppermost,  with  the 
shank  incompletely  extended  on  the  tibia,  which  again  is  partially 
Hexed  on  the  femur ;  the  stiHes  are  also  found  pressing  against  the 
margin  of  the  pubis,  while  beyond  this  the  croup  is  jammed  upon  the 
sublumbar  arch. 

Indications. — These  are  :  push  the  croup  forward  in  the  uterus  during 
the  inten-als  between  the  pains,  while  traction  is  made  on  the  cords 
which  have  been  attached  to  the  lower  part  of  the  legs. 

If  the  hind-legs  chance  to  be  incompletely  extended  in  the  reverse  or 
lumbo-ilial  position — which  is  possible,  particularly  in  the  Cow — the 
foetus  should  be  pushed  forwards,  its  hind-legs  extended,  and  the 
creature  placed  in  the  lumbo-sacral  position,  when  delivery  can  be 
completed. 


462 


FOETAL  DYSTOKIA. 
Hock  Peesentation. 


The  mechanism  of  hock  presentations  is  supposed  to  be  as 
follows: — The  foetus,  in  the  posterior  presentation,  lumbo-sacral 
position,  and  impelled  by  the  uterine  contractions  towards  the  cervix. 


Fig.  139. 
Hock  Presentation  :  Calf. 


reaches  the  inlet  with  the  hind-limbs  not  quite  extended,  nor  the  axis 
of  the  young  creature  quite  coinciding,  perhaps,  with  that  of  the  passage. 
Consequently,  the  legs  come  in  contact  with  the  pelvic  brim  below  by 


Fig.  140. 
Diagrams  of  the  Hind-Limbs  in  Hock  Presentation. 

the  posterior  surface  of  the  shank,   while  the  croup  encounters   the 
sacro-vertebral  angle  above. 

The  labour-pains  continuing,  the  croup  has  a  tendency  to  descend, 
and,  with  the  points  of  the  hocks,  to  advance  through  the  os:  the  latter 


ABNORMAL  POSTERIOR  PRESENTATIONS.  1(53 

joints  become  <;raclually  tloxed  until  at  last  the  cannon-bones  press 
against  the  thighs,  and  the  doubled  legs  and  croup,  jannned  in  the 
inlet,  form  far  too  large  a  mass  to  advance  further  (Fig.  139).  Labour 
is  therefore  suspended,  and  the  animal  becomes  exhausted  with  futile 
straining. 

The  increase  in  volume  is  well  exemplified  in  the  annexed  outlines 
(Fig.  140).  In  figure  A,  we  observe  that  the  direction  of  the  femur 
(a  b)  is  much  more  oblique  than  in  figure  B,  which  shows  the  limb 
extended,  and  that  bone  {a  b')  in  its  usual  position.  The  consequence, 
in  figure  A,  is  apparent  in  the  elevation  of  the  stifle  to  the  middle 
horizontal  line,  and  tlie  inclusion  of  the  hock  and  greater  portion  of  the 
metatarsal  bone  in  the  line  below,  which  only  touches  the  stifle  {a  b', 
figure  B). 

The  mechanism  is  quite  the  same  in  the  lumbo-pubic  and  lumbo- 
ilial  positions,  the  parts  of  the  pelvic  brim  against  which  the  croup  and 
limbs  impinge  being  alone  ditierent.  One  limb  only  may  be  retained  in 
this  malposition,  as  already  remarked,  the  other  being  extended  in  a 
normal  manner ;  but  this  does  not  in  any  way  alter  the  state  of  affairs 
— neither  with  respect  to  the  mechanism,  nature  of  the  complication, 
nor  measures  to  be  adopted. 

In  hock  presentation,  the  point  of  the  os  calcis  is  always  the  first 
part  the  hand  encounters  in  exploration  ;  but  it  may  be  found  at  various 
depths.  Sometimes  the  hocks  alone  are  in  the  canal,  the  body  of  the 
foetus  being  still  in  the  uterus ;  while  in  other  cases  they  and  the  croup 
are  within  the  inlet,  and  are  wedged  in  the  passage.  But  it  is  not  so 
much  these  which  form  an  obstacle  to  birth,  as  the  phalanges  of  the 
hind-limbs,  which,  owing  to  the  extreme  flexion  of  the  hocks,  are  flexed 
to  a  corresponding  degree,  and  so  form  two  hooks  which  cling  to  the 
edge  of  the  pubis.  Consequently,  birth  is  impossible  without  extraneous 
aid. 

Indications. — The  difliculties  vary  according  to  circumstances.  With 
the  larger  animals  at  their  full  period  of  pregnancy,  birth  cannot  take 
place,  as  a  rule,  until  the  deviation  has  been  rectified  ;  and  to  attempt 
delivery  before  this  has  been  done  is  to  expose  the  Cow  or  Mare — 
particularly  the  latter — to  great  danger.  With  the  Sheep,  Goat, 
Sow,  and  Bitch,  the  fcEtus  can  be,  and  often  is,  extracted  in  this  mal- 
position. 

The  indication  is,  therefore,  with  the  Mare  or  Cow,  to  give  the  hind- 
limbs  a  favourable  direction,  by  extending  tliem  in  the  genital  canal  ; 
and  this  is  more  easily  accomplished  in  the  Cow  than  the  Mare,  owing 
to  the  smaller  size  of  the  croup  and  shorter  limbs  of  the  Calf.  Some 
authorities  are  even  of  opinion  that  the  latter  may  at  times  be  extracted 
without  the  limbs  having  been  adjusted  ;  while  others  assert  positively 
that  delivery  may  be  effected  in  the  Cow  by  nmtation  of  the  fcetus,  but 
that  this  is  impossible  with  the  Mare,  unless  a  particular  operation  — 
to  be  noticed  immediately — is  adopted.  Saint-Cyr,  however,  has.  with 
more  or  less  trouble,  and  the  Mares  not  straining  severely,  succeeded  on 
four  or  five  occasions,  when  the  Foal  made  a  hock  presentation,  in  ex- 
tending the  limbs  in  the  genital  canal,  and  effected  delivery  without 
resorting  to  this  operation.  He  points  out,  nevertheless,  that  the  Foal 
dies  very  quickly  in  this  position,  while  very  often  the  Calf  is  extracted 
alive,  even  after  long  and  laborious  manipulations.  Other  writers 
corroborate  Saint-Cyrs  opinion  with  regard  to  deUvery. 


464  F(ETAL  DYSTOKIA. 

The  method  of  adjusting  the  hind-limbs  is  as  follows  : 

1.  Push  tJie  foetus  as  far  as  possible  into  the  uterus.  This  retropulsion 
can  be  effected  without  difficulty — even  in  the  Mare — at  the  commence- 
ment of  parturition,  when  the  foetus  has  not  yet  entered  the  pelvic  inlet, 
or,  at  most,  the  points  of  the  hocks  are  only  engaged.  But  at  a  later 
period,  when  labour  is  more  advanced,  and  the  croup  is  in  the  passage 
and  on  the  vaginal  side  of  the  inlet,  the  difficulty  is  greatly  increased 
in  the  Cow,  and  retropulsion  may  even  be  impossible  in  the  Mare.  It 
should  always  be  attempted,  however,  and  in  the  Cow  the  attempt  will 
be  generally  successful. 

The  hind-quarters  must  be  raised  as  much  as  possible,  and  the  hand 
should  be  applied  against  the  buttock  of  the  young  creature,  the  thumb 
on  one  hip,  the  fingers  on  the  other,  and  immediately  below  the  tail. 
If  the  repeller  is  used  (and  it  is  very  convenient  in  these  cases),  it 
should  be  placed  across  the  thighs.  The  retropulsion  should  be  made 
by  steady  pushes  in  the  interval  between  the  labour-pains ;  these  pushes 
should  be  directed  slightly  upward,  so  as  to  raise  the  croup.  At  first 
the  resistance  seems  to  be  insurmountable,  but  gradually  the  foetus 
begins  to  move  forward,  and  finally  is  entirely  propelled  into  the  uterus, 
and  at  a  sufiicient  distance  from  the  pubis  to  allow  the  limbs  to  be 
extended  backwards. 

When  the  animal  persists  in  lying,  the  hind-quarters  may  be  raised 
by  trusses  of  straw  ;  and  it  has  happened  in  some  cases,  especially  with 
the  Mare,  that  retropulsion  could  only  be  achieved  and  delivery  effected 
by  putting  hobbles  on  the  hind-pasterns,  and  drawing  up  the  hind- 
quarters by  means  of  the  rope  attached  to  them,  and  which  was  run 
over  a  beam  in  the  ceiling. 

Eainard  points  out  that  it  often  happens,  during  this  retropulsion, 
that  the  foetus  is  pushed  into  somewhat  of  a  transverse  position, — the 
head  and  fore-limbs  approaching  the  pelvis,  where  they  may  be  seized 
and  version  effected  by  moving  them  round  into  the  anterior  presenta- 
tion, bringing  them  into  the  passage,  and  then  completing  deliver)^ 
This  fortunate  movement,  however,  must  be  extremely  rare. 

2.  When  the  body  of  the  foetus  has  been  pushed  sufliciently  far  from 
the  pubis  to  allow  the  limbs  to  be  seized,  the  hand  may  then  fasten  a 
cord  on  each  'pastern  (by  means  of  the  porte-cord,  if  necessary),  in  order 
to  assist  in  extending  the  limbs  at  the  proper  moment,  by  a  few 
moderate  pulls  in  the  desired  direction. 

3.  To  extend  the  limbs  in  the  genital  canal,  the  lower  parts  must 
describe  the  arc  of  a  circle,  the  hock-joint  being  the  centre,  the  limb 
below  this  being  the  ray ;  so  that  the  foot,  which  is  at  first  directed 
forward,  may  be  brought  directly  back  towards  the  vulva  of  the  mother. 
The  limb  which  is  most  convenient  is  first  extended.  Some  obstetrists 
begin  by  seizing  the  hock,  the  fingers  in  front  and  below  the  joint,  the 
palm  and  thumb  on  the  calcis  and  shank  ;  the  lower  part  of  the  limb  is 
then  drawn  backwards,  while  the  thigh  is  pushed  forward,  and  by  a  turn 
of  the  wrist  the  leg  is  carried  through  the  inlet  and  straightened.  The 
same  procedure  is  carried  out  with  the  other. 

Other  practitioners  endeavour  to  flex  the  limb  as  completely  as 
possible,  commencing  with  the  tibia  and  lifting  it  well  up  against  the 
femur,  then  the  hock  is  bent ;  the  limb  is  now  seized  at  the  lower  end 
of  the  cannon-bone,  or  even  at  the  fetlock,  and  is  then  lifted  into  the 
vagina.  Schaack's  method  does  not  differ  much  from  this.  He  flexes 
the  leg  on  the  thigh  as  much  as  possible,  raising  the  point  of  the  hock 


ABXORMAL  POSTERIOR  PRESENTATIONS.  465 

as  near  the  buttock  as  he  can  ;  this  elevates  the  foot  and  brings  it 
nearer.  As  the  hibour-pains  usually  push  the  foetus  too  near  the  pubis, 
it  must  be  thrust  forward  again  by  acting  more  particularly  on  the 
point  of  the  hock,  using  it  as  a  kind  of  propeller.  When  sullicient  space 
has  been  gained,  the  hand  descends  along  the  cannon  bone  and  grasps 
the  front  of  the  foot — the  thumb  and  index-finger  meeting  round  the 
coronet,  so  that  the  toe  is  in  the  palm  of  the  hand ;  in  this  way  the 
pastern  and  fetlock  are  forcibly  flexed,  when,  by  a  vigorous  effort — 
seconded,  if  need  be,  by  the  cord  placed  round  it — the  foot  is  raised 
above  the  pelvic  brim,  brought  into  the  vagina,  and  the  leg  extended — 
an  easy  operation,  generally.  With  the  Foal,  however,  it  sometimes 
happens  that,  owing  to  the  length  of  the  limbs,  the  calcis  presses  against 
the  sacrum  of  the  mother  while  the  foot  jams  on  the  pubis.  In  such 
cases  the  pastern-cord  is  most  useful,  as  the  operator  may  allow  the 
foot  to  pass  from  his  hand,  and  press  the  point  of  the  hock  towards  the 
uterus ;  while  an  assistant  pulls  at  the  cord  witli  such  an  amount  of  force, 
and  at  such  times,  as  the  obstetrist  may  order.  The  other  limb  is  to  be 
brought  back  in  the  same  way. 

Cartwright  mentions  that,  in  those  cases  in  which  the  limb  cannot  be 
sufliciently  extended  backwards,  the  hock  should  be  drawn  as  far  as 
possible  into  the  passage,  and  the  tendon  of  the  flexor  metatarsi  divided 
above  its  point  of  bifurcation,  in  front  and  at  the  upper  part  of  the 
joint ;  this  allows  greater  mobility.  If  the  foetus  is  dead,  of  course 
there  can  be  no  objection  to  this  section  ;  if  alive,  it  will  require  con- 
sideration. 

This  is  the  method  to  be  recommended  in  every  case;  and  it  will  very 
often  be  attended  with  success,  even  in  the  Mare,  when  the  fci'tus  is  not 
too  firmly  fixed  in  the  pelvis,  and  can  be  pushed  into  the  uterus.  But 
it  frequently  happens  that  retropulsion  is  not  possible ;  the  hind-feet 
cannot  be  reached,  and  delivery  cannot  be  accomplished  in  the  way  in- 
dicated. We  must  then  adopt  other  methods  applicable  to  the  Mare 
and  Cow. 

With  the  Mare,  when  the  fa-tus  is  impacted  in  the  pelvis,  so  that  it 
cannot  be  moved  forward,  it  may  be  presumed  that  it  no  longer  lives, 
or  that  it  will  perish  before  delivery  is  completed.  There  can  be  no 
objection,  then,  in  resorting  to  embryotomy,  so  as  to  relieve  the  Mare 
as  quickly  as  possible. 

The  hind-limbs  of  the  foetus  may  be  amputated  either  at  the  stifle  or 
the  hock — some  authorities  recommend  the  former,  others  the  latter; 
while  others,  again,  advise  excision  at  the  coxo-femoral  articulations. 
Extraction  of  the  fcetus  has  been  effected  after  amputation  in  the  three 
regions,  but  preference  is  generally  given  to  division  at  the  hock.  This 
is  effected  by  drawing  the  joint  as  far  into  the  vagina  as  possible,  either 
by  the  hand  or  a  cord  passed  round  the  part  (Fig.  141);  if  it  can  be 
drawn  beyond  the  vulva,  all  the  better,  but  this  requires  much  force. 
The  joint  is  then  disarticulated,  and  the  separated  portion  of  the  hmb 
withdrawn  from  the  passage.  The  other  leg  being  served  in  the  same 
way,  deliveiy  can  be  completed  in  the  ordinary  manner — the  obstacle 
being  now  removed. 

"  Now  and  then,"  as  Cartwright  remarks,  "  we  are  not  able  to  bring 
the  legs  straight  into  the  passage,  but  have  to  get  away  the  fa'tus  by 
means  of  cords  around  the  hock  or  hocks,  with  one  or  both  of  the  legs 
doubled  forward  against  the  thigh.    In  these  cases  it  will  be  advisable  to 

30 


466 


FCETAL  DYSTOKIA. 


divide  the  tendons  (gastrocnemii)  at  the  back  of  the  legs,  just  above  the 
point  of  the  os  calcis,  and  also  the  flexor  tendons  belovy  the  hocks,  by 
which  means  the  flexion  at  the  hock-joints  will  be  more  perfect,  and  the 
leg  and  thigh  approximate  better.  After  we  have  done  this,  we  may 
pull  at  the  cords  around  the  hocks  pretty  freely  ;  but  we  must  not  omit 
forcing  the  breech  into  the  abdomen,  so  as  to  allow  the  limbs  or  the 
stifles  to  become  straightened,  and  prevent  the  latter  wedging  against 
the  anterior  part  of  the  pelvis.  ...  In  some  cases,!  have  known  the 
foetus  to  come  away  in  a  breech  presentation,  without  the  legs  being 
straightened  at  the  stifles  ;  but  it  is  bad  practice.  In  some  cases  we 
may  remove  the  leg-bone,  by  sawing  it  through,  close  up  to  the  hock, 
and  afterwards  passing  a  cord  above  the  os  calcis  to  pull  at,  and  then 
pushing  the  breech  forward." 


Fig.  141. 
Hock  Presextatiox  :  Hock  corded. 


"With  the  Coic,  the  Calf  is  very  frequently  alive,  and  an  important  con- 
sideration is  how  to  deliver  it  in  this  condition.  Shovild  it  be  impossible 
to  effect  retropulsion,  forced  extraction  in  this  malposition  should  be 
attempted  ;  it  has  often  proved  successful,  and  particularly  when  only 
one  limb  was  retained. 

To  effect  forced  extraction  with  one  limb  alone  flexed,  the  leg  extended 
in  the  vagina  should  be  corded  at  the  pastern,  or  above  the  hock  if  this 
can  be  reached.  A  cord  is  then  to  be  passed  around  the  bent  hock  by 
means  of  the  porte-cord,  and  traction  exercised  during  the  labour- 
pains. 

When  both  legs  are  flexed  at  the  hocks,  a  cord  must  be  passed  round 
each,  as  in  Fig.  111.     The  necessary  force  can  then  be  exercised. 

Should  forced  extraction  not  succeed,  the  limbs  may  be  amputated  at 
the  hocks,  as  with  tbe  Mare. 


ABNOIiMAL  roSTERIOR  PRESENTATIONS. 


4(57 


It  is  well,  in  this  malposition,  when  the  himl-liinbs  have  been  either 
removed  or  adjusted,  to  ascertain  the  direction  of  the  tail ;  as  it  is  some- 
times thrown  back  over  the  croup  (as  in  Fig.  Ill),  and  may  thus  increase 
the  dirticulty  to  be  surmounted.  It  may  readily  be  brought  back  to  its 
natural  position  by  passing  the  hand  from  the  root  to  its  extremity, 
and  bringing  it  into  the  vagina  by  witlidrawing  the  arm.  In  some 
instances  rctropulsion  maybe  necessary  before  the  tail  can  be  adjusted. 

This  hock  presentation  may  occur  in  other  than  tlie  lumbo-sacral  posi- 
tion, and  it  certainly  has  been  observed  in  the  lumbo-ilial.  The  croup 
does  not  enter  the  inlet,  but  presses  against  it;  so  that,  especially  with 
the  Cow,  the  foetus  can  be  pushed  forward,  the  limbs  extended,  and 
through  them  the  position  changed  to  lumbo-sacraL  With  the  Mare, 
however,  the  violent  straining  may  prevent  this  measure  being  carried  out 


Fig.  142. 
TmcH  ANi>  Crocp  Pre.sentatio\. 


until  the  fcetus  is  dead,  when  it  may  be  removed  by  drawing  the  hocks 
into  the  vagina,  dividing  the  gastrocnemii  tendons,  pushing  the  body 
into  the  uterus,  rotating  it  into  the  lumbo-sacral  position,  and  extract- 
ing it. 

With  the  Sheep  and  Goat  the  same  procedure  is  applicable,  but  the 
Bitch  generally  does  not  experience  any  difficulty  in  expelling  the  foetus 
in  this  malpresentation. 

Thigh  and  Ckoup  Pkesentation. 

The  cause  of  this  malposition  is  the  same  as  that  operating  in  hock 
presentation  ;  the  deviation  is  not  at  all  unusual  in  Mares  or  Cows  with 
a  very  pendulous  abdomen.  The  hind-legs  are  flexed  more  or  less  under 
the  body. 

When  the  thighs  and  croup  alone  present  at  the  inlet,  the  joints  of 


468  FCETAL  DYSTOKIA. 

the  hind-limbs  being  partially  or  only  very  slightly  flexed,  it  is  evident 
that  the  voluminous  mass  cannot  pass  into  the  pelvis.  Some  part  of  the 
posterior  region  of  the  fcEtus — -as  the  hocks — jams  against  the  pelvic 
border  and  cannot  get  beyond ;  while  the  points  of  the  buttocks,  placed 
in  front  of  the  inlet,  are  engaged  somewhat  in  the  passage.  With  the 
continuance  of  the  labour-pains,  this  part  gradually  enters  the  pelvic 
cavity,  while  the  retained  hind-limbs  are  proportionately  forced  forward 
beneath  or  on  each  side  of  the  abdomen  of  the  foetus,  until  at  last  they 
are  closely  applied  to  the  body ;  the  creature  has  assumed  the  position 
of  an  animal  lying  in  a  natural  manner,  and  the  posterior  part  of  the 
trunk  is  firmly  fixed  between  the  sacrum  and  pubis  of  the  mother 
(Fig.  142). 

The  tail  and  buttocks  of  the  foetus  are,  therefore,  the  first  parts  that 
the  hand  encounters  in  exploring  the  genital  canal ;  then  the  croup 
and  haunches,  and  below,  beneath  the  pubis,  are  found  the  hocks, 
which  may  be  more  or  less  accessible  to  manipulation,  according  to 
circumstances ;  though,  when  the  limbs  are  fully  extended  under  the 
body,  they  are  beyond  reach.  Though  the  croup  and  haunches  may 
have  passed  into  the  pelvic  inlet,  yet  nothing  of  the  foetus  is  discernible 
externally,  except  perhaps  the  tail,  no  matter  how  long  the  labour  may 
have  been  in  progress. 

In  the  majority  of  cases,  perhaps,  the  young  creature  is  in  the  lumbo- 
sacral position  ;  while  in  others  it  may  be  in  the  lumbo-pubic,  or  right 
or  left  lumbo-ilial  positions. 

Indications. — Authorities  are  generally  unanimous  in  asserting  that 
this  is  one  of  the  most  difficult  malpositions  the  veterinary  obstetrist 
can  encounter.  Very  frequently  the  mother  perishes  without  being 
delivered  ;  and  though  sometimes  a  live  Calf  may  be  extracted,  it  is  rare 
indeed  that  a  living  Foal  is  obtained,  and  only  too  often  the  Mare 
succumbs  after  parturition  has  been  accomplished  by  manual  force. 
The  chances  of  success  in  saving  either  mother  or  offspring  are  dimin- 
ished in  direct  proportion  to  the  time  labour  has  been  going  on,  the 
foetus  advanced  in  the  pelvic  cavity,  and  the  maternal  genital  organs 
injured  or  irritated  by  improper  manoeuvres.  The  difficulty  is  also 
greatly  increased  in  Heifers,  or  animals  whose  genital  canal  is  smaller 
than  usual ;  a  large  foetus  likewise  makes  the  malpresentatiou  more 
serious. 

The  rational  indication  is,  of  course,  to  extend  the  limbs  of  the  foetus 
backwards,  as  in  ordinary  breech  presentations,  and  to  give  these  and 
the  body  a  direction  in  harmony  with  the  axis  and  dimensions  of  the 
pelvic  inlet,  so  that  birth  may  be  effected  by  the  combined  efforts  of 
the  mother  and  the  obstetrist.  But  this  indication  is  often  most  diffi- 
cult to  fulfil ;  though  in  some  instances,  and  even  with  the  Mare,  it  is 
possible  when  labour  is  not  too  far  advanced,  and  when  the  foetus,  still 
in  the  abdominal  cavity,  is  movable,  and  can  be  pushed  sufficiently 
from  the  inlet  to  allow  the  lower  part  of  the  limbs  to  be  seized  and 
brought  into  the  vagina. 

Pushing  the  foetus  as  far  into  the  abdomen  as  possible,  one  of  the  limbs 
is  seized  above  the  hock,  and  the  thigh  and  leg  flexed  as  completely 
as  circumstances  will  permit,  by  lifting  that  joint  towards  the  mother's 
sacrum.  Still  pushing  the  foetus  ofi"  by  means  of  the  repeller,  the 
hand  is  passed  down  to  the  hoof  or  claws  until  the  toe  and  front  part 
of  these  rest  in  the  palm  of  the  hand ;  by  adopting  this  precaution, 
danger  of  injury  to  the  uterus  or  vagina  is  averted.     Then  the  foot  is 


ABNORMAL  POSTERIOR  PRESEXTATJONS. 


469 


brought  into  the  passage  by  flexing  all  the  joints  on  each  other.  Again 
pushing  the  fcetus  forward,  the  same  nianci-uvre  is  repeated  with  the 
other  hinb,  if  necessary  ;  though  forced  extraction  has  sometimes  suc- 
ceeded with  only  one  leg  in  the  passage,  that  which  is  retained  finding 
space  in  the  abdomen,  and  even  facilitating  the  passage  of  the  thorax, 
according  to  some  obstetrists. 

This  manipulation  is  rendered  more  diflicult  than  in  hock  presenta- 
tion, from  the  fact  that  the  hocks  in  this  are  deeper  in  the  uterus,  and 
jam  against  the  brim  of  the  pelvis,  where  they  cannot  be  freed  by  the 
hand.  The  difliculty  is  surmounted  by  passing  a  blunt  hook  round 
them,  or  a  cord  as  in  Fig.  141,  the  two  ends  of  this  outside  the  vulva 
being  twisted  and  drawn  upwards  and  outwards  by  an  assistant ;  wliile 
the  operator,  pushing  at  the  croup,  throws  the  body  of  the  fci'tus  for- 
ward, and  thus  allows  the  point  of  the  calcis  to  rise  above  the  pelvic 
brim,  when  the  leg  can  be  extended  backward  as  in  hock  presentation. 

This  method,  however,  does  not  succeed  in  every  case  ;  and  when  the 


Fig.  113. 
Thii;h  .\Nn  Ckovp  Prksextatio.v  :  Thigh  conoKn. 


croup  is  firmly  wedged  in  the  pelvic  canal  and  the  thighs  have  cleared 
the  inlet,  it  is  only  too  often  impossible  to  effect  retropulsion.  Conse- 
quently, there  are  but  two  courses  open — extraction  of  the  foetus  in 
this  abnormal  position,  or  removing  it  by  embryotomy. 

Forced  extraction  of  the  foetus,  without  adjustment,  is  a  very  serious, 
because  a  very  violent,  measure,  and  is  frequently  fatal  to  the  mother, 
as  well  as  to  the  offspring.  It  should,  therefore,  not  be  lightly  adopted, 
and  every  other  measure  of  a  milder  kind  should  be  tried  if  it  has  any 
probable  chance  of  success.  Throwing  the  motlier  on  the  back  or  side 
may  eftect  a  change  for  the  better  in  the  position  of  the  foetus  ;  or  if 
standing  or  lying,  then  raising  the  hindquarters  as  high  as  may  be 
without  injury  should  be  tried. 

These  faihng,  then  Lecoq's  method  may  be  resorted  to.  This  con- 
sists in  passing  the  hand,  furnished  with  a  cord,  between  the  wall  of 
the  pelvis  and  the  body  of  the  foetus  as  far  as  the  thigh  of  the  latter  ; 
the  cord  is  then  pushed  beneath  the  thigh  as  far  as  possible  and  left 
there,  while  the  hand  is  passed  above — between  the  leg  and  body,  so 
as  to  bring  the  end  of  the  line  up  around  the  stifle  and  back  through 


470  FCETAL  DYSTOKIA. 

the  vagina.  In  this  way  the  thigh  is  encircled  by  a  loop,  as  in  Fig.  143. 
The  other  thigh  may  be  secured  in  the  same  way  by  another  cord,  and 
this  part  of  the  operation  will  perhaps  be  much  facilitated  by  using  the 
long  bent  porte-cord  (Fig.  171). 

Saint-Cyr  states  that  one  thigh  corded  may  be  sufficient ;  but  it  is 
undoubtedly  better  to  cord  both,  if  possible,  as  traction  on  the  two 
limbs  keeps  the  body  of  the  foetus  in  a  straight  direction. 

The  ends  of  the  cord  being  joined  together  outside,  assistants,  under 
the  direction  of  the  operator,  pull  with  the  necessary  amount  of  force  ; 
while  the  hand  of  the  operator  assists  in  the  vagina,  either  in  guiding 
the  foetus,  seizing  on  and  pulling  at  any  part  that  may  offer,  or  smooth- 
ing down  the  folds  of  the  mucous  membrane  in  the  canal  which  might 
otherwise  increase  the  obstacles.  The  foetus  has  been  extracted  alive 
by  this  procedure. 

Saake's  method^  is  somewhat  similar,  except  that  there  is  only  one 
cord,  and  that  encircles  the  body  instead  of  the  thigh.  The  cord  has 
a  ring  or  noose  at  the  end,  and  this  or  the  other  end  is  passed  between 
the  thighs  and  brought  out  at  the  flank  of  one  side ;  then  the  other 
end  is  also  brought  out  in  front  of  the  other  flank.  Both  ends  are 
carried  to  the  top  of  the  back,  the  plain  end  is  passed  through  the 


Fig.  144. 
Thigh  and  Croup  Presentation  :  Body  corded. 

ring  (Fig.  144)  and  brought  outside  the  vulva.  The  body  of  the  foetus 
is,  it  will  be  observed,  enclosed  in  a  loop,  the  upper  part  of  which — 
that  over  the  loins — is  carried  back  over  the  tail  to  the  buttocks,  so 
that  the  cord  now  only  encircles  the  flanks.  The  advantages  of  this 
method  over  the  other  are  chiefly  its  simplicity,  only  one  cord  being 
required,  and  the  better  direction  in  which  traction  can  be  exercised. 

In  three  cases  this  method  was  successfully  employed  by  Saake. 

Deneubourg  makes  use  of  the  tail  of  the  foetus  for  traction. 

There  can  be  no  doubt  that  the  foetus  may  be  removed  in  this  mal- 
position, with  both  the  hind-limbs  extended  forward  under  the  abdo- 
men. Cartwright  says  :  "  I  perfectly  recollect,  in  one  instance,  delivering 
a  Cow  of  a  very  large  Calf  with  both  its  hind-legs  under  its  abdomen, 
and  I  never  saw  a  Cow  after  calving  do  better."  In  those  instances 
which  are  attended  by  success,  it  will  generally  be  found,  however, 
either  that  the  foetus  is  small  or  the  pelvis  large  and  well  formed. 

Some  practitioners  resort  to  the  sharp  crotchets,  fixing  them  in  the 
muscles  of  the  croup,  towards  the  hip-joint ;  but  unless  the  hook  has 
a  bearing  on  the  femur  the  hold  is  not  very  firm.  In  a  case  of  this 
kind,  Drouard  found  that  the  skin  and  muscles  yielded,  the  femur  was 
disarticulated,  and  the  hind-limb  itself  entirely  torn  away  from  the 
^  Magazin  von  Gurlt  und  Hertwig,  1869. 


ABNORMAL  POSTERIOR  PRESEXTATIOXS.  471 

body.  Notwithstanding  this  diminution  in  the  volume  of  the  foetus, 
deUvery  was  still  impossible ;  the  other  limb  was  torn  away  in  a  similar 
manner,  after  which  a  crotchet  was  lixed  in  each  cotyloid  cavity,  and 
the  fu?tus  was  then  easily  extracted.  In  addition  to  the  malpresenta- 
tion,  the  young  creature  was  atTected  with  hydrocephalus. 

The  use  of  sharj)  crotchets  in  such  cases  is  always  attended  with 
risk  ;  should  they  slip  during  traction,  or  not  be  carefully  implanted  in 
the  fa>tus,  they  may  do  great,  if  not  fatal,  injury  to  the  mother. 

To  escape  the  dangers  which  accompany  the  use  of  the  crotchets  in 
this  way,  another  method  has  been  proposed  and  practised  by  many 
veterinary  obstetrists.  The  perineal  region  of  the  foetus  is  largely  in- 
cised, and  the  hand,  armed  with  a  crotchet,  is  passed  into  the  pelvis 
by  this  opening,  the  crotchet  being  fixed  either  in  front  of  the  symphysis 
pubis,  on  one  of  the  branches  of  the  ilium,  or,  which  is  perhaps  better, 
in  one  of  the  oval  foramina.  Two  crotchets — one  for  each  side — may 
be  used.  By  this  method,  a  more  solid  hold  is  obtained,  and  greater 
force  can  be  easily  exerted. 

Cartwright  observes  :  "In  those  cases  in  which  we  are  unable  to 
extract  by  the  breech,  through  not  getting  the  legs  up  straight  by  lay- 
ing hold  of  the  feet,  or  when  bent  at  the  hocks,  we  should  make  pretty 
free  incisions  through  the  skin  about  the  ilio-femoral  articulations  or 
rump,  and  afterwards  cut  or  tear  the  muscles  around  these  asunder,  and 
then  we  can  secure  cords  around  the  iliac  processes  and  coccygeal  bones, 
and  hooks  against  the  edge  of  the  obturator  foramen,  by  which  means 
we  can  remove  the  pelvic  and  coccygeal  bones ;  and  having  done  so,  we 
can  apply  a  cord  around  the  head  of  the  thigh-bones  and  pull  them 
out.  We  must  next  make  an  incision  into  the  abdomen  and  remove 
the  viscera,  as  they  are  sometimes  pushed  forward,  and  prevent  our 
removing  the  other  parts  of  the  foetus.  Then  we  must  either  pass 
cords  around  the  skin  that  surrounds  the  thigh,  or  insert  hooks  into 
the  skin,  and  draw  the  remainder  of  the  foetus  out  with  its  hind-legs 
under  its  belly,  and  so  complete  extraction." 

RuetT  proposes  to  detach  the  coxte  from  the  sacrum,  by  operating  in 
the  pelvis  of  the  fa-tus,  and  afterwards  to  extract  the  hind-limbs  thus 
separated  from  the  trunk.  Others  recommend  symphyseotomy — an 
operation  to  be  described  hereafter. 

When  the  ftetus  is  in  the  lumbo-pubic  position,  the  same  obstacles 
are  encountered.  Very  often  the  hind- limbs  are  bent  at  the  hocks,  and 
these  wedge  against  the  floor  of  the  sacrum.  The  same  order  of 
mancDuvres  has  to  be  adopted.  Retropulsion  allows  space  to  flex  the 
upper  joints,  then  extend  the  limbs.  When  extraction  cannot  be 
accomplished  with  the  animal  in  a  standing  attitude,  it  should  be 
placed  on  its  back.  When  success  does  not  attend  the  ordinary  mani- 
pulations, then  the  hind-limbs  of  the  foetus  must  be  disarticulated  at 
the  hocks,  or  higher. 

In  all  manoeuvres  of  this  kind,  great  care  must  be  exercised  in  pre- 
venting injur}'  to  the  maternal  organs  by  the  feet  of  the  young  creature, 
or  the  jagged  ends  of  bones  ;  and  while  traction  is  being  employed,  the 
hand  of  the  operator  should  be  busy  guiding  these  parts  through  the 
genital  passage. 

The  smaller  animals — Bitch,  Sow,  Ewe — may  be  delivered  by  the 
forceps,  small  crotchet,  or  the  tube-noose  to  be  hereafter  described. 
The  Caesarian  section  may  also,  in  extreme  cases,  be  resorted  to  with 
the  Bitch  and  Sow. 


472  FCETAL  DYSTOKIA. 

CHAPTEE  III. 
Dystokia  from  Transverse  Presentations. 

The  foetus  is  said  to  be  in  a  transverse  position,  when  the  hand  of  the 
obstetrist,  instead  of  meeting  with  the  anterior  or  posterior  part  of  the 
body,  comes  in  contact  with  the  trunk,  either  at  the  shoulders,  withers, 
sides,  flanks,  haunches,  loins,  back,  sternum  or  belly,  or  (which  is  per- 
haps most  frequent)  all  of  the  limbs  collected  together.  The  foetus, 
instead  of  having  its  greater  axis  parallel  to  the  pelvis  of  the  mother, 
has  it  transverse,  or  more  or  less  perpendicular  to  the  antero-posterior 
diameter  of  the  pelvic  canal. 

The  possibility  of  the  foetus  assuming  a  transverse  position  in  the 
uterus  has  been  denied  on  various  occasions  by  Goubaux,  who  bases 
his  objections  on  anatorao-physiological  reasoning ;  contending  that  the 
uterus  cannot  contain  the  young  creature  when  so  placed,  if  the  various 
dimensions  of  the  latter  be  compared  with  those  of  the  gravid  organ. 
In  the  first  place,  however,  it  must  be  remembered  that  the  uterus  is 
not  an  unalterably-shaped  body  with  rigid  walls,  but  a  membranous 
sac  whose  parietes  are  soft  and  yielding ;  and  that  its  form  may  vary 
with  the  displacement  of  its  contents — in  a  word,  that  its  transverse 
diameter  may  be  increased  at  the  expense  of  its  length.  Besides,  the 
foetus  itself  is  not  a  compact  unyielding  mass,  but  is  so  flexible  that  it 
may  assume  the  most  varied  attitudes  and  shapes. 

But  the  strongest  proofs  in  favour  of  the  possibility  of  such  presen- 
tations are  furnished  by  obstetrical  experience — the  facts  published  by 
a  host  of  observers  entirely  demolishing  the  antagonistic  theoretical 
notions.  It  may  be  noted,  however,  that  though  the  presentations  are 
justly  designated  transverse,  yet  the  body  of  the  foetus  is  generally  a 
little  oblique  in  one  direction  or  the  other. 

Though  the  transverse  vertical  or  horizontal  presentations  are  not 
altogether  rare,  yet  they  are  much  less  common  than  the  longitudinal 
presentations,  and  especially  the  anterior  presentation.  They  do  not 
appear  to  be  primary,  and  they  are  more  frequent  in  the  Mare  than  the 
Cow — perhaps  because  of  the  more  energetic  contractions  of  the  uterus 
in  the  former  animal  not  allowing  natural  adjustment  of  the  foetus, 
should  the  latter  not  be  exactly  in  a  favourable  position  when  labour 
commences.  "When  the  liquor  amnii  escapes  prematurely,  the  deviation 
is  still  more  likely  to  occur,  and  particularly  if  the  os  is  not  sufficiently 
dilated.  Torsion  of  the  uterus ;  spasm  of  the  cervix  ;  violent  straining 
and  disordered  movements  of  the  mother ;  deviation  of  some  parts  of 
the  foetus — -especially  of  the  head;  hydrocephalus,  monosomianism, 
etc.,  have  all  been  noted  at  times  as  a  cause  of  transverse  presenta- 
tions. Deformed  head  may  also  lead  to  this  presentation,  especially  if 
it  is  distorted,  as  in  Fig.  103. 

These  presentations  are  essentially  dystokial ;  as  it  is  evident  that 
the  foetus,  if  of  normal  size,  cannot  pass  crossways  or  sideways  through 
the  pelvic  canal,  which  barely  affords  space  for  its  passage  longitudin- 
ally. Birth,  therefore,  cannot  take  place  without  assistance ;  version 
must  be  practised  in  order  to  change  the  presentation,  and  one  or  other 
of  the  extremities  of  the  oval  mass  which  the  body  of  the  foetus  repre- 
sents must  be  brought  towards  the  inlet.  The  malpresentatiou,  through 
hindering  birth  greatly,  endangers  the  life  of  the  young  creature,  and 
especially  if  it  be  a  Foal. 


DYSTOk'/A  FnoM  THE  DORSO-LUMnAH  rilKSHXTATlOX.  473 

As  mentionccl  at  p.  247,  the  transverse  presentations  of  the  body 
may  be  Hniited  to  two  kinds — the  dorso-lumbar,  in  which  some  part 
of  the  back  presents  at  the  inlet  ;  and  the  stcrno-abdominal ,  in  which 
the  lower  part  of  the  body  (belly)  oilers. 

The  foetus  may  either  be  Jiorizontal  or  vertical ;  when  the  former,  it 
may  be  direct  or  oblique  in  direction — i.e.,  placed  perpendicularly  or 
obliquely,  with  regard  to  the  axis  of  the  mother's  body.  Saint-Cyr 
remarks  that  the  first  is  the  most  serious,  because  the  extremities  of 
the  ovoid  fu'tal  mass  are  equally  distant  from  the  inlet ;  with  respect 
to  the  other  intermediate  presentations  between  the  direct  longitudinal 
and  transverse,  they  are  evidently  less  unfavourable  because  one  of  the 
extremities — anterior  or  posterior,  as  the  case  may  be — is  found  nearer 
the  genital  canal,  so  that  version  is  less  ditlicult.  The  oblique  presen- 
tations are  almost  the  only  ones  compatible  with  the  vertical  position 
of  the  fa'tus. 

The  direct  horizontal  presentations  may  be  often  suspected  from  the 
appearance  of  the  mother,  the  abdomen  showing  great  enlargement 
laterally  ;  not  unfrequently  the  movements  of  the  fcctus  can  be  seen  on 
both  sides — on  the  right  as  well  as  on  the  left. 

SKCTION   I.— DYSTOKIA   FROM  THK  DORSO-LUMBAR 
PRKSENTATIDN. 

This  presentation  is  somewhat  rare  ;  the  body  of  the  foetus  is  curved 
and  the  limbs  ai*e  directed  forwards.  When  it  is  lying  horizontally, 
the  fore  part  may  occupy  the  right  or  left  side  of  the  mother  ;  hence 
Saint-Cyr  distinguishes  them  as  right  or  left  cephalo-ilial  positions — 
though  this  does  not  imply  that  the  fa'tal  head  is  necessarily  in  con- 
tact with  the  ilium,  for  it  may  be  turned  round  to  one  side  or  bent 
downwards. 

When  the  futus  is  vertical  the  head  is  usually  uppermost,  the  hind- 
quarters being  inferior,  as  in  Fig.  147  —  Saint-Cyr's  ccphnlo-sncral 
position  ;  though  it  may  also — for  all  positions  are  possible — have  this 
position  reversed,  the  head  being  downwards  and  the  croup  towards 
the  lumbar  region  of  the  mother — the  ccphalo-abdominal  position. 

Cephalo-Ilial  Positions. 

To  diagnose  this  cause  of  dystokia — or  back  presentation^ — is  not 
always  easy.  Labour  has  been  going  on  for  some  time,  the  "  waters  " 
have  escaped,  and  though  the  straining  may  be  very  energetic — even 
violent — yet  nothing  is  seen  of  the  fcutus.  When  the  hand  is  intro- 
duced into  the  genital  canal,  in  order  to  discover  the  situation  of  the 
fcetus  and  the  nature  of  the  obstacle  which  hinders  l;irth,  it  encounters 
at  first  a  more  or  less  rounded  surface,  which  does  not  offer  any  special 
character  by  which  it  might  be  recognised.  The  hand  is  then  passed 
deeper  into  the  uterine  cavity,  and  turned  in  every  direction  over  the 
body  of  the  fa>tus  (for  such  it  is),  so  as  to  find  some  parts  which  may 
be  distinguished,  and  by  which  the  position  of  the  young  creature  in 
the  uterus  may  be  learned. 

By  this  methodical  exploration,  the  obstetrist  recognises  that  the 
body  of  the  foetus  is  more  or  less  curved  in  the  back,  one  of  the  regions 
of  which  presents  at  the  inlet ;  while  the  head  and  limbs,  more  or  less 
entangled  with  each  other,  and  more  or  less  accessible  to  the  hand,  are 


474 


FCETAL  DYSTOKIA. 


directed  towards  the  fundus  of  the  uterus  (Figs.  145,  146).  It  now 
remains  to  discover  the  region  which  first  met  the  hand,  and  the 
following  memoranda  will  assist  in  achieving  this  point.    The  loithers 


Fig.  145. 
Transverse  Presentation  :  Kight  Cephalo-Ilial  Position — Side  View. 

are  recognised  by  the  prominences  which  the  spinous  processes  form  at 
this  part ;  the  thin  wedge-shaped  outline  of  the  part ;  and  the  hair  of 


Fig.  146. 
Transverse  Presentation  :  Right  Cephalo-Ilial  Position — Upper  View. 

the  mane,  w^hich,  in  the  Foal,  ends  here.  The  lumbar  region  may  be 
distinguished  by  the  large  and  almost  level  surface  it  offers ;  the  pro- 
jecting external  and  internal  angles  of  the  coxae  in  its  vicinity  ;  the 


DYsroKIA  FRO.U  THE  DORSO- LUMBAR  PREflEXTATIOX.  475 

hollow  of  the  flank  leading  to  the  thigh  and  stille.  The  dorsal  region, 
or  back,  is  discovered  by  the  arches  of  the  ribs  springing  from  each 
side,  with  the  intercostal  spaces. 

Having  diagnosed  the  presentation,  the  2J0S  it  ion  must  now  be  deter- 
mined, and  this  is  done  by  ascertaining  the  direction  in  whicli  the  head 
lies.  With  regard  to  this,  we  pointed  out  at  p.  2-i9  that  there  were 
three  positions  of  the  fcetus  :  The  cephalo-ilial  positions,  two  in 
number,  in  one  of  which  the  fcetus  has  tlie  head  directed  towards  the 
Ti(jht  flank  of  the  mother  {riijht  cephalo-ilial  position),  and  in  the  other 
towards  the  left  flank  {left  ccphaloilial  position),  the  head  and  feet 
occupying  the  uterine  cornua  ;  while  in  the  ccphalo-sacral  position,  the 
fa'tus  looks  as  if  seated  on  the  udder  of  the  mother,  the  head  being 
directed  forward,  the  mane  towards  the  sacro-lumbar  region  of  the 
dam. 

It  can  scarcely  be  necessary  to  mention  that  the  exact  position  of 
the  fcetus  should  be  ascertained  before  attempts  at  extraction  are 
ventured  upon ;  as  this  presentation  is,  in  nearly  every  case,  a  very 
serious  one,  and  only  too  frequently  requires  all  the  skill  and  judgment 
of  the  obstetrist  to  rectify.  The  gravity  of  the  case  will,  however, 
much  depend  upon  the  period  when  the  veterinary  surgeon  is  called  in, 
and  the  condition  of  the  parturient  animal.  When  sufticiently  early 
in  his  attendance,  however,  a  favourable  result  may  often,  if  not  always, 
be  anticipated  :  the  mother  m.ay  be  saved,  and  frequently  the  oifspring 
— particularly  in  the  Covr  and  Goat. 

This  favourable  issue  is  due  to  the  fact  that  the  presentation  does 
not  admit  of  the  foetus  entering  the  inlet,  and  it  therefore  remains  in 
the  abdominal  cavity,  where  there  is  space  to  manipulate  it,  and  thus 
remedy  the  presentation.  The  obstetrist,  though  he  may  have  to  con- 
tend with  the  paralysing  and  fatiguing  uterine  contractions,  has  not  to 
overcome  the  wedging  of  the  fci'tus  in  the  pelvic  canal — so  common  in 
the  defective  anterior  or  posterior  presentations. 

With  the  Mare,  however,  tlie  case  is  always  more  serious,  because  of 
the  energetic  contractions  which — unless  they  can  be  controlled  early 
in  parturition  by  partial  amcsthesia  or  other  means — ofl'er  a  formidable 
obstacle  to  mutation  of  the  foetus. 

Indications. — -The  principal  indication  in  such  cases  is  to  convert  the 
dorsal  into  an  anterior  or  posterior  presentation,  according  to  circum- 
stances. Hippocrates  has  well  said  that  tlie  foetus  is  like  a  cork  which 
has  fallen  into  a  bottle,  and  which  can  only  be  extracted  by  one  end  or 
the  other. 

Certainly  the  presentation  ofTers  serious  difficulties,  from  the  fact 
that  there  is  nothing  about  the  foetus  to  lay  hold  of  advantageously,  or 
to  which  cords  can  be  attached.  In  the  majority  of  instances,  a  long 
interval  has  elapsed  since  parturition  began ;  tlie  "  waters "  have 
escaped,  the  genital  canal  is  swollen  and  congested  from  the  attempts 
of  amateurs  at  delivery,  the  interior  of  the  uterus  is  dry  and  adhesive, 
the  organ  lies  as  close  to  the  fa^tus  as  a  glove  does  to  the  hand,  and 
the  parent  is  exhausted  with  unavailing  straining,  and  perhaps  mal- 
treatment— though  the  most  trifling  manipulation  in  the  uterus  will 
excite  it  to  the  most  vigorous  contractions. 

It  is  ordinarily  in  these  circumstances  that  the  veterinary  surgeon 
is  required  to  save  mother  and  offspring.  What,  then,  is  the  first,  most 
urgent,  and  indeed  the  chief  indication  ?  This  must  be  version.  The 
presentation  must  be  converted  into  an  anterior  or  posterior  one,  and 


476  FCETAL  DYSTOKIA. 

this  at  the  expense  of  much  patience,  fatigue,  and  skill.  But  in  what 
direction  is  version  to  be  practised  ?  Eainard  lays  it  down,  as  a  rule, 
that  the  extremities  of  the  foetus  which  are  nearest  the  pelvis  are  those 
which  should  be  brought  into  the  inlet ;  and  that  if  both  ends  of  the 
foetus  are  at  about  an  equal  distance  from  it,  the  anterior  should  be 
chosen,  because  it  is  the  easiest  for  delivery.  This  rule,  however,  has 
not  been  recognised  by  the  majority  of  the  best  authorities.  On  the 
contrary,  experience  and  theory  have  demonstrated  that  in  the  majority 
of  cases  pelvic  version  is  the  most  advantageous  ;  inasmuch  as,  when 
this  has  been  effected,  there  are  only  the  hind-limbs  of  the  young 
creature  to  deal  with,  whereas  in  anterior  version  there  is  the  head  in 
addition  to  the  fore-legs,  and  this  may  offer  difficulties  which  have  not 
to  be  encountered  in  the  posterior  presentation — more  especially  if 
there  is  anything  abnormal  in  the  condition  of  the  head.  Not  unfre- 
quently,  and  particularly  when  the  foetus  is  yet  alive  and  vigorous,  a 
kind  of  spontaneous  change  is  effected  in  an  unexpected  direction ;  for 
it  has  been  found  that,  in  acting  on  the  croup  of  the  foetus,  this  has, 
by  energetic  movements  of  its  own,  and  coincident  with  sudden  con- 
tractions of  the  uterus,  described  nearly  a  half-circle  ;  so  that  instead 
of  the  loins  being  under  the  hand,  the  withers  and  upper  part  of  the 
neck  are  encountered,  and  delivery  can  be  readily  accomplished. 

But  this  spontaneous  mutation  cannot  take  place  if  the  foetus  is- 
torpid  or  dead,  and  then  version  becomes  imperative.  Before  this  is 
attempted,  the  intrauterine  injection  of  emollient  fluids  should  be 
practised ;  this  is  most  essential  if  the  waters  have  escaped  for  some 
time.  Then  retropulsion  must  be  had  recourse  to.  The  foetus  must  not 
be  pushed  directly  forward  into  the  uterus,  but  rather  obliquely,  and  in 
a  direction  the  opposite  to  that  of  the  part  we  wish  to  bring  before  the 
inlet.  The  hand  or  repeller  must  be  used  for  this  purpose,  and  in 
proportion  to  the  difficulty  of  effecting  it,  so  must  the  intra-uterine  in- 
jections be  frequent. 

The  retropulsion  and  injection,  together  with  the  uterine  contractions, 
have  the  effect,  in  many  cases,  of  making  the  body  of  the  foetus  glide 
around  the  inner  surface  of  the  uterus,  until  a  convenient  part  presents. 
Then  the  limbs  and  head — if  they  are  required,  or  only  the  hind-limbs, 
if  it  should  be  so  decided — are  brought  into  the  genital  canal  by  the 
hand  or  by  cords.  If  the  occasion  demands  it,  rotation  may  be  resorted 
to,  in  order  to  convert  the  vertebro-ilial  position  into  the  vertebro-sacral 
or  vertebro-pubic.     Delivery  is  completed  by  moderate  traction. 

The  manipulations  will,  of  course,  vary  with  circumstances ;  but  it 
will  generally  be  found  that,  in  all  cases,  raising  the  hind-quarters  of  the 
mother  will  render  them  much  easier  of  accomplishment. 

When  these  manoeuvres  have  failed,  embryotomy  must  be  practised. 
The  intestines  and  other  organs  can  be  extracted  by  an  incision  in  the 
flank ;  the  vertebrae  may  be  divided  at  the  presenting  part,  and  the 
entire  body  cut  through  at  this  division  ;  then  each  half  can  be  extracted 
in  the  best  and  easiest  manner  possible. 

The  same  indications  are  applicable  to  this  kind  of  dystokia  in  the 
Ewe  and  Goat ;  though  if  version  be  impossible  and  embryotomy  not 
practicable,  the  Caesarian  operation  may  be  successful.  In  the  Bitch 
and  Cat,  when  other  measures  fail,  the  latter  operation  may  be  attempted 
with  some  prospect  of  a  favourable  result ;  though  version  by  means  of 
forceps  or  external  abdominal  manipulation  is  often  effected. 


DYSTOKIA  FROM  THE  DORSO-LUMBAR  PRESENTATION. 


477 


Cephalo-Sacral  Position. 

As  has  been  mentioned,  in  this  position  the  anterior  portion  of  the 
body  is  higher  than  the  posterior,  and  the  head  may  be  either  turned 
to  one  side  or  bent  downwards.  This  accident  is  more  rare  than  the 
preceding.  On  exploration  the  back  is  discovered  to  be  more  or  less 
vertical,  instead  of  horizontal,  as  in  the  cephalo-ilial  positions ;  though 
it  is  seldom  directly  in  front  of  the  inlet,  for  one  end  or  other  of  the 
body  is  generally  nearest  it — sometimes  it  is  the  posterior,  when  the 
presentation  somewhat  resembles  the  lumbo-sacral  (Fig.  147) ;  at  other 
times  it  is  the  anterior,  when  it  is  like  the  dorso-pubic.  It  therefore 
happens  that  the  hand  will  meet  with  the  anterior  part  of  the  croup 
and  may  feel  the  base  of  the  tail  in  the  first  case,  and  in  the  other  it 
encounters  the  back,  withers,  and  base  of  the  neck. 


Fig.  147. 
Transverse  Pre.sent.\tion  :  Verticvl  or  Ceimialo-Sacrai,  Position. 


This  position  is  not  so  diflicult  to  deal  with  as  the  horizontal  lumbo- 
sacral, as  it  approaches  the  longitudinal  presentations. 

Indications. — An  endeavour  must  be  made  to  bring  one  of  the  ends  of 
the  body  of  the  foetus  to  the  inlet — that  which  is  nearest  this  opening. 
Ketropulsion  is  therefore  necessary,  pressure  being  made  on  tlie  end 
farthest  from  the  inlet.  If  the  mother  is  placed  in  the  dorsal  position 
and  the  posterior  parts  of  the  fa^tus  manipulated  through  the  abdominal 
walls,  the  task  of  the  operator  will  be  facilitated.  When  tlie  posterior 
parts  of  the  fcetus  are  nearest  the  inlet,  an  assistant  should  push  against 
its  lumbar  region,  so  as  to  bring  the  buttocks  and  thighs  in  front  of  the 
opening,  while  the  operator  with  his  hand  on  the  repeller  pushes  the 
dorsal  region  forwards. 

When  the  anterior  part  of  the  body  is  nearest  the  inlet — the  mother 
being  in  the  dorsal  position — the  assistant  pushes  the  hind-quarters 
forwards  and  downwards,  while  the  operator  endeavours  to  bring  the 
neck  towards  him,  using  the  crotchet  if  need  be.     The  object  is,  of 


478  FCETAL  DYSTOKIA. 

course,  to  bring  the  foetus  into  the  posterior  lumbo-sacral  position,  with 
the  Hmbs  forward  and  completely  retained  ;  or  into  the  anterior  dorso- 
pubic  presentation,  with  the  head  and  limbs  retained.  It  can  then  be 
dealt  with  as  has  been  described  for  these  presentations. 

No  mention  appears  to  be  made  in  the  literature  of  veterinary- 
obstetrics  of  the  cephalo-abdominal  position  (vertical  dorso-lumbar  pre- 
sentation), though  such  is  possible.  The  head  of  the  foetus  would  be 
towards  the  floor  of  the  abdomen — though  lack  of  space  would  prevent 
the  body  being  directly  vertical,  and  either  forward  or  backward. 

The  measures  necessary  to  remedy  the  position  should  be  similar  to 
those  recommended  for  the  cephalo-sacral  position,  except  that  the 
external  manipulation  would  be  exercised  on  the  head  of  the  fcetus, 
instead  of  its  hind-quarters. 

SECTION  II.— DYSTOKIA  FROM  THE  STERNO-ABDOMINAL 
PRESENTATION. 

The  sterno-abdominal  presentation  is  a  rather  common  one,  particu- 
larly in  the  Mare.  The  foetus  is  lying  on  its  side,  with  the  sterno- 
abdominal  region  and  crossed  limbs — either  flexed  or  extended — 
presenting  at  the  inlet  or  engaged  in  the  passage,  while  the  dorsal 
region  is  towards  the  fundus  of  the  uterus. 

There  is  no  difficulty  in  discovei'ing  this  malpresentation,  the  hand 
encountering  the  feet — usually  all  four — in  the  uterus,  and  generally 
two  or  more  of  them  in  the  genital  canal.  Nevertheless,  as  there  are 
two  positions  in  the  presentation,  it  is  necessary  to  distinguish  which 
of  them  we  may  have  to  deal  with.  The  situation  of  the  head,  of 
course,  defines  the  position ;  so  that  we  may  have  a  right  cephalo-ilial, 
in  which  the  foetus  is  lying  on  its  left  side,  the  head  directed  towards 
the  right  flank  of  the  mother ;  and  a  left  ceplialo-ilial ,  the  reverse  of  the 
preceding.  If  the  foetus  is  vertically  placed,  with  the  head  upwards, 
then  the  position  is  cephalo-sacral ;  when  the  head  is  downwards  it  is 
cephalo-abdominal. 

Cephalo-Ilial  Positions. 

In  these  positions  the  foetus  is  placed  horizontally  across  the  uterus, 
with  the  body  curved^ — the  back  convex  in  the  majority  of  cases — so 
that  the  abdomen  is  farther  from  the  inlet  than  the  back  was  in  the 
dorso-lumbar  presentation.  The  left  cephalo-ilial  position  (Fig.  148)  is, 
according  to  Saint-Cyr,  much  more  frequent  than  the  right. 

Usually,  one  or  more  of  the  limbs  enter  the  genital  canal,  and  even 
protrude  from  the  vulva  ;  but  occasionally  they  are  doubled  against  the 
body  and  remain  in  the  uterus,  where  they  cannot  be  detected  by  the 
hand.  The  head  may  also  enter  the  canal  or  be  retained  in  the  uterus, 
which  is  most  frequently  the  case,  and  then  it  is  either  turned  back- 
wards, or  placed  above  or  below  the  body ;  when  the  latter,  then  it  is 
either  deformed  or  the  neck  is  contracted. 

When  the  limbs  appear  at  the  vulva,  if  they  are  the  hind  and  fore, 
t-^o — a  hind  and  fore — are  at  the  right  side  and  two  at  the  left,  though 
they  are  sometimes  crossed.  "When  they  project  equally,  then  it  is  an 
indication  that  the  transverse  presentation  is  direct ;  but  if  they  are 
unequally  protruded  it  may  be  inferred  that  the  foetus  is  lying  obliquely 
more  in  the  vertebro-ilial  position.     In  some  instances  only  one  limb 


DYSTOKJA  FROM  THE  STERNO-ABDOMIXAL  PRESENT  A  TIOX.       »79 

appears  ;  it  may  be  there  are  two — either  anterior  or  posterior,  or  one  of 
each;  or  three — a  fore  and  two  hind,  or  two  fore  and  one  hind.  In 
otlier  instances,  again,  there  is  nothing  of  the  foetus  to  be  found  in  the 
genital  canal. 

It  is  only  by  a  careful  examination  of  the  presenting  limbs — their 
conformation,  number,  direction,  and  degree  of  projection — that  the 
practitioner  can  decide  as  to  the  position  of  the  fcetus  ;  though  those 
parts  of  the  body  accessible  to  the  hand  will  supply  valuable  informa- 
tion as  to  whether  the  limbs  belong  to  one  or  more  foetuses  or  to  a 
monstrosity ;  while  the  position  of  the  head  should  be  ascertained  if 
possible,  in  order  to  decide  which  kind  of  version  is  most  likely  to  be 
successful. 

When  the  limbs  are  not  visible,  they  may  be  found  in  the  vagina  or 
at  the  inlet,  where  they  are  usually  crossed  ;  though  it  sometimes 
happens — especially  with  the  Mare — that  the  arm  extended  into  the 


Fig.  148. 
Sterno-Abdominal  Pbksentatiox,  Head  and  Fket  encagkd  :  Foal. 

uterus  as  far  as  possible,  can  touch  nothing,  even  with  the  tips  of  the 
fingers,  except  the  belly  or  sternum  of  the  fcetus  ;  or  pushing  the  hand 
obliquely  to  one  side  of  the  cavity,  the  stifles  may  be  felt,  and  on  the 
other  side  the  elbows.  This  may  be  all  that  can  be  discovered  of  the 
position,  owing  to  the  foetus  being  curved  and  the  limbs  and  neck  bent 
in  different  directions  ;  so  that  the  difliculty  in  arriving  at  a  correct 
notion  as  to  the  state  of  affairs  is  much  greater  than  in  the  dorso- 
lumbar  presentation.  In  the  Cow,  however,  owing  to  the  wider 
abdomen,  the  fa?tus  being  also  shorter,  the  latter  is  nearer  the  inlet,  and 
thei'efore  more  accessible  to  the  hand. 

It  is  generally  admitted  that  this  presentation  is  one  of  the  most 
diflicult  and  serious  the  obstetrist  can  meet  with  ;  though  when  the 
limbs  can  be  seized  it  is  not,  as  a  rule,  so  troublesome  as  the  dorso- 
lumbar  presentation.  In  order  to  effect  deliver)-,  the  presentation  must 
be  modified,  and  it  is  often  most  convenient  to  resort  to  posterior 
version  and  bring  the  hind-limbs  into  the  genital  canal     The  two  fore- 


480 


FCETAL  DYSTOKIA. 


legs  in  the  passage  make  the  case  more  difficult,  and.  one  only  yet 
more  so  ;  while  it  is  less  embarrassing  if  all  four  limbs  come  together, 
or  two  hind  ones  and  a  fore  one.  This  statement  is  made  on  the 
understanding  that  the  presentation  is  either  altogether  transverse,  or, 
if  oblique,  that  the  hind-quarters  of  the  foetus  are  nearest  the  inlet ; 
but  if  the  anterior  part  of  the  body  is  nearest,  and  if  the  head  is 
engaged,  or  can  be  easily  brought  into  the  passage,  the  fore-legs  there 
are  an  advantage  to  the  operator,  while  the  hind  ones  present  at  the 
same  time  would  be  baffling. 

When  the  limbs  cannot  be  laid  hold  of,  the  skill  of  the  obstetrist  is 
most  severely  taxed,  and  all  the  more  if  much  time  has  elapsed  since 
parturition  commenced  and  amateurs  have  been  at  work. 

Indications. — It  has  just  been  remarked  that  posterior  version  is  most 


Fig.  149. 

Sterno-Abdominal  Peesentation,  Hind  Limbs  most  advanced,  Head  ketained: 

Calf. 


favourable  for  delivery  in  this  presentation,  and  with  this  object  in  view, 
the  hind-limbs  should  be  secured  and  corded  at  the  pasterns — even  one 
limb  is  often  sufficient  if  the  other  is  not  attainable.  Should  the  head  be 
engaged,  it  must  be  pushed  as  far  into  the  uterus  as  possible,  and  if 
the  fore-limbs  are  likewise  present  they  must  also  be  repelled.  This 
retropulsion  is  comparatively  easy  when  there  is  plenty  of  room  and 
the  straining  is  not  very  severe  ;  but  in  the  Mare  it  is  often  the 
opposite,  and  some  authorities  assert  that  it  is  impossible  or  very 
dangerous  to  push  the  fore-limbs  into  the  uterus,  while  others  declare 
that  it  can  be  done  if  the  repeller  be  employed.  If  they  cannot  be 
pushed  into  the  uterus,  then  they  must  be  amputated  at  the  knee, 
elbow,  or  shoulder,  and  the  fore-part  of  the  foetus  thrust  forward  while 
traction  is  made  on  the  hind  limbs  ;  gradually  these  approach  the 
vulva  and  pass  through  it,  the  hind-quarters  follow — the  body  being 


DVSTOKIA  Fli'i'M  THE  STEKXO-ABDOMJXAL  I'llESEXTATIVX.       IM 

very  often  in  the  lurabo-ilial  position,  when  it  can  now  be  changed 
into  the  lumbo-sacral.  In  order  to  prevent  the  hind-quarters  jamming 
against  the  maternal  ihum,  the  traction  on  the  hind-hmbs  should  he 
oblique — from  right  to  left  or  left  to  right,  according  to  the  position  of 
the  fa^tus — when  bringing  it  into  the  inlet. 

When  the  liind-quarters  are  too  distant  to  he  brought  first  iiuo  the 
inlet,  then  anterior  version  should  be  tried.     The  hind-legs  are  pushed 
into  the  uterus — though  the  fojtus  may  be  delivered  witla  one,  or  even 
both  of  these,  Hexed  under  the   body — but  it   is  well  to  have  them 
corded  before  retropulsion  is  attempted.      The  head   and    fore-limbs 
should  also  be  corded,  and  knots  ought  to  be  made  on  all  the  cords 
used  in  order  to  distinguish  the  parts  to  which  they  are  attached. 
Then,  while  traction  is  made  on  the  head  and  fore-limbs,  the  croup 
should  be  pushed  forwards  into  the  uterus  ;  if  the  head  cannot  be  got 
into  a  proper  direction  it,  or  one  of  the  hind-legs  on  the  side  opposite 
to  it,  must  be  amputated.     If  the  foetus  cannot  be  extracted  from  the 
uterus  without  risk  of  bringing  that  organ  with  it,  then — provided  the 
chest  and  abdomen  can  be  reached — evisceration  should  be  resorted  to. 
In   those  not  infrequent   cases  in  which   the   foetus  has   the  limbs 
doubled  against  the  body,  and  can  only  be  touched  with  the  tips  of  the 
fingers,  the  hind  quarters  of  the  mother  should  be  lowered  by  placing 
her  on  a  sloping  Hoor — on   the  back  if  necessary  ;  an  assistant  then 
manipulates  the  ftt>tus  through  the  abdominal  wall,  so  as  to  move  it 
towards  the  inlet,  where  one  or  more  of  its  limbs  may  be  secured,  and 
•one  or  two  repellers — or  a  repeller  and  crotchet — might  now  be  utilized 
to  effect  either  anterior  or  posterior  version. 

It  must  not  be  forgotten  that,  in  some  instances,  the  uterus  itself 
in  this  presentation  offers  a  serious  obstacle  to  delivery,  when  its 
mucous  membrane  forms  folds  or  bands  towards  the  os,  which  prevent 
access  to  its  interior,  and  imprison  the  limbs  of  the  fcetus.  Through 
these  the  hand  must  pass,  and  in  trying  to  smooth  or  lay  them  down 
the  legs  must  be  freed. 

CEPn.\LO-SACR.\L  Position. 

In  the  sterno-abdominal  presentation,  this  position  is  said  to  be  less 
frequently  noted  than  the  last,  and  of  the  cases  reported  the  greater 
number  occurred  in  Mares.  The  fa'tus  is  more  or  less  in  a  sitting 
posture,  the  breech  being  towards  the  floor  of  the  abdomen,  and  the 
withers  and  head  in  the  direction  of  the  sacrum,  or  to  one  of  its  sides. 
All  the  limbs  are  usually  in  the  genital  canal,  and  they  may  extend  to 
or  beyond  the  vulva,  the  soles  of  the  hoofs  being  inclined  downwarels, 
though  it  may  happen  that  only  two  or  three  are  visible.  When  all 
protrude  eciually,  it  is  evident  that  the  position  of  the  fcetus  is  vertical; 
but  should  the  two  fore  or  the  two  hind  limbs  project  most,  then  the 
position  is  oblique. 

It  has  been  found  that  the  foetus  nearly  always  succumbs  in  this 
position,  though  the  mother  may  be  saved. 

Indications. — Here  again  version  must  be  resorted  to,  and  this  should 
be  posterior  when  all  the  limbs,  or  only  the  hind  ones,  protrude  ; 
the  fore-limbs  must  be  entirely,  or  tto  a  great  extent,  pushed  forward 
into  the  uterus,  or,  if  that  cannot  be  done,  amputated  at  the  knees  or 
elbow-joints — if  possible  at  the  shoulders — then  traction  on  the  hind- 
limbs  will  complete  deliver}-. 

31 


482  FCETAL  BY  ST  OKI  A. 

Should  the  fore-limbs  be  most  advanced,  anterior  version  must  be 
attempted — this  will  bring  the  fcetus  into  the  dorso-sacral  position ; 
but  it  is  a  troublesome  operation,  and  necessitates  retropulsion  of  the 
hind-limbs,  or  their  removal  wholly  or  partially,  as  well  as  straighten- 
ing the  head  and  neck.  If  neither  of  these  measures  appears  advisable, 
the  fore-limbs  may  be  entirely  removed  or  amputated  at  the  elbow- 
joints,  and  posterior  version  adopted  ;  evisceration  of  the  foetus,  by 
diminishing  its  volume,  will  facilitate  delivery. 

A  cephalo-ahdominal  position — vertical  sterno-abdominal  presentation 
— has  been  described,  but  it  must  be  exceedingly  rare,  and  the  remarks 
that  have  been  made  with  regard  to  the  cephalo-sacral  position  are 
equally  applicable  to  this. 

A  lateral  or  costal  presentation  has  also  been  noticed  by  several 
writers.  In  this  the  foetus,  having  the  limbs  doubled  under  the  body, 
presents  at  the  inlet  by  one  of  its  sides,  as  it  lies  horizontally  on  its 
chest  and  abdomen.  The  limbs  are  more  or  less  accessible  to  the 
operator,  and  therefore  the  mode  of  extraction  is  obvious  after  what 
has  been  said  of  the  other  presentations. 


■Jt. 


OBSTETRICAL  OPERATIONS.  483 

BOOK    III. 

OBSTETKICAL  OPEKATIONS. 

In  the  various  malpresentations  and  malpositions,  as  well  as  for  the 
other  causes  of  dystokia  already  enumerated,  the  indications  for  recti- 
fication and  extraction  were  alluded  to  and  described  at  sullicient 
length,  and  the  nieans  to  be  adopted  for  carrying  them  out  were  like- 
wise mentioned.  It  was  shown  that,  in  many  cases,  it  is  sufficient  to 
correct  the  abnormal  presentation  or  position,  and  rectify  the  deviation 
of  limbs,  neck,  or  liead,  to  effect  delivery  in  the  ordinary  manner  by 
means  of  the  hand  alone.  For,  as  has  well  been  said,  the  practised 
hand  is  the  best  and  most  perfect  of  all  instruments,  and  it  can  effect 
in  obstetrical  operations  what  no  instrument  is  competent  to  achieve. 
Therefore  it  is  that  an  operator  with  a  long  and  powerful  arm,  and  a 
small  hand  with  strong  fingers,  possesses  many  advantages  as  an 
obstetrist,  and  is  in  a  better  position  to  afford  relief  than  one  with  a 
short  arm  and  large  hand — especially  in  the  correction  of  those  devia- 
tions which  are  so  frequent,  and  oftentimes  so  baffling. 

Extraction  by  the  hand  alone  may  be  effected  in  many  cases  of 
difficult  parturition,  when  these  rectifications  have  been  made ;  though 
even  then  it  is  essential  that  the  os  uteri  be  fully  dilated,  the  vagina 
and  vulva  dilatable,  and  sutliciently  prepared  to  allow  the  young 
creature  to  pass  througli  ;  it  is  likewise  necessary  that  such  a  relation- 
ship in  proportions  should  exist  between  the  volume  of  the  fcetus  and 
the  capacity  of  the  pelvis,  that  extraction  can  be  accomplished  without 
much  difficulty.  Finally,  it  is  particularly  desirable  that  the  uterus 
retain  its  contractile  power,  and  that  its  regular  contractions  should 
second  the  efforts  of  the  operator. 

In  only  too  many  cases  of  dystokia,. however,  one  or  more  of  these 
conditions  are  absent,  and  the  unaided  hand — no  matter  whether  it  be 
ever  so  well  endowed  and  practised — fails  to  effect  delivery ;  so  that, 
in  order  to  overcome  the  dilficulties,  recourse  must  bo  had  to  various 
surgical  instruments  and  appliances,  and  there  must  be  performed, 
either  on  the  mother  or  fcetus,  more  or  less  complicated  and  serious 
•operations  which  demand  strength,  expertness,  and  an  accurate  know- 
ledge of  anatomy  and  physiology,  and  even  of  meciianics,  in  addition 
to  a  thorough  acijuaintance  with  surgical  pathology.  Some  of  the 
obstetrical  operations  have  been  alluded  to  ;  but  it  is  necessary  to  study 
them  as  a  whole,  in  order  to  master  their  special  features,  and  par- 
ticularly the  manner  in  which  they  are  to  be  performed,  as  upon  the 
exactness  of  our  knowledge  with  regard  to  them  will  generally  depend 
their  successful  results. 

These  operations  have  for  their  object  either  to  supplement  the 
forces  of  Nature,  which  are  insufficient  to  secure  the  birth  of  the  young 
creature  ;  to  rectify  its  presentation  or  position  ;  to  diminish  its  size 
when  it  is  cither  too  large,  too  deformed,  or  too  deviated  or  distorted, 
to  pass  through  the  maternal  passages ;  to  enlarge  the  latter,  or  to 
extract  the  foetus  by  an  artificial  passage  when  these  last  do  not  admit 
of  extraction.  This  leads  to  a  consideration  of :  (1)  Preliminary 
precautions  and  operations ;  (2)  Rectification  of  presentations  and  posi- 
tions of  the  fcetus  ;  (3)  Mechanical  means  for  the  extraction  of  the  fcetus  ; 
(4)   Embryotomy ;    (5)    Vaginal    hysterotomy ;    (6)    Ccesarian   section ; 


484  OBSTETRICAL  OPERATIONS. 

(7)  Symjjhysiotomy  ;  (8)  Artificial  premature  hirtli ;  (9)  Siqjplementary 
observations  regarding  another  and  progeny.  In  several  of  these  the 
obstetrist  requires  the  aid  of  assistants,  who  only  too  often  have  to  be 
instructed  in  the  part  they  are  called  upon  to  perform  at  the  very 
moment  their  services  are  required. 

Not  only  this,  but  far  too  frequently  the  veterinary  surgeon  is  not 
called  in  sufficiently  early,  and  the  delay,  and  perchance  the  mal- 
treatment to  which  the  parturient  animal'  has  been  subjected  by 
unskilled  attendants,  has  resulted  in  most  serious  complications,  which 
the  most  competent  assistants  can  afford  little  service  in  remedying. 


CHAPTEB  I. 
Preliminary  Precautions  and  Operations. 

A  FEW  observations  may  be  made  on  certain  precautions  and  opei'ations 
which  have  to  be  attended  to  before  any  active  measures  are  adopted 
in  cases  of  dystokia.  And  first  as  to  the  animal  which  is  to  be 
handled. 

With  the  larger  creatures,  and  especially  the  Mare,  the  position  of 
the  veterinary  surgeon  immediately  behind  the  posterior  limbs  might 
be  considered  perilous,  did  we  not  know  that  the  most  irritable  and 
vicious  animals  are  generally  rendered  tractable  by  the  parturient 
pains  ;  and  even  the  hand  and  arm  introduced  into  the  vagina,  instead 
of  provoking  resentment,  appear  only  to  increase  the  expulsive  strain- 
ing. But  it  is  sometimes  necessary  to  have  a  strong  assistant  to  hold 
up  a  fore-foot — in  the  case  of  the  Mare— while  the  hand  is  being  passed 
into  the  genital  canal.  And  while  manipulation  is  going  on  it  is 
advisable  that  the  Mare's  head  should  be  held  by  a  person  the  animal 
is  accustomed  to  ;  while  a  strong  man  on  one  side  of  the  hind-quarters 
steadies  this  part  with  one  hand  and  holds  the  tail  aside  with  the 
other,  and  another  on  the  opposite  side  also  steadies  the  quarter  with 
one  hand,  and  the  other  hand  pinches  the  loins  when  the  Mare  attempts 
to  strain  or  be  restless. 

But  it  sometimes  happens  that  a  twitch  has  to  be  applied  to  the 
nose,  or  side-lines  or  hopples  put  on  the  legs ;  for  the  Mare  is,  as  has 
been  already  remarked,  very  often  a  most  troublesome  and  dangerous 
animal  to  deal  with,  and  unsteady  in  the  extreme.  Not  so  the  Cow, 
which  rarely  requires  any  more  constraint  than  a  person  holding  the 
nose  and  horn  ;  though  it  is  advantageous  to  have  a  man  on  each  side 
to  act  in  the  same  manner  as  for  the  Mare. 

Obstetrical  manipulations  are  usually  effected  while  the  larger 
animals  are  standing,  and  this  is  undoubtedly  the  most  convenient 
position.  But  it  not  infrequently  happens  that  the  veterinary  surgeon 
is  called  when  the  animal  has  been  in  labour  for  many  hours,  and  per- 
haps been  roughly  handled  by  novices ;  so  that,  being  exhausted,  it  has 
assumed  the  recumbent  position,  and  is  disinclined  to  get  up.  This  is 
more  especially  the  case  with  the  Cow,  for  the  Mare  can  generally  be 
induced  to  arise  by  mild  persuasion  ;  and  it  has  been  found  that  the 
sight  of  a  dog  will  cause  the  first-named  animal  to  start  up  when  other 
means  fail. 

But  it  may  be  that  the  creature  really  cannot  arise,  or  if  it  gets  up 
it  cannot  stand ;  then  the  operator  has  to  do  as  he  best  can  while  it  is 


rKKLlMlXAnV  rnECAUTIOXS  AX1>  OPEliATlOXS.  485 

recumbent,  and  must  kneel,  or  even  assume  the  horizontal  position. 
With  regard  to  the  animal  itself,  the  lateral  and  ventral  positions  are 
very  unfavourable,  because  of  compression  of  the  abdomen,  which  <^reatly 
hinders  manipulation  and  interferes  with  delivery.  To  obviate  this, 
the  animal  ou^'ht  to  be  placed  on  its  back,  and  kept  in  that  position  by 
having'  previously  had  the  feet  brought  together  by  means  of  a  rope  or 
hopples,  and  tying  another  rope  to  these  by  which  assistants  can  steady 
the  body  ;  a  truss  of  straw  placed  close  on  each  side  of  the  back  will 
greatly  aid  in  securing  this  position.  In  some  cases  it  is  most  advan- 
tageous to  have  the  front-part  of  the  body  raised  by  litter,  so  as  to 
bring  the  foetus  nearer  the  pelvic  cavity ;  in  other  cases  it  may  be 
equally  advantageous  to  have  the  hind-quarters  raised  either  by  litter 
or  by  suspension,  the  hind-feet  being  fastened  together  by  a  rope,  the 
end  of  which  is  passed  over  a  beam  and  pulled  until  the  required  eleva- 
tion is  obtained.  This  raising  of  the  hind-quarters  has  been  success- 
fully employed,  as  we  have  remarked,  in  reducing  torsion  of  the  uterus  ; 
and  it  has  been  no  less  useful  in  cases  of  dystokia  due  to  bending  back 
of  the  head  or  neck  of  the  fttitus. 

Cases  are  met  with  now  and  again  in  which  it  is  desirable  to  place 
the  animal  in  the  recumbent  position,  and  then  the  gi'eatest  care  is 
necessary  to  prevent  its  being  injured  in  laying  it  down. 

The  Cow  has  been  placed  on  its  side  by  passing  a  bed-sheet,  folded 
lengthways  two  or  three  times,  beneath  the  abdomen,  in  front  of  the 
udder,  two  men  holding  each  end  and  lifting  up  as  if  to  carry  the 
animal  off  its  feet ;  the  Cow  immediately  turns  on  its  side  and  the 
hind-quarters  fall  softly  on  the  litter,  but  the  sheet  must  be  kept  tense. 
Another  plan  is  almost  as  simple :  A  long  rope  is  provided,  with  a 
noose  at  one  end ;  this  is  passed  around  the  horns,  the  rope  is  carried 
along  the  ridge  of  the  neck,  and  a  turn  is  made  around  the  shoulders, 
another  behind  the  shoulders,  and  a  third  around  the  abdomen,  the 
rope  being  then  brought  along  the  sacrum.  A  slow  and  steadily  in- 
creasing pull  is  made  upon  it,  and  the  animal  soon  bends  the  fore-legs, 
then  the  hind  ones,  and  lies  down  in  the  most  gentle  manner. 

Sheep  and  Pigs  are  generally  recumbent,  and  the  operator  has  to 
kneel ;  but  they  are  more  easily  handled  than  the  Cow  or  Mare. 

Dogs  and  Cats  are  also  readily  managed,  and  can  be  placed  upon  a 
bench  or  table,  and  moved  about  to  any  position  required  without 
restraint. 

When  about  to  deal  with  a  case  of  dystokia,  the  practitioner  has,  of 
course,  first  ascertained  its  history,  and  satisfied  himself  as  to  the 
general  condition  of  tlie  animal  before  connnencing  his  exploration. 
With  the  larger  animals  it  is  necessary  that  he  divest  himself  of  some 
of  his  upper  garments — how  many  will  depend  upon  the  nature  of  the 
case  ;  it  may  sutVice  to  remove  the  coat  and  vest,  and  roll  up  the  shirt- 
sleeves, or  it  may  demand  removal  of  everything  save  under-vest  and 
trousers  ;  indeed,  for  such  cases  it  is  well  to  be  provided  with  a  long 
sleeveless  blouse,  fastened  round  the  waist  by  means  of  a  band,  and  a 
pair  of  waterproof  trousers. 

Before  introducing  the  hand  and  arm  into  the  genital  canal,  they 
should  be  covered  with  olive-oil  or  grease,  in  order  not  only  to  faciUtate 
their  introduction,  but  to  protect  the  operator  against  septic  infection. 
It  is  very  fortunate  for  him  if  he  can  use  both  hands  alike,  as  the  left 
hand  is  sometimes  more  convenient  than  the  right,  and  in  tedious 
operations  the  one  reheves  the  other.     The  fingers  are  brought  together 


486  OBSTETRICAL  OPERATIONS. 

in  cone-shape,  and  pushed  into  the  vulva  gently,  then  into  the  vagina, 
with  a  slight  rotatory  motion,  while  the  animal  is  not  straining;  should 
it  strain,  the  hand  must  not  be  pushed  on,  but  wait  until  the  animal  is 
again  quiet.  In  this  way  the  vagina  is  explored,  and  if  necessary  the 
hand  is  carried  into  the  uterus,  should  there  be  no  obstruction.  A 
careful  exploration  makes  the  practitioner  acquainted  with  the  state  of 
affairs — the  condition  of  the  genital  canal  and  the  presentation  and 
position  of  the  foetus,  if  the  membranes  are  ruptured,  as  they  nearly 
always  are — and  allows  a  diagnosis  to  be  formed,  from  which  indica- 
tions for  treatment  can  be  arrived  at. 

It  should  not  be  necessary  to  add  that  all  this  procedure — much  of 
which  has  also  to  be  observed  in  cases  of  maternal  dystokia — ought  to 
be  carried  out  carefully  and  methodically,  and  without  undue  haste  ; 
and  to  accomplish  it  satisfactorily  a  perfect  knowledge  of  the  obstetrical 
anatomy  of  both  mother  and  foetus — familiar  to  the  hand  no  less  than 
to  the  mind — is  of  the  greatest  value. 

Mention  has  already  been  made  of  the  necessity  for  employing  some 
bland  emollient  fluid  with  which  to  lubricate  the  genital  canal  when 
this  has  become  dry  ;  as  owing  to  the  "waters"  having  escaped  for 
some  time,  the  uterus  is  applied  close  to  the  foetus — which  may  have 
made  some  progress  towards  expulsion — and  much  manipulation  may 
have  already  taken  place  before  the  arrival  of  the  practitioner.  Any 
oily  or  mucilaginous  fluid  will  answer  the  purpose,  but  perhaps  the  best 
of  all  is  what  is  known  as  "linseed  tea,"  or  "  linseed  jelly,"  mixed  with 
some  oil — olive  to  be  preferred.  When  there  is  not  time  to  prepare  this, 
it  has  been  found  very  serviceable  to  inject  first  a  few  ounces  of  oil, 
then  tepid  water,  and,  finally,  another  quantity  of  oil.  The  chief  thing 
to  be  observed  is  to  inject  a  sufficiency — say  two  or  three  gallons  for 
the  larger  females,  and  from  a  few  ounces  to  a  pint  for  the  smaller. 

If  the  manipulations  are  long  continued,  it  may  be  necessary  to 
repeat  the  injection,  and  for  the  Cow  or  Mare  it  is  most  advantageous 
to  introduce  a  long  piece  of  india-rubber  tubing  well  into  the  uterus,  and 
inject  the  fluid  through  this  by  putting  the  nozzle  of  the  syringe  into 
the  outer  end.  When  neither  syringe  nor  tubing  is  available,  a  bottle 
may  be  used,  and  in  this  case  raising  the  hind-quarters  of  the  animal 
will  facilitate  the  introduction  of  the  lubricant. 

With  the  smaller  animals  much  benefit  is  often  derived  from  immer- 
sing the  hind-quarters,  or  even  the  whole  of  the  body,  in  warm  water 
for  some  time,  as  this  tends  to  relax  the  parts. 

The  expulsive  efforts  of  parturient  animals,  and  especially  the  Mare, 
when  violent,  are  generally  a  great  hindrance  to  the  operator  in  cases  of 
dystokia,  and  sometimes  prevent  him  from  attaining  success  in  delivery. 
To  modify,  or  partially  or  completely  suspend  them  for  even  a  short 
period,  may  be  of  the  greatest  service ;  so  that  various  measures  have 
been  resorted  to  in  these  cases — such  as,  for  the  Mare,  a  twitch  on  the 
nose,  and  for  the  Cow,  pinching  the  nasal  septum,  pressing  on  the  loins, 
or  raising  the  hind-quarters.  Causing  the  Mare  to  walk  on  soft  sloping 
ground  or  in  a  straw-yard,  and  not  allowing  it  to  stop,  has  been  found 
to  allay  the  pains  for  a  sufficiently  long  period  to  allow  what  was 
required  to  be  done. 

The  administration  of  narcotics  is  also  frequently  adopted  with  this 
object,  and  anaesthesia  by  ether  or  chloroform  has  been  found  of  great 
service  with  the  Mare.  It  is  seldom  necessary  to  place  the  animal  in 
the   recumbent   position,  as  complete    insensibility  is  not  required — 


RECTIFICATION  OF  PRESENTATIONS  AND  POSITIONS.  487 

indeed,  is  not  desirable ;  for  partial  unconsciousness  will  allay  the 
excitement  and  abnormal  straining,  but  -will  not  suspend  the  uterine 
contractions.  The  chloroform  may  be  inhaled  from  a  piece  of  sponge 
or  lint  placed  in  a  basin  or  similar  vessel  and  held  under  the  animal's 
nostrils,  a  blanket  being  thrown  over  the  head  to  keep  in  the  vapour ; 
or  the  sponge  may  be  laid  at  the  bottom  of  a  nose-bag  put  on  the  head. 
The  antf  sthetic  should  be  inhaled  until  the  introduction  of  the  hand 
into  the  vagina  or  uterus  no  longer  excites  the  severe  straining.  Partial 
narcosis  might  also  be  tried  in  some  dillicult  cases  of  parturition  in  the 
Cow,  but  then  it  must  be  remembered  that  in  the  event  of  slaughter 
the  flesh  will  have  the  odour  of  the  drug.  With  the  smaller  animals 
the  production  of  this  condition  is  often  beneficial. 

We  will  now  consider  the  principal  mutation  movements  required  to 
effect  a  change  in  the  position  of  the  fcjctus. 


CHAPTER  II. 

Rectification  of  Presentations  and  Positions  of  the  Foetus. 

Wh  have  seen  how  numerous  and  varied  are  the  presentations  and 
positions  of  the  foetus,  and  how,  in  order  to  effect  delivery,  some  of 
these  must  be  changed  or  modified  ;  this  can  only  be  done  by  moving 
the  fcctus  itself,  and  so  altering  its  relations  to  the  adjacent  parts  of  the 
mother.  These  movements  are  sometimes  designated  mutations  by 
obstetrists,  and  the  procedure  necessary  to  effect  them  varies  with 
circumstances  ;  sometimes,  for  instance,  the  object  may  be  achieved  by 
merely  altering  the  position  of  the  parturient  animal,  or  by  sustaining 
its  abdomen  and  manipulating  externally ;  but  in  the  great  majority  of 
cases  it  is  necessary  to  introduce  the  hand  into  the  genital  canal,  and 
operate  directly  on  the  foitus. 

The  pi-incipal  of  these  mutation  movements  are  four  in  number : 
lictropulsion,  Rotation,  Version,  and  Extension  and  Flexion. 

In  order,  however,  that  these  movements  may  be  effected,  certain 
conditions  are  necessary.  In  the  first  place,  it  is  essential  that  tlie  os 
uteri  be  sufficiently  dilated,  or  relaxed  and  extensible,  so  that  the  hand 
may  reach  the  interior  of  the  uterus ;  next,  the  body  of  the  fcctus  must 
be  movable  in  the  uterus — a  circumstance  not  always  noted,  as  the 
organ  is  often  contracted  closely  on  the  fcctus  when  the  liquor  amnii 
has  escaped,  or  the  fa-tus  itself  may  be  fixed  in  the  genital  canaL 
And,  finally,  the  fcctal  envelopes  must  be  ruptured,  as  it  is  impossible 
to  manipulate  the  young  creature  effectively  while  it  is  entirely  invested 
by  them. 

Before  any  alteration  in  the  presentation  or  position  of  the  foetus  can 
be  accomplished,  these  conditions  must  be  assured. 

Retrgpulsion. 

When  the  foetus,  in  a  vicious  position,  has  entered  the  pelvic  cavity 
and  become  fixed  there,  or  even  when  in  the  uterus  and  approaching 
the  inlet,  before  the  position  can  be  corrected  it  is  nearly  always  neces- 
sary to  push  the  creature  forward  again  into  the  uterus  ;  as  there  only, 
from  the  greater  space  this  organ  affords,  and  the  elasticity  of  its  walls, 
can  the  impediment  be  overcome  and  adjustment  effected. 

"  Retropulsion  "   is  often   necessary  during  protracted  labour,  even 


488  OBSTETRICAL  OPERATIONS. 

when  the  foetus  is  in  a  good  position,  to  enable  the  obstetrist  to  attach 
cords  to  the  limbs  or  some  part  of  the  head  or  body. 

In  the  anterior  presentation,  for  instance,  the  fore-limbs  have  often 
to  be  pushed  forward  from  the  pelvic  cavity,  in  order  that  the  operator's 
arm  may  find  room  to  search  for  and  seize  the  head  ;  or  the  latter  has 
to  be  pushed  into  the  uterus  to  allow  the  limbs  to  be  felt  for;  and 
even  in  this  presentation  retropulsion  of  the  hinder  limbs  may  be 
necessary.  This  procedure  may  also  have  to  be  adopted  in  the  posterior 
presentation  when  these  limbs  are  flexed  in  the  uterus,  and  the  body 
has  to  be  pressed  forward  as  far  as  possible,  so  that  they  may  be 
extended  and  brought  into  the  pelvic  inlet ;  while  it  is  also  advantageous 
in  transverse  presentations  when  version  has  to  be  attempted. 

This  retropulsion  is  sometimes  easy,  at  other  times  it  is  most  difficult 
and  laborious,  and  in  certain  cases  it  may  even  be  altogether  im- 
possible. 

The  most  favourable  attitude  for  performing  this  operation,  in  the 
larger  animals  at  least,  is  undoubtedly  the  standing  one  ;  but  the  body 
of  the  animal  should  not  be  perfectly  horizontal,  for  a  great  advantage 
will  be  derived  by  raising  the  hind-quarters  to  a  considerable  degree, 
as  we  thereby  throw  the  uterus  and  its  contents  forward,  and  away 
from  the  pelvic  inlet.  This  elevation  may  be  effected  by  straw  or  litter 
placed  under  the  animal's  hind-feet.  In  order  to  obtain  this  inclina- 
tion promptly,  the  Cow  may  be  made  to  kneel,  two  assistants  keeping 
the  fore-limbs  flexed,  while  other  two  maintain  the  hind-quarters  in  an 
upright  position. 

When  the  animal  is  recumbent  and  cannot  be  induced  to  rise,  there 
is  little,  if  anything,  to  be  gained  by  raising  and  supporting  it  by  means 
of  slings  or  other  appliances  ;  as  the  pressure  which  these  produce  on 
the  abdomen  opposes  the  manoeuvres  we  have  mentioned.  Not  un- 
frequently  the  sight  of  a  strange  dog,  as  has  been  mentioned,  will  cause 
the  animal  to  get  up. 

When,  however,  the  Mare  or  Cow  is  exhausted,  and  it  would  be 
injudicious  or  impossible  to  make  it  stand,  then  manipulation  must  be 
attempted  in  the  recumbent  posture.  When  this  is  decided  upon,  in 
the  great  majority  of  cases  it  will  be  found  that  a  considerable  advan- 
tage will  be  obtained  by  placing  the  animal  on  its  back,  propping  it  up 
in  this  position  with  trusses  of  straw  placed  on  each  side,  and  raising 
the  croup  by  introducing  another  truss  beneath  the  hind-quarters. 

With  regard  to  the  smaller  animals,  such  as  the  Bitch,  they  can  be 
placed  on  their  back  on  a  table,  and  an  assistant  will  raise  the  pelvis 
as  high  as  may  be  deemed  necessary.  Eetropulsion  of  the  foetus  may 
be  effected  with  the  hand  in  the  large  animals,  the  operator  supporting 
himself  firmly  on  his  legs ;  but  the  arm  must  be  strong,  and  very  often 
it  has  to  be  engaged  in  the  genital  canal  as  high  as  the  shoulder.  It 
may  sometimes  happen  that  both  hands  have  to  be  employed  as 
repellers,  and  the  body  of  the  operator  pushed  forward  by  assistants. 

Seeing  the  difficulties  attending  this  operation,  and  finding  that  the 
hand  and  arm  are  not  always  sufficient,  Continental  veterinarians  have 
for  a  long  time  resorted  to  a  "crutch"  or  "  repeller "  (French, 
repoussoir  ;  German,  Geburtskrilcke),  in  conjunction  with  the  hand. 

This  instrument  is  of  iron,  and  is  between  two  and  three  feet  in 
length;  it  has  a  handle  at  one  end,  and  a  concave  transverse  piece, 
like  the  head  of  a  crutch,  at  the  other.  This  piece  may  be  either  solid 
or  jointed  (Figs.  150,  151,  152,  153).     Provided  the  latter  is  sufficiently 


RECTIFICATION  OF  PRESEXTATIOXS  AND  POSITIONS. 


489 


strong  at  the  joints,  it  possesses  advantages  over  the  solid  instrument, 
the  principal  of  which  is  its  easier  introduction  into  the  vagina  and 
uterus.     The  crutch  end  being  carefully  carried  by  one  hand  through 


Fig.  150. 
SoLin  Rkpeller, 

WITH    A    ReMOV- 

ABLK  Spike. 


SlMPI,E-.TOINTEn 

Kepeller. 


Fig.  152. 


JOINTKI)   RepELLEB 

Open. 


Fig.  ir..3. 

.TniNTEI>  Rei'eller: 
Closbd. 


the  genital  canal,  towards  the  foetus,  is  applied  to  the  most  convenient 
part  of  the  latter  ;  while  the  handle  is  seized  in  the  other  hand,  and 
propulsion  effected  either  by  this  hand,  the  breast  of  the  operator,  or 
by  an  assistant. 


490  OBSTETRICAL  OPERATIONS. 

Many  authorities  speak  very  highly  of  this  instrument,  from  the  fact 
that  it  permits  the  displacement  of  the  foetus  much  further  forward 
than  the  hand  alone  can  effect,  and  thus  allows  a  wider  space  between 
the  pelvic  inlet  and  the  body  of  the  young  creature ;  consequently, 
adjustment  of  the  latter  is  more  easily  and  promptly  accomplished. 

An  assistant  can  maintain  the  body  of  the  foetus  some  distance  from 
the  pelvis  by  this  instrument,  while  the  hand  of  the  operator  is  making 
the  necessary  rectifications  ;  the  latter  is  therefore  much  relieved,  and 
to  some  extent  he  is  also  exempted  from  the  difficulty  and  fatigue 
caused  by  the  uterine  contractions. 

The  ordinary  repeller  has  some  disadvantages,  the  greatest  of  which, 
perhaps,  is  its  being  inapplicable  to  certain  regions  of  the  foetus  which 
may  chance  to  be  in  an  oblique  line  to  its  direction — such  as  the  head, 
limbs,  etc.  To  remedy  this  defect,  I  have  added  a  short,  pointed  spike, 
which  can  be  screwed  into  the  middle  of  the  crutch,  opposite  the 
handle,  when  necessary  (Fig.  150),  and  this  effectually  prevents  its 
slipping ;  the  part  in  contact  with  the  foetus,  when  provided  with  this 
tooth  or  spike,  resembles  a  trident.  While  the  instrument  is  being 
employed— all  propulsion  should  only  be  made  during  the  intervals 
between  the  pains — one  hand  of  the  operator  must  guide  and  maintain 
it  against  the  foetus,  to  prevent  injury  to  the  maternal  organs. 

Some  authorities,  however,  object  to  the  employment  of  the  repeller 
— or,  rather,  assert  that  they  have  never  required  its  services.  Brunet 
and  Shaack  observe  that  when  their  own  strength  is  not  sufficient, 
they  are  aided  by  an  assistant.  Brunet  has  the  hand  and  arm  of  the 
latter  acting  on  the  foetus  at  the  same  time  as  his  own — both  arms 
being  in  the  genital  canal ;  while  Shaack  gets  his  assistant  to  seize  his 
right  arm  with  one  of  his  hands,  resting  the  other  on  his  left  shoulder, 
and  pushing  him  forward — Schaack's  right  arm  and  hand  in  this  way 
playing  the  part  of  the  crutch. 

In  order  to  propel  the  head,  Binz  invented  an  instrument  like  a 
goblet,  furnished  with  a  long  handle  ;  the  hollow  portion  fitted  on  the 
muzzle  of  the  foetus,  and  the  head  could  then  be  pushed  forward. 
Solid  rods  to  be  fixed  to  the  limbs  of  the  foetus,  in  order  to  push  them 
out  of  the  way,  have  been  proposed,  but  their  utility  is  questionable. 

It  must  not  be  forgotten  that,  after  all,  the  hand  is  the  safest  and 
most  perfect  of  instruments,  and  should  always  be  preferred — at  least 
at  first — to  such  appliances  as  we  have  described.  For  it  feels  the 
parts  on  which  it  is  placed  ;  it  adapts  itself  more  exactly  to  the  surfaces 
with  which  it  comes  in  contact ;  it  perceives  the  resistance  they  offer, 
and  warns  the  operator  as  to  the  amount  of  force  necessary  to  effect  a 
certain  object ;  whereas  the  presence  of  a  hard  and  rigid  instrument 
increases  the  uterine  contractions,  and  however  well  adapted  it  may  be, 
it  may  suddenly  glide  off  rounded  and  slippery  surfaces,  and  cause 
serious  injury. 

Nevertheless,  there  may  be,  and  often  are,  occasions  when  the  hand 
cannot  accomplish  what  is  necessary  in  the  way  of  retropulsion,  and 
it  is  then  that  the  repeller  may  be  most  useful ;  it  will  generally 
be  found  quite  safe  when  employed  by  a  careful  and  experienced 
operator. 

The  spasmodic  contraction  of  the  uterus,  especially  during  the 
labour  pains,  is  a  great  obstacle  to  every  kind  of  manipulation  in  the 
interior  of  the  organ  ;  the  way  to  subdue  them  has  been  referred  to. 

Eetropulsion,    as   we   have    said,    should   only   be    effected   in   the 


RECTIFICATION  OF  PRESEXTATIONS  A XI)  POSIT  10 XS.  491 

intervals  between  the  "pains";  thouf^li  during  these  the  expulsive 
eflbrts  should  be  resisted,  so  that  what  lias  been  accomplished  may  not 
be  lost.  The  propulsion  should  be  done  by  jerks,  which  are  far  more 
effective  than  a  continuous  push,  and  they  are  not  productive  of  any 
inconvenience. 

It  is  nearly  always  necessary  to  secure  some  part  of  the  foetus  which 
is  to  be  repelled — head  or  limbs — by  cords,  so  that  it  may  be  readily 
seized  again  and  brought  into  the  pelvic  cavity.  This  will  be  alluded 
to  presently. 

K0T.4.TION. 

"  Rotation  "  of  the  fcetus  consists  in  turning  it  more  or  less  round  its 
longitudinal  axis,  with  the  view  of  changing  the  relation  between  the 
presenting  parts  and  the  maternal  pelvis,  or  modifying  the  position 
without  interfering  with  the  presentation.  It  is  required  occasionally 
in  all  the  domestic  female  animals,  and  most  frequently  in  the  Cow, 
when  the  greatest  diameter  of  the  foetus  is  presented  to  the  smaller 
diameter  of  the  pelvic  cavity,  as  in  the  majority  of  the  lateral  positions. 

After  pushing  away  the  body  of  the  foetus — but  not  its  limbs,  if  they 
are  well  placed — from  the  pelvic  inlet,  the  hand  and  fore-arm  are 
introduced  in  supination  and  well  forward  between  the  body  of  the 
young  creature  and  the  floor  of  the  uterus  ;  then  resting  the  arm  on 
the  pubis,  it  is  employed  as  a  lever  in  raising  and  turning  the  part  of 
the  fcetus  in  hand  to  the  right  or  left,  as  may  be.  If  the  young  ci-eature 
is  alive,  this  mana'uvre  is  much  more  easily  executed  than  when  it  is 
dead,  as  it  seconds  the  effort.  Boutrolle  advises  that  the  abdomen  of 
the  mother  be  raised  by  means  of  a  girth  or  folded  blanket,  while 
rotation  is  being  effected ;  and  other  authorities  have  recommended  the 
employment  of  a  lever  between  the  foetus  and  the  uterus  to  effect  this 
turning.  Kainard  recommends,  when  the  limbs  are  in  the  pelvis,  to 
tie  them  together,  draw  them  beyond  the  \Tilva,  put  a  piece  of  stick  or 
any  other  convenient  article  between  them,  and  to  use  this  as  a  kind 
of  lever  to  turn  the  body  of  the  foetus  round  to  the  necessary  extent ; 
or,  which  is  preferable — as  in  the  latter  operation  the  limbs  of  the 
young  animal  may  be  seriously  injured — to  give  the  limbs  to  an  assistant 
who,  acting  under  instructions  from  the  operator,  turns  them  one  over 
the  other  in  a  kind  of  twisting  and  swinging  manner,  in  the  direction 
indicated  by  the  operator,  whose  efforts  are  in  this  way  greatly  assisted. 

The  operation  of  rotation  is  completed  when  the  greatest  diameter 
of  the  foetus  is  coincident  with  the  sacro-pubic  diameter  of  the  pelvic 
inlet — a  right  or  left  vertebro-ilial  position,  for  example,  being  trans- 
formed into  a  vertebro-sacral  position. 

This  modification  need  not  always  be  so  complete,  and  it  fre- 
ijuently  suffices  to  convert  a  lateral  position  into  an  oblique  one,  by 
making  the  dorso-sternal  diameter  of  the  fcetus  correspond  to  the 
oblique  diameter  of  the  inlet — measuring  this  from  the  supra-cotyloid 
crest  of  one  side  to  the  sacro-iliac  articulation  of  the  other.  The  same 
observation  is  applicable  to  posterior  presentations. 

Version. 
"  Version,"  or  "  turning,"  in  veterinary  obstetrics  signifies  effecting 
a  change  of  presentation,  or,  in  other  words,  bringing  towards  the  inlet 
a  part  of  the  fcetus  other  than  that  which  presented  spontaneously,  and 
thus  correcting  a  faulty  presentation. 


492  OBSTETRICAL  OPERATIOXS. 

A  longitudinal  presentation  is  that  in  which  spontaneous  birth  can 
be  alone  effected ;  transverse  presentations  render  birth  impossible,  and 
these,  consequently,  give  rise  to  dystokia.  Version  is  therefore  in- 
dicated in  all  transverse  presentations,  no  matter  what  region  of  the 
body  may  first  offer  at  the  pelvic  inlet ;  it  may  even  be  required  in 
certain  forms  of  anterior  or  posterior  presentation ;  and  in  all  cases  it 
is  necessary  to  repel  the  presenting  part,  so  as  to  bring  one  or  other  of 
the  ends  of  the  oval  mass  formed  by  the  body  of  the  foetus  to  the  pelvic 
inlet. 

Hence  we  have  two  kinds  of  version :  one  which  has  for  its  object 
the  movement  of  the  head  of  the  foetus  towards  the  pelvic  inlet — 
anterior  or  cephalic  version ;  and  the  other  the  posterior  part  of  the 
body  to  the  same  opening — posterior  or  pelvic  version,  corresponding  to 
the  piodalic  version  in  human  obstetrics.  Each  of  these  versions  has  its 
advantages  and  disadvantages,  according  to  circumstances ;  though  the 
majority  of  authorities  prefer  pelvic  version,  for  the  simple  reason  that 
with  this  there  are  two  mere  appendages  to  care  for — the  hind-limbs, 
to  which  it  is  comparatively  easy  to  give  a  good  direction  ;  while  in 
cephalic  version  there  are  not  only  the  fore-limbs  to  attend  to,  but  also 
the  head  and  neck,  the  unfavourable  direction  of  which  may  give  rise  to 
much  trouble  in  delivery. 

Version  can  only  be  effected  in  the  uterine  cavity,  and  when  the 
uterus  is  entirely  in  the  abdomen  ;  so  if  any  portion  of  the  foetus  has 
entered  the  inlet,  retropulsion  must  be  resorted  to.  Then  the  operation 
can  be  commenced.  It  is  divided  into  two  principal  movements : 
Bepulsion  and  Evolution. 

In  these  manoeuvres,  the  veterinary  obstetrist,  as  in  so  many  other 
instances,  has  not  the  advantages  which  the  accoucheur  of  woman 
possesses  with  regard  to  manipulation,  and  especially  that  which  can 
be  practised  outside  the  abdominal  walls  in  conjunction  with  the 
version  movements  in  the  uterus. 

Bepulsion.— The,  hand — usually  the  right — being  introduced  into  the 
uterus,  reaches  the  presenting  part  of  the  foetus,  and  by  a  succession  of 
forcible  pushes,  moves  it  away  from  the  inlet— in  fact  propels  it ;  though 
this  retropulsion  should  not  be  made  directly  forward,  but  obliquely, 
so  as  to  press  the  region  we  desire  to  get  rid  of  upward,  downward,  or 
to  either  side,  according  to  circumstances.  In  this  way,  the  opposite 
parts  glide  over  the  uterine  walls — previously  lubricated :  they  move 
round  towards  the  hand,  and  are  more  easily  reached. 

Evolution. — When  the  parts  which  are  sought  for  reach  the  hand, 
they  are  firmly  seized  by  the  operator  and  drawn  towards  him.  The 
uterine  contractions  assist  in  this  operation,  the  version  movement  is 
continued,  the  foetus  becomes  lengthened,  as  it  were,  and  unfolded,  and 
when  its  larger  diameter  is  brought  into  the  axis  of  the  pelvis  the 
manoeuvre  is  completed. 

Version  is  not  always  successful  when  first  attempted ;  indeed,  it  has 
often  to  be  relinquished  and  again  tried,  until  successful — notwithstand- 
ing the  fatigue  and  demands  on  patience  these  repeated  efforts  entail. 

Complete  version  is  required  in  the  transverse  position  of  the  foetus, 
and  is  generally  difficult ;  it,  and  indeed  all  degrees  of  turning,  and  all 
vicious  positions  of  the  foetus,  demands  that  the  first  thing  to  be  done 
is  to  secure  the  most  useful  parts  which  present — as  the  limbs  or  head 
— by  cords  or  other  appliances,  so  as  to  be  able  to  find  and  utilise  them 
again  if  circumstances  require  that  they  should  be  used  to  assist  in 


KECriFICAriOX  OF  rilESKXTATIoys  AM)  POSIT lOXS.  493 

delivery.  Very  frequently  traction  on  one  or  more  of  these  cords,  and 
the  manipulations  of  a  hand  in  the  uterus,  will  greatly  facilitate  turning. 
As  in  so  many  other  obstetrical  operations,  undue  haste  and  violence 
are  to  be  guarded  against  in  these  mutations,  and  gentleness,  patience, 
and  perseverance  should  be  observed.  We  not  unfrequently  find  that, 
when  the  presentation  is  anterior  or  posterior,  and  the  limbs  are  in  a 
favourable  direction,  though  the  body  of  the  fa'tus  may  be  somewhat 
inclined  to  the  right  or  left,  the  uterine  contractions  are  sulhcient  to 
eftect  adjustment,  gradual  and  well-directed  traction  being  alone  re- 
quired from  the  operator. 

Extension  .\nd  Flexion. 

Independently  of  the  ijeneral  mutations  which  have  for  their  object 
the  movement  of  the  whole  mass  of  the  foetus  in  the  uterus,  it  is  some- 
times only  required  to  resort  to  i^artial  mutations — as  in  the  adjustment 
of  one  or  more  of  the  limbs,  head,  neck,  etc.,  these  consisting  of  extension 
— as  when  the  arm  is  extended  on  the  shoulder,  the  fore-arm  on  the 
arm,  the  head  on  the  neck,  the  latter  on  the  trunk,  etc.,  and  jlexion,  in 
bending  the  various  articulations — as  those  of  the  limbs,  in  order  to 
place  them  or  the  body  in  a  better  direction  ;  and  rotation.  In  all  these 
manoeuvres  a  rudimentary  knowledge  of  mechanics  will  be  of  gi'eat 
advantage,  and  especially  that  pertaining  to  levers,  which  is  particu- 
larly applicable  to  manipulations  of  the  limbs  that  so  frequently  prove 
of  the  greatest  service  in  obstetrical  operations. 

It  only  too  often  happens  that  the  arm  of  the  obstetrist  is  found  to 
be  sadly  too  short  in  version  and  other  manoeuvres,  and  these  are  conse- 
quently rendered  more  diflicult  of  accomplishment.  With  regard  to 
this,  it  is  well  to  point  out — what  is  not  always  known — that  the 
obstetrist  should  always  employ  the  arm  corresponding  to  the  side  of  the 
foetus  on  which  the  limb,  the  part  sought  for  or  to  be  manipulated,  is 
situated.  For  instance,  if  the  fcctus  is  in  the  anterior  presentation  and 
dorso-sacral  position,  with  the  head  bent  round  towards  tlie  left  Hank, 
or  the  left  fore-limb  (right  hind-limb  in  a  posterior  presentation)  doubled 
under  the  body,  he  will  use  his  right  arm  ;  but  the  left  will  be  employed 
in  the  opposite  conditions.  By  doing  so,  the  operator  gains  in  length 
of  arm,  particularly  towards  the  shoulder,  and  can  consequently  reach 
deeper  into  the  uterus. 

Flexion  and  extension  of  a  limb  are  often  made  simultaneously,  and 
it  sometimes  happens  that  in  extending  such  a  part  as  the  head  to 
straighten  it,  it  effects  its  own  rotation.  Extension  alone  serves  to 
bring  the  limbs  from  under  the  chest  or  abdomen  ;  flexion  is  rarely  re- 
sorted to,  and  chiefly  when  it  is  desired  to  return  an  extended  limb 
again  into  the  uterus.  In  these  operations  on  the  limlis,  when  the 
weight  of  the  fa'tus  is  an  obstacle,  the  body  of  the  creature  is  inclined 
to  the  side  opposite  to  that  of  the  limb  to  be  manipulated  ;  thus,  if  the 
right  limb  is  flexed  under  the  body,  and  we  desire  to  extend  it,  the 
fcctus  is  inclined  from  right  to  left,  so  that  the  right  side  being  raised, 
the  limb  can  be  taken  from  under  it.  The  body  is  turned  in  the  way 
indicated  for  rotation. 

We  have  casually  alluded  to  the  attitude  of  the  larger  animals  during 
version,  retropulsion,  and  rotation,  and  pointed  out  the  advantage  to  be 
derived  from  elevating  the  hind-quarters,  either  by  placing  litter  under 
the  hind-feet,  or  causing  the  animal,  if  a  Cow,  to  kneel  on  its  knees. 
And  we  have  also  remarked  that  it  is  not  always  possible  to  obtain  the 


494  OBSTETRICAL  OPERATIONS. 

desired  attitude,  but  that  these  mancBUvres  must  sometimes  be  performed 
when  the  animal  is  recumbent.  It  may  even  happen  that  it  will  be 
advantageous  to  place  the  animal  in  a  recumbent  position.  Leconte 
strongly  recommends  laying  it  on  its  sternum,  and  flexing  the  fore  and 
hind  limbs  under  the  body  ;  as  in  this  attitude  the  uterine  cavity  can  be 
more  easily  explored,  and  the  necessaiy  alterations  made  in  the  position 
of  the  foetus — the  operator  lying  extended  behind  the  animal.  Some 
obstetrists  place  the  animal  on  the  right  or  left  side,  the  operator  lying 
on  either  of  his  sides,  according  to  the  arm  he  intends  to  use. 

Throwing  down  an  animal  for  this  purpose  is  always,  however,  to  be 
avoided  if  possible  ;  and  if  it  is  already  down,  it  should  either  be  placed 
on  its  sternum  or  compelled  to  get  up.  When  the  uterus  is  lying  very 
low  in  the  abdomen,  should  the  latter  be  extremely  pendulous,  or  when 
the  foetus — as  in  the  Cow — is  fixed  beneath  the  brim  of  the  pelvis,  it 
may  be  found  very  advantageous  to  place  the  parturient  creature  on  its 
back. 

As  for  the  operator,  he  must  conform  his  attitude  to  that  of  his 
patient.  We  have  already  written  on  this  point  when  treating  of 
parturition,  and  we  have  nothing  to  add.  If  the  animal  is  standing  and 
the  hind-quarters  are  raised,  and  particularly  if  the  obstetrist  is  not 
tall — and  more  especially  if  the  patient  is  a  Mare — the  plan  adopted  with 
much  success  by  Dickens  may  be  followed. ^  This  consists  in  placing 
the  animal,  if  the  case  is  likely  to  be  protracted,  under  an  open  shed, 
tying  the  head  to  the  manger  or  rack,  and  supporting  the  body  by  two 
sacks  passed  under  the  belly  and  attached  to  ropes  which  pass  over  a 
beam  above.  A  partition  on  the  right  side,  to  prevent  swerving,  is  pre- 
ferred, the  assistant  being  placed  on  the  left  side.  Immediately  behind 
the  animal  is  put  a  strong,  four-legged  wooden  cow-crib,  which  serves 
many  purposes.  Firstly,  it  prevents  the  Mare  backing ;  secondly,  the 
operator  standing  in  it  is  perfectly  safe  from  injury  during  his  manipu- 
lations, while  it  gives  him  a  great  advantage  in  the  elevation  it  affords 
■ — especially  with  tall  animals  ;  thirdly,  it  forms  a  convenient  stage 
whereon  to  place  cords,  instruments,  medicinal  agents,  etc. 

We  will  briefly  notice  some  of  the  occasions  when  these  movements 
have  to  be  effected,  though  reference  may  have  been  made  to  one  or  two 
of  them  already. 

Extension  or  Straightening  of  the  Head  and  Neck. — This  is  resorted  to 
when  these  are  not  in  a  proper  direction,  and  the  foetus  must  always  be 
pushed  into  the  abdomen  in  order  to  carry  out  the  operation. 

The  head  may  be  flexed  at  the  occiput,  so  that  the  chin  is  applied  to 
the  lower  border  of  the  neck,  and  if  it  has  not  entered  the  pelvis  and 
can  be  moved  somewhat,  extension  is  easily  effected  by  passing  the 
hand  into  the  cavity,  insinuating  it  between  the  pubis  and  the  forehead 
of  the  foetus  until  the  nose  is  in  the  hollow  palm,  with  the  fingers  if 
possible  under  the  chin,  or  the  thumb  in  the  mouth  and  the  fingers  in 
the  intermaxillary  space ;  then  it  is  lifted  sideways  above  the  margin  of 
the  pubis,  when  it  can  be  brought  straight  into  the  genital  canal  by  gentle 
traction. 

When  the  neck  has  entered  the  pelvic  inlet,  then  it  is  imperative  that 
it  be  pushed  into  the  abdominal  cavity ;  before  this  is  attempted,  how- 
ever, cords  should  be  passed  round  the  fore-feet  (though  these  are  not 
to  be  pulled  at  first),  and  another  around  the  neck  of  the  lower  jaw  or 
the  under  part  of  the  head ;  this  cord  the  operator  holds  in  one  hand  or 
^   Vettrinarian,  vol.  xxxiv.,  p.  260. 


ItECTIFlL'ATluX  OF  VJIESEXTATIOXS  AND  I'oslTloXS.  495 

gives  to  ail  assistant,  while  he  presses  the  neck  forwards  and  to  one 
side,  raising  the  nose  by  means  of  the  cord  and  hand  when  there  is 
sulVicient  room. 

An  exaggerated  and  more  difficult  form  of  this  condition  is  the  head 
and  neck  flexed  beneath  the  chest,  but  it  can  be  remedied  if  the  labour 
has  not  been  protracted.  The  lower  jaw  should  first  be  corded,  the 
cord  being  pulled  by  an  assistant  while  the  operator  pushes  the  body 
back  until  the  head  is  somewhat  relieved,  when  the  propulsion  ceases, 
and  the  hand  seizes  the  lower  part  of  the  head  and  raises  it  and  the 
forehead  ;  and  so  pushing  away  the  body  and  guiding  the  head  alter- 
nately, the  latter  is  brought  into  the  canal.  ^Vhen,  however,  the 
practitioner  is  not  called  in — which  is  usually  the  case — until  after  the 
waters  have  escaped  some  time,  attempts  have  been  made  at  delivery  by 
amateurs,  the  genital  passage  is  dry,  and  the  uterus  is  applied  close  on  the 
foetus,  then  adjustment  of  the  head  and  neck  is  a  serious  atlair ;  as  the 
prolonged  straining  and  pulling  have  put  the  head  farther  beyond  reach 
— pushed  even  beneath  its  abdomen  ;  so  that  the  tips  of  the  fingers  can 
scarcely  touch  the  nose,  much  less  grasp  it,  while  the  contractions  of 
the  uterus — closely  enveloping  the  fojtus — paralyse  the  arm,  whicli  has 
to  be  bent  downwards  in  search  of  the  head.  In  such  a  case  retropul- 
sion  is  futile,  and  the  first  thing  to  be  done  is  to  inject  a  large  quantity 
of  strained  hnseed-jelly,  or  some  other  mucilaginous  fluid,  into  the 
uterine  cavity,  to  compensate  for  the  absence  of  the  waters — unless  it 
be  decided  to  place  the  animal  on  its  back,  which  is  decidedly  advan- 
tageous in  this  embarrassing  case,  when  the  injection  should  not  be 
administered  until  the  animal  is  cast.  Having  had  the  passage  well 
lubricated  and  the  uterus  separated  from  the  foetus,  this  may  now  have 
the  fore-legs  secured  l)y  cords,  and  the  front-part  of  the  body  pushed 
forward,  downwards,  or  sideways,  so  as  to  reach  the  head,  which  may  be 
seized  by  the  ears,  orbits,  or  lips,  until  the  neck  of  the  lower  jaw  can 
be  grasped  and  corded,  when,  with  steady  manipulation  and  traction, 
the  head  and  neck  can  be  adjusted.  Pulling  at  the  limbs,  then  pushing 
the  body  forwards,  so  as  to  effect  displacement  of  some  kind,  will  often 
assist  the  operator  when  the  head  is  beyond  his  hand.  Such  cases  in 
the  Mare  are  nearly  always  impossible  to  rectify,  and  even  in  the  Cow 
they  are  most  formidable,  and  not  always  satisfactory  in  their  termina- 
tion. 

Whcyi  the  head  is  bent  npicards  ami  backwards — the  opposite  condi- 
tion to  the  last — somewhat  similar  measures  must  be  adopted.  The 
fore-limbs  should  be  corded,  as  well  as  the  neck  of  the  lower  jaw  if  it 
can  be  reached.  Then  the  body  is  to  be  pushed  away  from  the  brim  of 
the  pelvis  —  employing  mucilaginous  injections,  if  necessary,  before 
attempting  this,  and  by  means  of  the  hand  in  the  uterus  and  alternate 
traction  on  the  head-cord  and  retropulsion,  the  foetus  can  generally  be 
got  into  a  proper  position  for  delivery. 

A  somewhat  frequent  misdirection  is  tlie  head  bent  round  to  one  side 
— extending  to  the  shoulder,  or  even  as  far  as  the  chest  or  flank.  When 
only  slightly  inclined  to  one  side,  reposition  is  easily  effected  by  seizing 
the  lower  part  of  the  head,  raising  it  upwards  and  bringing  it  round  to 
the  genital  canal.  It  must  not  be  forgotten  that  the  hand  employed  to 
bring  the  head  round  must  correspond  to  the  side  on  which  it  lies :  for 
instance,  if  the  head  is  bent  to  the  right,  then  the  left  hand  must  be 
used  to  manipulate  with. 

When  the  head  is  as  far  back  as  the  elbow,  even,  it  may  often  be 


496  OBSTETRICAL  OPERATIONS. 

brought  straight  by  first  cording  the  fore-limbs,  then  reaching  the  neck 
of  the  lower  jaw  over  the  shoulder,  and  cording  that  also — retropulsion 
and  manipulation,  with  traction  in  the  intervals  of  the  straining,  will 
effect  the  rest.  The  case  is  very  different,  however,  when  the  head  is 
carried  as  far  back  as  the  flank  or  hind-quarter,  and  especially  if  the 
uterus  is  retracted  on  the  foetus,  and  the  interior  is  dry  and  adhesive. 
In  the  Mare  this  is  always  a  most  formidable  affair  to  deal  with.  Here 
the  mucilaginous  and  emollient  injections  are  indispensable,  and  should 
be  at  once  resorted  to.  Then  the  fore-limbs  must  be  corded,  and 
pushed  into  the  uterus  if  they  are  in  the  way  (using  Darreau's  porte- 
cord  if  necessary),  the  hand  passed  along  the  convexity  of  the  neck, 
and  between  it  and  the  uterine  wall,  until  the  lower  jaw  is  seized  and 
corded.  Pressure  is  now  made  on  the  breast  of  the  foetus,  so  as  to 
push  it  away  from  the  pelvic  brim  and  towards  the  side  of  the  uterus 
opposite  to  that  on  which  the  head  lies,  so  as  to  bring  this  nearer  to 
the  inlet.  Then  the  hand  turns  the  lower  jaw  upwards  by  placing  the 
fingers  in  the  submaxillary  space,  and  pulling  the  head  round  by  means 
of  the  cord,  the  hand  in  the  uterus  keeping  the  body  away  from  the 
pelvis  and  to  the  opposite  side,  as  well  as  protecting  the  uterus  from 
injury  by  the  incisors.  If  there  is  a  tendency  to  twisting  of  the  neck, 
this  must  be  overcome  by  manipulation  of  the  head,  which  must  be 
brought  gradually  and  carefully  round. 

But  it  only  too  frequently  happens  that  the  hand  cannot  reach  the 
head,  or  can  only  touch  the  ear-tips,  and  then  the  difficulty  is  very 
great — it  may  even  be  insurmountable.  Various  plans  have  been  tried, 
such  as  exciting  the  foetus  to  move  if  it  be  alive ;  raising  the  abdomen 
of  the  mother,  elevating  the  front  part  of  the  body  or  placing  her  in 
the  dorsal  position  ;  or  implanting  hooks  in  the  foetal  orbits.  But  there 
is  no  certainty  in  any  or  all  of  these  methods,  and  the  only  one  which 
has  hitherto  been  most  successfully  employed  is  that  introduced  by 
Delafoy,  more  than  sixty  years  ago.  Having  satisfied  himself  as  to  the 
state  of  affairs,  he  passed  the  end  of  a  strong  rope,  about  twelve  feet 
long,  with  a  knot  at  the  end  to  prevent  it  slipping  from  his  hand, 
between  the  neck  and  chest  of  the  foetus ;  this  end  he  passed  down- 
wards, seized  it  at  the  lower  side  of  the  neck,  and  brought  it  out  of  the 
vaginal  canal,  so  that  the  middle  of  the  cord  was  inside  the  bend  in  the 
neck.  Again  introducing  his  hand  into  the  uterus,  he  pushed  the  loop 
of  cord  by  the  tips  of  his  fingers  as  near  to  the  head  as  possible, 
when  he  directed  an  assistant  who  held  the  two  ends  to  twist  them 
round  and  round  each  other,  until  the  cord  was  quite  tight  around  the 
part  on  which  it  was  placed ;  at  the  same  time  his  hand  prevented  any 
of  the  placenta  or  cotyledons  from  getting  into  the  twists.  This  having 
been  accomplished,  the  hand  was  placed  on  the  breast  or  one  of  the 
shoulders  of  the  foetus,  and  while  he  pushed  it  towards  the  fundus  of 
the  uterus  the  assistant  exercised  steady  traction  on  the  cord.  In  this 
way,  by  good  management  the  head  was  brought  towards  the  cervix 
uteri,  where  it  was  immediately  accessible,  and  could  be  placed  in  its 
normal  position.  A  small  weight  of  any  kind  attached  to  the  end  of 
the  cord,  instead  of  the  knot,  would  carry  it  more  readily  between  the 
neck  and  shoulder  or  chest,  and  the  porte-cord  might  also  be  used  to 
pass  the  cord  if  the  hand  could  not  be  extended  sufficiently  far  (see 
Binz's  porte-cord). 

Extension  of  the  Limbs. — The  limbs  are  not  unfrequently  a  cause  of 
difficulty  in  parturition,  and  have  to  be  adjusted  before  delivery  can  be 


nECTIFICATIOX  OF  rj^KSKXTATIOXS  JXJ>  msiTfnys  497 

^^^^^^Lt:^:-:^:^^,^^^^  ^^  -.  difficult  m 

leg  being  longer  consequence  of  the  different  segments  of  the 

^^^'^e^::^.n^j::^X:l^^^^  the  g^ital  canal  or 

the  uterus  before  they  can  be  extendoi  „^?  .  be  pushed  forward  into 
cord  the  lower  ia^^orTead  nrpv     '  V      '  -'^^ 

the  fore-arm^s  brou?4t  infol  'V,^^'  ^^"^5  attempted^    Then 

before,  the  shlnk  is  leLd  Id  smarUv  :\^'."t"'  '■'  ^^^^^  °°^  «° 
being  adducted  and  the  knee  "^.X^.^^^^^^^^^  T  ^'Z  ^'' J°"^^  ^°^ 
the  pastern  is  opposite  the  inloJ  fh!  i  "PJ^'^^  ^"^  outwards,  so  that 
and  hoof,  which^fs  elVi  ^he  mhn  the"n.S  "'"  ?'f''^  '°  *^^  ^^^^^°^k 
the  lower  part  of   the  li  nb  i.  n     ' -5       P^^tern-joints  are  well  Hexed. 

whole  extended  ?Le     ^^th    hr^xff  flpl'^'f  f,''"^  ^"^  '^^ 

necessary,  as  they  are  shorter  than  H  0=  ?°.u^  S^^  pbalanges  is  not  so 
immediatdy  extended  but  thp  )?^  f  .  °/.l^^  ^°^^'  ''^"^^  ^hey  may  be 
pre..n.  lacey.r^flhe'^e^Jl^al  tt^^^^^^^^^  ^^  ^^^  ^anJl  to 

held1s°ttn  Ct;ht1rthe\'nltir"^  "^^''/^  !'  '^^  ^^  ^-^^'  -^^  the 
ance  of  the  hand  °  "'^'^  ^^  ^'^°'  °^  ^^^  ^^^'^  and  the  guid- 

tiof/"f"\t"Ss1"ec:ion"ot"'  ^'-^'^'^^  ^^^^^  «^  ^^e  condi- 
limbs  corded  ar'h;Zers  or  sS^^  ^"^^  "^"^'  be  made,  the 

cords  while  the  operatoi  raisp.fhA  '  ^  ^n  assistant  pull  on  these 
same  time  pushin'  the^  orwarL  .?• ''^''''^^  T^  outwards,  at  the 
with  attempts  to  brin'the  nh«  1  '  '.  manipulation  is  alternated 
straightening  theni  th^re  at  thrf^  '°'.^  '^'  '"^^^  ^^ '^^  ^^^"^1'  and 
n^ucousmembraneVomdimlg^'byrLo^'  -"^^^'"°"   ^'^  "^^'^'^^^ 

firsV"ire:':Sd1ly  Set'f^'^^r/'  ^'^'^f  ^^^  ^°---  i^  - 
uterus  ;  if  the  fore  arm  rnn^hl  7^f^-  '^'^^'^'  ^^^  f'^^dus  of  the 

knee  upwards!  rnd-pTo5kLln^^^^^  V  ^''''?'  ^°  ^'  '^  ^ring  the 
lower  part  of  the   imb  can  be^ex  p  d'^^^^  ^°T  ^°'"'"enced^the 

arm  cannot  be  firn  I  seized  so  as  o  1 '" •  *^^^.^^"al.  But  if  the  fore- 
passed  between  the  le'  and  thl  K 'i  ^'  -^f  ^'^'^^tion.  a  cord  must  be 

the  side-the  two  ends  be  n'  twi.f/r^f  T^  '^.'  l''""'^  ^^°"^1^^^  »^ack  on 
while  the  loop  around  the  or!  n  °"V''^"  ?^  ^'^'^  by  an  assistant, 
possible  by  the  hand  TlL  h;  '  ''  ^'°"^'^'  ^'  ""^^'  '°  ^*^«  ^"^^^  as 
arepushed^orwa^i-pJe  sSrfonS^  part  of  the  leg  and  the  body 
assiLnt  puUs  stead  l/oTthecod\P°;;;^  '^""^^?^^'  7^'^'^  '^' 

cavity,  when  the  limb  is  extended  in  h  "''^  ''  '"   '^^  P^'^''^ 

p.  438).  extended  m  the  manner  just  described  (see 

3eque„ce  of  their  heater  ShaLLr  ^°'''  "'""  ""'  ^"'f'  i"  '=°'>- 
than  the  fore-h,ubf  while  th!.,n'„  .7  T  P™P°rtionately  longer 

interdependeVt  thai  one  caJnoTK^?''  m  "^^Pr'^'P''l  Joints  are°so 

""tii^fr '' ""'""°-  -^"3-e  an  rb^ru?'  "^^  °"'"^' 

oons^t'ethXt/rro'"a«:  "{":;'»'"'"  '"  "-.^la-.it  is  generally 
nearly  aUvaysV^lh^^r^  Ta^-  Crin'^r^r  tJ^'I 


498  OBSTETRICAL  OPERATIONS. 

Mare  pain  and  exhaustion,  to  divide  the  gastrocnemii  tendons,  and  so 
straighten  the  limbs. 

"With  the  Cow  the  case  is  not  so  serious,  and  the  Calf  may  be  de- 
livered alive.  Eetropulsion  of  the  hind-quarters  and  hocks  is  absolutely 
necessary ;  this  can  be  effected  by  persistent  effort  and  the  exercise  of 
patience,  the  pushing  forward  being  done  by  jerks  in  the  intervals  of  strain- 
ing, until  the  foetus  has  been  removed  some  distance  from  the  brim  of 
the  pelvis.  Eaising  the  hind-quarters  of  the  Cow  is  very  serviceable  in  this 
measure.  Then  the  tibia  is  placed  in  a  horizontal  direction,  the  pastern 
or  shank  is  corded — as  with  the  fore-limb,  and  the  hock  being  kept  as 
far  away  as  possible  from  the  inlet,  and  towards  the  maternal  flank, 
the  lower  part  of  the  leg  is  carried  backwards  by  cord  and  hand  until 
it  is  in  the  canal.  In  doing  this  the  operator  uses  the  point  of  the 
calcis  to  push  the  hock,  the  body  of  the  foetus  being  kept  obliquely,  and 
care  being  taken  that  the  points  of  the  hocks  do  not  damage  the  uterus, 
by  covering  them  with  the  palm  of  the  hand — a  procedure  which  must 
also  be  adopted  with  the  hoofs. 

Wlien  the  hind-limhs  are  retained  in  the  viatcrnal  ahdominal  cavity  of 
the  Mare,  the  case  is  quite  as  serious  as  when  the  hocks  present ;  but  in 
the  Cow  it  is  not  so  formidable,  and  a  similar  procedure  must  be 
adopted  as  in  the  hock  presentation.  The  body  of  the  foetus  is  pro- 
pelled forward  as  far  as  possible,  and  the  tibia  is  flexed  on  the  femur,  so 
as  to  bring  the  hocks  up  towards  the  inlet ;  this  is  not  very  diflicult  if 
the  foetus  can  be  readily  moved,  for  the  hand  can  be  then  passed  to  the 
stifle  and  the  limb  drawn  towards  the  pelvic  cavity,  when,  seizing  the 
tibia,  this  is  flexed  on  the  thigh.  A  cord  may  be  passed  round  the 
thigh  and  brought  down  to  the  hock,  or  as  near  it  as  possible,  in  par- 
ticularly difficult  cases ;  and  in  propelling  the  buttocks  into  the  uterine 
cavity  the  assistant  steadily  pulls  the  cord,  the  hand  of  the  operator 
not  only  pushing,  but  also  guiding  the  direction  of  the  lower  part  of  the 
limb  and  preventing  injury  to  the  uterus,  until  the  hock  has  reached 
the  inlet,  when  the  leg  should  be  extended  in  the  manner  before 
described.  In  this  diflicult  and  fatiguing  operation,  a  repeller  used  by 
a  second  assistant  will  be  found  most  valuable. 


CHAPTEE  III. 

Mechanical  Means  for  the  Extraction  of  the  Foetus. 

Mechanical  means  for  the  extraction  of  the  foetus  are  required  when 
the  expulsive  efforts  of  the  parent,  and  perhaps  the  hand  of  the  obste- 
trist,  are  insufficient  to  produce  delivery.  These  means  are  employed 
to  efi'ect  change  in  the  position  of  the  foetus,  or  to  apply  force  sufficient 
to  overcome  the  resistance  offered  by  the  obstacle  to  birth  ;  they  com- 
prise a  number  of  articles,  the  chief  of  which  are  cords  and  hands, 
halters,  crotchets  or  hooks,  a.ndi  forceps  of  various  kinds.  The  uses  and 
advantages  of  these  we  will  now  notice.  But  before  doing  this,  we 
must  again  point  out  the  great  advantage,  should  the  "  waters  "  have 
escaped,  and  the  genital  canal  and  interior  of  the  uterus  be  dry  and 
tenacious,  of  moistening  these  parts  well  before  resorting  to  mechanical 
operations. 


MECHANICAL  EXTRACTION  OF  THE  FQ-TUS.  499 

SECTION  I. -CORDS  AND  BANDS 

forceps  are  to  ti,.  Imumn  p"etiZer     Thfy  Ce'l"  ddltif  ,"'T 
vantage  l,hat  they  are  readily  procurable    are  che",     ver?'!n 
and  can  be  eiiiploved  wbere  and  wl„.„  J  J"     cneap,  veiy  p.irtable, 

or  put  out  of  the  way.  as  the  cords  will  Xavs  bHn'  ft.      f     r"""!,' 

They  are  used  with  the  view  of  applying  trictinn  fo  f].o  f    <-  ^ 

they  can   be  attached  to  the  head,Tod>li  nbs   or  t^U    I     ^''  ""'f 
circunistanppQ      TI10  i;,>,k„  '^'-'^v..  iimos,  01   tail,   accordui"  to 

t  s  ttVaiT  ri  tttS-!?;iti:tr-T;fe  :/:£ 

fhVbodTo  :f°"">'  "T^^"'"  "^""S''  ■'  '=  ='  .«ost-i,„portant  ?e„io  ™ 

isSPIiiili 

a?d'i7re™ovtl  "'"''  '°  ^"'^  °'  "'''  ''«'>'■  ^""^  "'»  '°  sbre^'olslinlTo 

orll'^r&^ugt't;^^^ 

from  a  quarter  to  half-an-inch  or  moro  thir>k      A /  ^  i  '       l^  "  ^°P^' 

l.»p  or  ,ron  ri„«.  by  whicht  forZnlt.  n'oo  e  ?K^  "'5^^  \\l  ^ 
bon,e  practitioners  recommend  strands  of  ManHla  hemp  and  in  mr'' 
t.cular  mstances,  as  when  a  somewhat  ri^id  loon  is  rmnbwl  t       ' 

Uther  obstetrists  prefer  a  leather  band  "cnip. 

to  ptenrtm'^n^r  £s°^il'iTa^\i;V''r^°''^^^  ',°  '"  "'^^ 
hardness  thinners,  and  strands, riL-^liaiTorruf  B°„uhis!aceidt't 
need  not  be  much  feared,  and  the  durability,  convenience  and  other 
advantages  possessed  by  the  cords,  are  K.-eati;  in  the  r  favou       TiZ 

o^atyK^^^^^^^^ 

un^  a^np  pe^to^-r omfd  feL^tb^^  O^^ 


500 


OBSTETRICAL  OPERATIONS. 


When  running  knots  or  loops  are  made,  these  should  be  so  tied  that 
there  is  no  chance  of  their  becoming  untied  through  slipping,  when  they 
come  in  contact  with  lubricating  fluids  and  are  strained. 

Whatever  is  used  for  this  purpose  should  be  very  pliable,  and  yet 
sufficiently  strong  to  withstand  energetic  pulling.  A  very  good  pattern 
of  cord  is  that  used  by  Schaack  (Fig.  155). 

This  is  merely  a  cord  with  a  running  noose  at  one  end,  and  a  small 
piece  of  round  wood  at  the  other,  to  give  the  assistant  a  better  hold, 
and  enable  him  to  use  more  force. 

When  cords  are  employed  on  the  limbs,  they  are  generally  applied  to 
the  pasterns  of  the  Foal,  as  these  parts  are  most  accessible,  and  afford 
the  most  secure  hold.  They  can  also  be  apphed  above  the  knees  and 
hocks,  when  it  is  necessary  to  amputate  the  limbs  at  these  joints.  The 
head  may  be  secured  around  the  lower  jaw,  but  it  is  sometimes  better 


Fig.  154. 

Traction  Coed  and  Band,  and  the 
Manner  of  applying  theji. 


Fig.  155. 
Schaack's  Traction  Cord. 


to  pass  the  noose  into  the  mouth  and  around  the  top  of  the  head,  like 
a  gag-rope. 

When  the  cords  are  to  be  applied  to  the  limbs,  either  of  two  modes 
can  be  resorted  to  with  this  object.  If  the  limb  is  bent,  it  must  be  ex- 
tended and  brought  opposite  the  inlet,  or  into  the  genital  canal,  as  the 
case  may  be.  Then  Eainard  recommends  that  the  fingers  be  gathered 
together  and  slightly  bent,  so  as  to  form  a  kind  of  cone,  on  which  the 
running  noose  of  the  cord — sufficiently  wide  to  pass  over  the  foot  of 
the  foetus— is  placed,  as  in  Fig.  154.  The  noose  is  kept  in  its  place  on 
the  fingers,  in  tightening  the  cord,  by  the  free  portion  which  passes 
along  the  under  side  of  the  hand  and  arm  ;  unless  this  precaution  is 
adopted,  the  noose  will  be  pushed  back  over  the  hand  when  introduced 
into  the  vagina,  and  cannot  easily  be  got  forward  again.  The  hand 
and  cord  being  oiled,  are  introduced  into  the  passage,  and  when  the  foot 
is  reached  it  is  seized  in  the  fingers ;  these  are  then  suddenly  bent,  so 
as  to  shorten  the  cone  and  cause  the  noose  to  run  on  to  the  pastern  by 


MECHAXICAL  EXTRACTIOX  OF  THE  FCETUS.  f.Ol 

a  f:cntle  pull  of  the  cord,  which  can  then  be  tightened  and  given  to  an 
assistant. 

The  other  method,  which  is  Schaak's,  and  by  some  obstetrists  con- 
sidered preferable  to  that  just  described,  consists  in  placing  the  middle 
of  the  noose  on  the  dorsal  aspect  of  the  ends  of  the  two  middle  fingers, 
the  finger  on  each  side  holding  it  against  these,  while  the  thumb  keeps 
it  in  the  palm  of  the  hand  (Fig.  161).  The  left  hand  maintains  the 
cord  sufficiently  tense  to  assist  in  keeping  the  noose  on  the  hand  ;  and 
if  the  part  of  the  cord  which  runs  through  the  loop  is  placed  towards 
the  thumb,  the  latter  can  readily  increase  the  size  of  the  noose.  The 
hand  is  passed  into  the  vagina  sideways,  the  little  finger  downwards, 
and  when  the  foot  is  reached,  the  thumb  and  index-finger  are  placed 
within  the  noose,  which  they  enlarge  in  separating  from  each  other, 
while  the  remaining  fingers,  flexing  on  the  hand,  are  passed  around  the 
foot,  and  cause  the  noose  to  glide  over  the  hoof  on  to  the  pastern.  The 
fingers  now  press  on  the  loop,  while  the  other  hand,  drawing  at  the 
cord  outside  the  vulva,  tightens  the  noose  around  the  limb. 

When  the  limb  is  flexed  and  cannot  be  extended,  as  at  the  knee  or 
hock,  the  looped  cord  may  be  employed ;  though  a  long  cord,  doubled, 
will  be  found  to  answer  very  well.  This  is  passed  round  the  flexure, 
the  doubled  end  pulled  to  the  vulva,  and  the  other  end  passed  through 
the  loop  ;  this  done,  the  loop  may  be  tightened,  passed  up  to  the 
elbow  or  stifle,  or  down  to  the  pastern. 

The  lower  jaw  is  "corded"  in  a  similar  manner;  the  mouth  of  the 
foetus  being  opened,  the  noose  is  passed  around  the  neck  of  the  jaw, 
and  the  knot  or  loop  placed  beneath  the  chin. 

In  embr^'otomy  cords  render  good  service,  as  they  can  be  attached 
to  any  part  within  reach  ;  after  decapitation  of  the  fd'tus,  for  instance, 
a  cord  passed  through  a  thick  fold  of  the  skin  on  the  upper  part  of  the 
neck  affords  an  excellent  means  of  traction. 

When  long  cords  are  used,  and  energetic  traction  is  likely  to  be  em- 
ployed, it  will  be  found  convenient  to  have  knots  at  intervals,  to  pre- 
vent the  hands  of  the  assistants  slipping. 

Jlaltcr,  Head-Cord,  or  Ilcad-Collar. 

In  addition  to  the  limbs  and  other  parts,  we  have  stated  that  the 
traction-cord  can  often  be  advantageously  applied  to  the  lower  jaw. 
Indeed,  in  the  anterior  presentation,  even  when  the  fore-limbs  are 
"  corded  "  and  the  head  is  in  a  favourable  position,  it  will  generally  be 
found  very  useful  to  apply  traction  to  the  head  in  addition,  as  not  in- 
frequently pulling  at  the  fore-limbs  alone  only  fixes  them  more  firmly 
in  the  passage. 

We  have  also  mentioned  that  the  interdental  space,  or  "  neck  "  of  the 
lower  jaw,  is  the  most  convenient  for  the  attachment  of  the  cord  ;  but 
nevertheless  it  will  be  found  in  practice  that  this  does  not  afiford  nearly 
so  firm  a  hold  as  the  limbs,  and  that  if  the  noose  does  not  slip  off  the 
jaw,  which  is  often  the  case,  should  the  traction  be  at  all  energetic  the 
bones  will  probably  be  smashed,  the  foetus,  if  alive,  irreparably  damaged, 
and  an  important  accessory  means  to  extraction  lost ;  besides,  traction 
on  this  part  throws  the  head  too  much  upwards.  Should  the  head  be 
turned  back  towards  the  side,  cording  the  neck  does  not  reduce  the 
deviation,  but  only  allows  it  to  be  brought  in  a  doubled  condition  into 
the  genital  canal. 

It  is,  therefore,  most  important  that  means  be  at  hand  to  secure  the 


502 


OBSTETRICAL  OPERATIONS. 


bead  firmly  and  solidly,  either  with  a  view  to  correct  deviation  when 
this  part  is  in  malposition,  or  to  exercise  traction  upon  it  when  it  is 
adjusted,  and  when  the  foetus  remains  immovable  by  pulling  at  the 
fore-limbs. 

We  have  suggested  that  the  noose  of  the  cord,  sufficiently  widened, 
instead  of  being  placed  on  the  lower  jaw,  should  be  first  passed  into  the 
mouth  of  the  foetus,  then  carried  up  over  the  head  and  behind  the  ears 
— the  loop  of  the  noose  remaining,  of  course,  tightly  drawn  in  the 
mouth,  as  this  must  be  the  direction  from  which  the  traction  is  exercised; 
if  pulled  at  from  behind  the  ears,  the  noose  would  be  drawn  off.  In 
placing  the  noose  in  this  position,  the  straight  porte-cord — and  especially 
Mr.  Cartwright's  pattern — will  be  found  very  useful. 

Instead  of  this  simple  noose,  which  can  readily  be  made  when  needed, 
rarious  kinds  of  head-stall  have  been  proposed  by  veterinary  obstetrists 


Fig.  156. 


Fig.  157. 


BiNz's  Simple  Head-Collar.    Rueff's  Head-Collar. 

No.  1. 


Fig.  158. 

Rueff's  Head-Collar. 
No.  2. 


from  time  to  time,  and  some  of  these  possess  certain  advantages. 
Giinther,  many  years  ago,  pointed  out  the  advantages  of  a  head-band 
like  that  represented  in  Fig.  154,  the  upper  part  of  which  was  passed 
behind  the  ears,  while  the  inferior  part  with  the  running  knot  lay  between 
the  branches  of  the  lower  jaw.  Binz  soon  after  proposed  a  kind  of  head- 
collar,  or  halter,  which  could  be  adapted  to  different-sized  heads 
(Fig.  156).  It  is  made  from  a  long  piece  of  cord  with  a  loop  or  eyelet 
at  one  end,  and  at  a  certain  distance  from  this — from  fourteen  to  six- 
teen inches — a  second  loop.  The  other  end  of  the  cord  is  passed 
through  the  first  loop,  so  as  to  make  a  noose  which  goes  round  the 
neck  of  the  foetus  ;  then  through  the  second  loop  which  goes  round  the 
lower  part  of  the  head,  and  may  be  made  large  or  small.  The  remain- 
ing portion  is  used  for  traction.  This  improvised  halter  is  held  at  its 
upper  part  by  the  index-finger  and  thumb,  passed  into  the  genital  canal 


Mi:CHAMVAL  KXTUAi'TKiX  OF  THE  I'OiTUS. 


503 


or  uterus,  where  it  is  placed  on  the  head  of  the  fcxitus  and  the  sides 
appHed  to  the  cheeks  ;  the  lower  portion,  which  was  open,  is  now  closed 
by  running;  the  end  of  the  cord  throu<,'h  the  second  loop,  by  which  the 
head  is  tirinly  secured,  as  in  the  figure  (loG). 

Instead  of  having  the  first  loop  at  the  end  of  the  cord,  Bautneister 
makes  it  nearly  in  the  middle,  with  the  second  loop  at  the  same  distance 
as  in  the  other  halter.  This  allows  of  two  cords — one  on  each  side  of 
the  head— to  pull  at  (Figs.  157,  158). 

Binz  has  devised  a  special  head-apparatus  (Fig.  159),  to  which  he 
has  given  the  name  of  "  Forceps-band"  {Zamjctihand).  This  is  a  band 
of  flax,  silk,  or  some  other  woven  material,  which  is  at  its  widest  part 
about  four  inches  broad,  and  in  length  about  six  or  seven  feet.  At  one 
end  is  a  moderately  large  opening,  while  the  other  is  divided  into  two 
portions  to  within  some  distance  from  the  loop ;  these  last  pass  through 
a  round,  movable,  cork-shaped  piece  of  wood,  metal,  or  leather.  The 
head  of  the  foetus  is  passed  between  the  divided  ends  of  this  band, 
which  are  then  tightened  behind  the  jaw  by  running  the  keeper  close 
up  to  the  chin,  the  undivided  portion  being  brought  over  the  forehead 
towards  the  nose,  and  the  divisions  passed  through  the  loop.     In  this 


Fig.  159. 
BiNz's  Forceps-Band. 


way  the  head  is  firmly  held,  and  powerful  and  direct  traction  can  be 
made  on  the  head,  above  and  below,  by  means  of  the  upper  part  with 
the  hole  at  the  end,  and  the  two  portions  beneath.  It  has  been  found 
particularly  useful  in  cases  of  hydrocephalus. 

Schaack,  in  1S48,  introduced  another  kind  of  head  apparatus,  which 
he  designated  a  "sliding  head-stall"  {U'ticre  d.  coulant),  but  which  is 
perhaps  better  known  in  France  as  a  "  forceps  halter  "  (licol-forccps),  by 
reason  of  its  shape  and  use.  It  is  composed  of  two  doubled  cords,  one 
of  which  (Fig.  100,  1,  I)  forms  the  headstall,  while  the  other  (3,  3) 
makes  the  nose-band.  The  two  arc  united  by  a  metallic  runner  (5) 
which  allows  the  apparatus  to  be  increased  or  diminished  in  si/e  at 
will.  The  runner,  which  forms  the  key  of  the  apparatus,  is  a  piece  of 
brass  or  pewter  a  little  more  than  an  inch  in  length,  about  an  inch  m 
breadth,  and  half  an  inch  in  thickness.  It  is  perforated  by  three  holes, 
two  of  which  are  parallel  and  pass  through  the  wider  part  of  the  metal, 
while  the  third,  placed  between  them,  runs  through  its  narrower  surface. 
The  two  ends  of  the  head-stall  loop  go  through  the  parallel  holes,  the  cord 
composing  this  being  nine  or  ten  feet  long  and  one-third  of  an  inch  thick, 
the  loop  itself  being  intended  to  lie  behind  the  ears  of  the  fcetus.  One 
side  of  the  loop  is  fixed  in  the  runner,  by  rings  of  waxed  pack-thread 


504 


OBSTETRICAL  OPERATIOXS. 


above  and  below  the  hole  ;  this  waxed  thread  being  also  run  up  on  the 
loop,  to  give  it  a  certain  degree  of  rigidity.  The  other  half  of  the  cord 
is  freely  movable  in  its  hole  in  the  runner,  and  a  knot  tied  near  its  end 
allows  it  to  be  distinguished  from  the  fixed  half.  The  nose-hand  (3,  3) 
is  made  of  two  strong  but  soft  strips  of  leather  sewn  one  within  the 
other,  and  doubled  in  the  middle  to  constitute  a  loop  eight  to  ten  inches 
long :  the  two  portions  being  made  into  a  single  cord  (-4)  between  three 
and  four  feet  long,  and  which  passes  through  the  single  hole  across  the 
runner.  The  middle  part  of  the  nose-loop  has  a  kind  of  shield  or  button 
of  thin  leather,  to  prevent  the  loop  slipping  through  the  hole. 

This  was  the  apparatus  first  devised  by  Schaack,  but  recently  he  has 
somewhat  modified  and  simplified  it,  by  dispensing  with  the  nose-band 


IM 


Fig.  160.  Fig.  161. 

Schaack's  Forceps-Halter.  Manner  of  placing 

Schaack's  Halter. 
1,  1.  Head-stall;  2,  2.  Two  Cords,  its  con- 
tinuation ;  3,  3.  Nose-band  ;  4.  Single  Cord 
forming  a  continuation  of  the  Loop  con- 
stituting the  Nose-band  ;  5.  Metal  Runner, 
uniting  the  several  parts  of  the  Halter. 

altogether,  as  he  found  that  the  nose  of  the  foetus  could  be  better 
guided  and  held  by  the  hand.  Experience  has  proved  that  this  simpli- 
fication allows  the  halter  to  be  more  easily  applied. 

The  manner  in  which  the  original  halter  was  employed  is  described 
as  follows : — The  head  of  the  foetus  being  in  front  of  the  inlet  and 
readily  accessible  to  the  hand,  the  nose-loop  is  pulled  through  the  runner 
until  stopped  by  the  leather  button,  while  the  head-stall  loop  is  made 
sufficiently  wide.  The  middle  of  the  latter  is  placed  at  the  end  of  the 
middle  fingers,  the  movable  part  of  the  cord  being  between  the  middle 
and  index-finger,  the  fixed  side  between  the  ring  and  little  finger 
(Fig.  161).  The  apparatus  is  at  first  held  by  the  index  and  middle 
fingers  against  the  other  fingers,  as  well  as  by  the  thumb,  which  keeps 
both  cords  in  the  palm  of  the  hand ;   and  finally  by  the  left  hand, 


MECIIAMCAL  EXTRACT  ION  OF  THE  FCETUS. 


505 


which,  di-awinjj;  lij^htly  on  the  three  cords,  keeps  them  sufTiciently  tij^ht. 
The  runner  should  be  at  the  wrist,  the  button  of  the  nose-loop  towards 
the  hand. 

The  apparatus  being  so  disposed,  the  hand  is  introduced  sideways 
(little  linger  downwards)  into  the  vagina,  until  it  arrives  at  the  head  of 
the  f(ctus  ;  then  the  nose  of  the  latter  is  passed  into  the  head-stall  loop, 
which  is  pushed  forward  by  one  side  of  the  face — say  the  right — towards 
the  neck  and  over  the  ear  ;  the  other  half  being  now  carried  on  the 
opposite  side  towards  the  left  ear,  and  then  the  runner  is  seized  below 
the  jaw.  In  tliis  way  the  hand  has  passed  round  the  length  of  the 
head-stall  from  its  fixed  to  its  movable  part — the  latter  readily  allowing 
the  loop  to  enlarge  and  pass  over  the  salient  portions  of  the  head,  the 
loop  being  nevertheless  kept  sufliciently  tense  by  the  right  hand  pushing 
the  runner  up  towards  the  throat ;  while  the  left  hand,  pulling  at  the 
movable  cord — recognised  by  the  knot  at  its  end — tightens  it  as  much 
as  may  be  necessary.      The  nose-loop  is  placed  by    introducing   the 


Fig.  1G2. 

ScH.\ACK's    H.\I.TKK    TLACKIi   ON    A    CaLK'S    HeAD,   THE   RlGHT    FoRK-PaSTKRN 
liEIXf;    ALSO   CORDED. 


index-finger  of  the  right  hand  under  the  button,  and  drawing  the  loop 
through  the  runner  to  a  suflicient  length,  the  left  hand  keeping  the 
other  two  cords  tight ;  the  end  of  the  nose  is  passed  into  the  loop,  which 
is  lifted  as  high  as  need  be.  This  done,  the  right  hand  is  withdrawn 
from  the  uterus  and  vagina,  along,  while  keeping  tight,  the  three  cords. 
These  are  tied  together  in  a  knot  outside  the  vulva,  and  the  head  is  thus 
securely  and  solidly  fixed. 

Saint-Cyr  and  others  highly  recommend  this  apparatus,  which  in  its 
modified  form  difl'ers  but  little  from  tliat  described  by  Binz  some  years 
previously.  He  remarks  that  its  extreme  simplicity,  its  trifling  cost, 
the  facility  with  which  it  can  be  placed  after  a  little  practice,  its 
solidity — which  enables  it  to  withstand  any  amount  of  traction — and  its 
absolute  innocuousness,  all  combine  to  render  it  one  of  the  best  and 
most  precious  instruments  required  in  veterinary  obstetricy.  In  the 
first  place,  when  it  is  properly  applied  it  cannot  slip,  and  all  the  amount 
of  force  necessary  under  the  circumstances  may  be  employed  without 


506  OBSTETRICAL  OPERATIONS. 

fear ;  next,  being  formed  of  small  and  flexible  cords,  which  are  well 
oiled  before  use,  it  cannot  injm-e  the  maternal  organs  in  any  way  ; 
thirdly,  from  the  manner  in  which  it  acts  on  the  neck,  the  lower  jaw, 
and  the  face,  and  the  impossibility  of  its  becoming  tighter  when  once 
it  is  fixed,  it  is  absolutely  inoffensive,  so  far  as  the  foetus  is  concerned ; 
and,  finally,  owing  to  the  nose-loop,  it  always  keeps  the  head  in  a  good 
direction,  prevents  it  from  deviating,  and  compels  it  to  follow  the 
course  most  favourable  for  its  extraction  :  in  the  words  of  Schaack  him- 
self, "  Without  exaggeration,  the  forceps  of  the  accoucheurs  could  not 
answer  better  for  the  human  foetus."  As  an  agent  of  prehension  and 
traction — but  particularly  the  latter,  Saint-Cyr  asserts  that  he  does  not 
know  of  anything  superior  to  this  apparatus. 

Shaack's  halter  is  more  especially  applicable  to  the  Bovine  foetus, 
the  head  of  which  is  so  much  larger  and  squarer  than  that  of  Solipeds, 


Fig.  163.  Fig.  164. 

Haltek  with  a  Single  Traction  Halter  with  Two  Traction 

Cord.  Cokds. 

a.  Check-knot  ;  h,  Running  Knot  or  a,   b,   Two   ends  of    the   Cord  ;    r, 

Loop.  Check-knot  on  the  a  portion  ;  d,  Run- 

ning Knot  or  Loop  on  the  b  portion. 

and  sometimes  requires  very  energetic  pulling  to  remove  it  from  the 
pelvis. 

It  is  not  always  an  easy  task,  however,  to  place  anything  like  a 
formed  halter  over  the  head,  especially  if  this  is  in  the  genital  canal ;  so 
that  it  has  been  found  more  convenient  to  make  the  halter  on  the 
head.  Detroye^  takes  a  cord  about  ten  feet  long,  in  the  middle  of 
which  he  makes  a  simple  knot — a  check-knot  ;  this  is  passed  by  the 
hand  or  porte-cord  around  the  neck  behind  the  head,  and  the  knot 
withdrawn  to  the  vulva  ;  a  loop  or  running-knot  is  made  on  the  cord 
at  a  certain  distance  from  the  check-knot,  and  the  shorter  portion  of 
the  cord  is  passed  through  it,  the  loop  being  tightened  and  run  up 
until  it  is  close  to  the  knot  (Fig.  164).  The  length  of  cord  between  the 
two  knots  should  be  sufficient  to  encircle  the  upper  part  of  the  neck, 
and  form  a  kind  of  halter  without  the  nose  portion ;  the  loop  may  be 
made  previously,  when  it  is  possible  to  make  it  glide  on  the  head, 

^  Recueil  de  Medecine  Vetdrinalre,  1889,  p.  309. 


MECHANICAL  EXTRACTIOX  OF  THE  FCETf'S. 


607 


After  drawing  the  portion  with  the  check-knot  on  it  sufliciontly  tight 
to  place  the  head-piece  in  its  proper  situation,  the  same  portion  should 
be  passed  or  hitched  round  the  lower  end  of  the  head; 
the  knots  ought  to  lie  between  the  branches  of  the  lower 
jaw.  If  it  is  desired  to  have  only  one  traction  cord,  the 
running-knot  or  loop  should  be  made  at  one  end,  and  the 
check-knot  a  calculated  distance  from  it  (Fig.  1G3). 

This  forms  a  very  simple  and  solid  apparatus  for 
exercising  any  amount  of  traction  on  the  head,  without 
much  risk  of  danger  to  the  fcctus. 

A  still  simpler  method  is  passing  the  middle  of  a  ten 
or  twelve  foot  cord  behind  the  ears  of  the  foetus,  carrying 
the  sides  down  behind  the  lower  jaw,  and  then  twisting 
them  outside  the  vulva  until  the  two  ends  form  one 
portion  between  the  branches  of  the  jaw.  This,  how- 
ever, has  rather  a  tendency  in  some  cases  to  tilt  the  nose 
too  much  upwards. 

With  the  smaller  animals,  cords  cannot  be  passed 
around  the  head  of  the  fa3tus  in  the  same  manner  as 
in  the  Mare  or  Cow,  because  of  the  want  of  space ;  and 
on  the  same  grounds  forceps  are  objectionable.  For 
anatomical  reasons,  it  is  essential  that  the  traction  force 
should  be  applied  behind  the  head,  as  if  the  sum  of  the 
expulsive  efforts  were  directed  there.  With  this  object, 
Defays  devised  an  apparatus  which  fulfils  this  indication, 
and  is  very  simple  and  easily  applied.  It  consists  merely 
of  two  very  pliable  copper  or  brass  wires — twisted  picture- 
frame  wire  I  have  found  to  answer  admirably — about 
sixteen  inches  in  length,  and  looped  in  the  middle,  so  as 
to  be  applied  to  the  fcctus  in  the  following  manner :  The 
first  finger  of  the  left  hand  being  passed  into  the  vagina, 
-erves  to  guide  one  of  the  loops  towards  the  summit  of 
and  behind  the  foetal  head  ;  and  it  then  conducts  the 
loop  of  the  other  wire  beneath  the  head  behind  the  jaw. 
This  done,  the  two  wires  on  each  side  are  twisted  by  a 
little  machine  (Fig.  IGo)  composed  of  a  thin  iron  rod  in  a 
handle,  the  other  end  of  which  is  thickened  and  pierced 
by  holes  running  nearly  parallel  to  the  stalk.  Into  these 
holes  the  two  wires  of  one  side  are  passed  ;  the  machine 
on  each  side  is  pulled  up  as  close  as  possible  to  the  head 
of  the  fcotus,  and  then,  each  being  turned  round  three  or 
four  times,  the  neck  is  enclosed  in  a  kind  of  noose  or 
collar  formed  by  the  two  wires  (Fig.  166). 

The  rods  are  now  withdrawn  from  the  latter,  and  the 
foetus  can  be  extracted  by  exercising  traction  on  the  ends 
of  the  four  wires  outside  the  vulva.  By  this  contrivance, 
delivery  is  effected  without  injury  to  the  Bitch,  and, 
unless  it  is  much  decomposed,  without  separating  the  with  the  Tob- 
head  of  the  foetus.  «'on  Rons. 

We  have  tried  Defays'  apparatus,  and  can  speak  highly  of  it  ;  not 
infrequently  we  have  succeeded  in  extracting  the  Puppy  alive,  and 
when  the  use  of  forceps  would  have  been  impossible. 

A  much  simpler,  readier,  and  perhaps  more  successful  apparatus  (so 


Fig.  ifi.'i. 

r)Er.\Ts'   WlRK 

Extra  rroR 


508 


OBSTETRIC  A  L  OPERA  TIONS. 


far  as  our  experience  enables  us  to  speak),  is  that  devised  by  Breulet, 
of  Marche,  Belgium,  which  meets  every  requirement  in  the  accouche- 
ment of  small  Bitches,  and  might  be  successfully  employed  v^ith  Sows, 
Ewes,  and  Goats.     This  apparatus  is  the  same  in  principle  as  Defays' 


Fig.  166. 
Defays'  Wire  Extractor  applied. 


wire  extractor,  but  there  is  only  one  wire.  The  principal  part  of  the 
invention  is  a  noose-tube,  consisting  of  a  tubular  piece  of  round  wood, 
from  four  to  six  inches  long,  and  half  an  inch  thick.  The  wire  may 
either  be  of  copper,  brass,  or  iron,  about  sixteen  inches  long  (we  have 


Fig.  167. 
Breulet's  Tube  and  Noose. 


generally  used  a  piece  of  catgut,  and  prefer  it) ;  this  is  doubled,  passed 
through  the  tube  to  a  certain  extent,  so  as  to  form  a  loop  or  noose  at 
the  end  (Fig.  167).  When  it  is  to  be  used,  the  first  finger  of  the  left 
hand  carries  the  loop  into  the  vagina  of  the  Bitch,  and  slips  it  behind 


Fig.  168. 
Breulet's  Noose  fixed  on  the  Foetus. 

the  occiput  of  the  Puppy  ;  then  the  two  ends  of  the  wire  are  passed 
through  the  tube,  and  this  is  pushed  into  the  vagina  under  the  chin  of 
the  foetus ;  the  operator  now  tightens  and  secures  the  wire,  by  giving 
it  a  turn  round  the  first  finger  of  his  right  hand,  placing  his  thumb  at 
the  end  of  the  tube  (Fig.  168).  A  little  traction  then  extracts  the 
foetus,  and  without  doing  it  or  the  Bitch  [the  least  damage.     I  have 


MECUAXICAL  EXTRACTION  OF  THE  FCETl'S. 


509 


employed  this  instrument  in  canine  obstetricy,  and  my  success  has 
always  been  complete,  even  with  the  tiniest  toy  terriers.  When  sought 
for  in  time,  I  have  generally  managed,  expeditiously  and  easily,  to 
extract  the  Puppies  alive. 

It  will  be  seen  that  the  noose  is  not  unlike  the  "  iillet "  used  in 
human  obstetrics. 


Fig.  169. 

CAK-nVKIGHT's 
POBTK-COKD. 


Fig.  170. 

Daubeai'h 
PobteCoku. 


FiK-  171. 

GCNTHKU's    ClRVKD 

porte-cori)  a.vd 
Blunt  Cuotchet, 
armko  with  a 
Cord  and  Rin*;. 


i 


Fig.  172. 


|I).\hukau'h 
Curved  1'oute-Cord. 


t 


SECTION  II.— PASS-  OR  PORTE-CORUS. 

When  treating  of  certain  presentations,  it  was  remarked  that  though 
the  use  of  cords  is  urgently  indicated  in  some  cases,  the  arm  is  not 


510 


OBSTETRICAL  OPERATIONS. 


sufficiently  long  to  pass  them  to  the  region  where  they  might  be  most 
effectively  fixed  ;  while  the  energetic  uterine  contractions  paralyse  the 
hand  of  the  operator,  and  often  prevent  it  manipulating  accessible  j)arts 
which  it  is  desirable  to  secure  by  these  means.  In  such  circumstances 
the  porte-cord,  or  pass-cord — which  has  been  sometimes  referred  to — 
is  of  great  service.  The  instrument  is  of  two  shapes,  straight  and 
curved. 

The  straight  porte-cord  is  usually  a  rod  of  |-  inch  iron,  furnished  with 
a  wooden  handle  at  one  end,  and  an  eyelet  or  double  open- 
ing at  the  other  to  receive  the  cord  (Figs.  169,  170). 

The  curved  porte-cord  has  the  end  through  which  the 
cord  passes  more  or  less  bent,  and  in  certain  cases  it  is 
more  useful  than  the  straight  one,  from  which  it  only 
differs  in  having  this  curvature  (Figs.  171,  172). 

Different  forms  of  these  instruments  have  been  described, 
but  in  principle  they  are  all  really  the  same. 

The  straight  one  can  be  used  to  pass  the  traction  cord 
around  the  limbs,  or  the  neck  of  the  lower  jaw,  and  may 
act  with  the  cord  in  pulling  these  towards  the  vulva  ;  or, 
if  properly  constructed,  it  may  also  be  most  serviceable  as 
a  repeller  in  pushing  them  forward  into  the  uterus.  A  very 
good  and  simple  pass-cord  of  this  kind  is  that  introduced 
by  Darreau  (Fig.  173),  which  can  be  employed  as  a  re- 
tractor and  repeller.  Two  of  these  may  be  used  at  the 
same  time,  on  two  limbs.  For  instance,  in  the  sterno- 
abdominal  presentation,  when  posterior  version  is  decided 
on,  the  hind-limbs  are  corded  in  the  usual  way ;  then  this 
repeller,  armed  with  a  noosed  cord  of  sufficient  length,  is 
introduced,  the  noose  passed  on  to  the  pastern  or  knee  of 
one  fore-limb,  and  the  cord  drawn  tight  and  fastened 
around  the  handle.  Another  pass-cord  is  attached  in  the 
same  manner  to  the  other  fore-limb,  so  that  each  instru- 
ment becomes  a  solid  fixture  to  the  leg,  and  is  confided  to 
an  assistant.  The  operator  then  pushes  back  the  fore- 
limbs  as  far  as  possible  by  hand,  while  each  assistant 
seconds  his  efforts  with  the  repellers.  When  all  has  been 
conveniently  adjusted,  ti-action  is  made  on  the  hind-limbs, 
the  repellers  being  still  employed  to  overcome  the  resistance 
of  the  foetus  and  follow  its  movements. 

The  curved  pass-cord  has  its  uses  in  certain  cases  when 
the  straight  one  cannot  be  serviceable — as  in  passing  a  cord 
round  the  head  or  bent  neck,  thigh,  or  loins  ;  there  are 
also  several  patterns  of  this  instrument,  but  if  the  straight 
one  is  made  of  iron,  it  may  be  bent  sufficiently  to  answer 
the  purpose  in  the  case  of  flexed  limbs  or  bent  neck.  An 
ordinary  walking-stick  with  a  crook  handle  may,  on  an 
emergency,  be  made  to  serve  this  purpose  by  making  one 
or  two  holes  in  the  handle  for  the  reception  of  the  cord.  Or  when  this 
cannot  be  procured,  an  excellent  substitute  will  be  found  in  a  piece  of 
iron  or  lead  attached  to  the  end  of  the  traction  cord,  the  weight  of 
which  greatly  facilitates  the  passage  of  the  cord  around  the  straight 
or  bent  neck,  hocks,  or  knees. 

Tyvaert^  has  for  a  long  time  made  profitable  use  of  a  simple  porta- 
^  Annaks  de  Medicine  Veterinaire,  1876,  p.  320. 


Fig.  173. 

Dareead's 
Repeller. 


MECHAXICAL  EXTRACTIOX  OF  THE  F(ETUS. 


511 


cord.     This  is  composed  of  a  somewhat  short  piece  of  iron  wire,  about 

the  thickness  of  a  goose-quill,  and  bent  a  little  round,  the  length  and 

curve  varying  with  the  part  to  be  secured.     One  end  is  turned  to  form 

a  small  ring,  while  the  other  is  bent  to  make  a  hook, 

a  little  longer  than  wide.     A  cord  being  attached  to 

the  ring  end,  the  wire  is  passed  round  the  part  it  is 

sought  to  seize  ;  the  hook  end  remains  free,  and 

afterwards  receives  the  traction    cord,    serv'ing    to 

form  a  running   noose   on   the  part.      This  porte- 

cord   is  very   simple,   and  may   be  made    on    the 

spot  when  required ;  it  has  proved  most  useful  for 

securing  the  neck  or  hocks. 

Binz's  pass-cord  (Fig.  174)  is  much  used  in 
Germany.  It  is  sufliciently  large  to  pass  round 
the  doubled  neck  of  the  fa'tus,  while  its  shortness 
allows  it  to  be  easily  manipulated  in  the  uterus.  It 
is  from  twelve  to  sixteen  inches  long,  and  made  of 
wood  or  iron  ;  at  the  bent  end  is  an  opening  through 
which  the  cord  passes.  The  instrument  (named  a 
Gcburtssunile  by  the  Germans)  is  passed  to  the 
middle  of  the  cord,  and  may  then  be  introduced 
into  the  uterus,  where,  from  its  curvature  and  its 
shortness,  it  can  be  pushed  behind  or  between  the 
limbs,  in  the  double  of  a  bent  neck,  etc.  The  hand 
seeks  the  half  of  the  cord  on  the  opposite  side 
of  the  part,  and  pulls  it  into  the  vagina ;  the  in- 
strument is  then  withdrawn,  and  the  part  is  ready  to  be  pulled  at  by 
the  cord  left  encircling  it. 

The  ordinary  curved  pass-cord  is  introduced  into  the  genital  canal  in 
the  same  manner  as  the  other  form,  but  with  only  a  loop  or  ring — no 
noose — at  the  end  of  the  cord ;  the  curved  portion  is  pushed  around 
the  part  to  be  secured,  and  the  hand,  leaving  it,  is  passed  to  the  oppo- 
site side  of  the  part,  where  it  searches  for  the  loop  or  ring,  which,  when 
found,  is  drawn  into  the  genital  canal.  The  instrument  is  then  with- 
drawn, the  cord  remaining  around  the  part ;  the  free  end  of  the  cord  is 
passed  through  the  loop  or  ring,  and  being  pulled  at,  the  limb,  neck, 
body,  or  whatever  it  may  be,  is  secured  in  the  noose  so  formed,  and 
traction  can  in  this  way  be  directly  exerted  upon  it. 


Fig.  17). 
Binz's  Pobtk-Cord. 


SECTION  III.— CROTCHETS  OR  HOOKS. 

Obstetrical  crotchets  or  hooks  are  iron  or  steel  instruments  of  variable 
dimensions,  more  or  less  curved  at  one  end — which  is  blunt,  sharp,  or 


Fig.  175. 
Short  Blckt  Crotchet. 


Fig.  170. 
Blcxt  Fikoeb  Crotchet. 


pointed — the  other  end  having  a  ring  (Fig.  176)  or  eyelet  (Fig,  175)  if 
short,  a  handle  if  long.     The  latter  is  from  thirty  to  thirty-six  inches 


512  OBtiTETllICAL  OPEIIATIONS. 

in  length  (including  the  handle),  and  acts  directly  on  the  foetus  without 
any  other  appliance  intervening  ;  while  the  short  hooks  have  cords 
attached  to  them,  or  they  may  fit  on  the  finger  of  the  operator  by  means 
of  a  ring.  Some  sharp  crotchets  are  jointed  at  the  end  curve,  so  as  to 
permit  them  to  be  more  readily  and  safely  introduced  into  the  genital 
passage  by  bringing  the  sharp  point  near  the  stalk,  the  curve  being 
restored  by  a  spring  when  the  fcetus  is  reached.  But  the  advantages 
of  the  jointed  hooks  are  very  few,  while  their  strength  is  impaired  and 
their  expense  increased.  In  using  the  long  or  short  pointed  crotchets, 
risk  of  injury  to  the  maternal  organs  may  be  obviated,  if  the  hand  is 
not  found  sufficient  to  guard  the  instrument  during  its  introduction,  by 
fixing  the  point  in  a  piece  of  cork  or  soft  wood,  to  w^hich  a  long  piece 
of  twine  is  attached ;  when  the  crotchet  is  required  to  be  implanted  in 
the  foetus,  this  shield  may  be  removed  from  the  point,  and  withdrawn 
from  the  genital  organs  by  pulling  at  the  end  of  the  twine  outside  the 
vulva. 

Blunt  and  sharp  crotchets  are  much  employed  in  veterinary  obstetrics, 
and  are  very  valuable.  The  blunt  crotchets  are  more  particularly 
resorted  to  when  the  foetus  is  alive,  and  it  is  hoped  to  extract  it  before 
it  is  dead ;  they  are  most  serviceable  in  correcting  deviations  of  the 
head  or  limbs,  and  the  long  crotchet  is  especially  useful  in  finding  and 


Fig.  177.  Fig.  178. 

Short  Sharp  Crotchet,  Short  Sharp  Crotchet, 

WITH  Broad  or  Flakged  Point.  with  Eocnd  Point. 

straightening  the  latter.  The  curve  should  be  about  four  inches  wide. 
The  finger  crotchet  may  be  usefully  employed  when  the  hand  is  fatigued 
or  paralysed  by  the  uterine  contractions.  Blunt  crotchets  of  a  much 
smaller  size  than  those  required  for  the  larger  animals  can  be  most 
successfully  employed  in  delivering  the  Sow,  Sheep,  Goat,  Bitch,  or 
Cat. 

Giinther's  long  porte-cord  (Fig.  171)  can  be  most  effectively  used  as  a 
blunt  crotchet  and  at  the  same  time  as  a  carrier  of  the  cord.  A  German 
long  blunt  crotchet  has  a  concealed  sharp  blade  in  the  concavity  of  the 
curve  ;  by  means  of  a  spring  in  the  hanclle  this  blade  can  be  projected, 
and  the  instrument  will  then  do  good  work  in  embryotomy. 

With  the  sharp  crotchet,  the  curve  should  certainly  not  be  very  wide; 
the  smaller  it  is  the  more  readily  it  can  be  passed  into  the  genital 
passage,  and  the  less  chance  of  injury  is  there  to  the  mother  or 
operator  ;  it  should  not  be  greater  than  the  hand  can  cover.  At  the 
same  time,  if  the  curve  is  too  small,  the  crotchet  does  not  obtain  suffi- 
cient hold  of  the  fcetus,  is  readily  torn  out,  and  for  this  reason  may  be 
most  dangerous.  The  point  should  be  so  bent  as  to  readily  penetrate 
the  part  in  which  it  is  determined  to  fix  it,  and  the  angle  of  the 
curvature  should  be  such  that  the  more  the  crotchet  is  pulled  at,  the 
deeper  and  more  firmly  the  point  will  enter. 


MECHANICAL  EXTRACTION  OF  THE  FCETUS. 


518 


So  it  is  that  the  point  should  not  bo  turned  round  in  a  semicircular 
manner,  but  rather  at  an  acute  angle,  as  in  Figs.  181,  182. 

There  is  rather  a  diversity  of  opinion  with  regard  to  the  preference 
to  be  accorded  to  the  crotchets ;  some  practitioners  preferring  the  short 
ones,  as  they  can  be  readily  carried  into  the  uterus  guarded  by  the  hand 
and  moved  about  there,  so  as  to  be  implanted  in  the  most  convenient 
part  of  the  foetus ;  while  the  cords  attached  to  them  allow  traction  to 
be  made  in  the  most  favourable  direction.     Other  obstetrists  prefer  the 


<f^ 


<f\ 


fn 


H  A 


Fig.  179. 

Long  Blunt 
Cbotchet. 


Fig.  180. 
Long  Pointeh 

CllOTtHET. 


Fig.  181. 


Fig.  182. 


Long  Pointed  Crotchets, 
Darreau'.s  Pattern. 


long  rigid  crotchet,  which  they  aflirm  is  more  easily  placed — one  hand 
guiding  the  point  through  the  passage,  the  other  hand  acting  on  the 
handle. 

These  preferences  depend  very  much  upon  whether  the  operator  is 
more  practised  in  the  use  of  one  or  other  of  the  crotchets,  and  also, 
doubtless,  upon  circumstances  peculiar  to  each  case  requiring  the  em- 
ployment of  such  instruments.  Both  long  and  short  crotchets  are 
most  useful,  and  the  obstetrist  should  have  several  of  each,  of  various 

33 


514  OBSTETRICAL  OPEEATIOSS. 

forms  and  dimensions,  so  as  to  be  able  to  select  that  which  is  best 
adapted  to  meet  the  requirements  of  particular  cases. 

It  must  be  observed,  also,  that  many  practitioners  are  not  in  favour 
of  crotchets,  and  decry  their  use.  But  there  is  something  unreason- 
able in  this,  and  the  experience  of  almost  every  day  goes  to  prove  that 
these  instruments  afford  a  simple  and  ready  means  of  getting  hold  of 
the  foetus  in  regions  of  its  body  which  the  hand  cannot  possibly  reach, 
or  if  it  did,  where  it  could  do  very  little  service  either  from  the  shape 
of  the  part,  its  slipperiness,  or  the  paralysing  effect  of  the  uterine  con- 
tractions on  the  hand  and  arm  of  the  operator.  They  can  also  be 
profitably  employed  in  cases  in  which  cords  and  halters  are  useless  ; 
for  not  only  will  they  serve  in  allowing  traction  to  be  made  on  parts 
which  actually  present  at  the  inlet,  but  they  can  also  be  utilised  in 
effecting  those  mutations  which  are  necessary  in  order  to  bring  par- 
ticular parts  of  the  young  creature  in  front  of  the  pelvic  opening  or 
through  the  genital  canal,  and  which  the  hand  could  not  seize  or 
move. 

It  is  no  doubt  true  that  the  sharp  or  pointed  crotchets  have  certain 
disadvantages  which  must  not  be  lost  sight  of,  and  which  lead  to  pre- 
ference being  given  to  the  cords  or  halter  when  they  can  be  employed. 
In  the  first  place,  their  introduction  into  the  uterus  is  not  such  an 
easy  matter  as  it  might  appear  without  trial  or  consideration  ;  for  the 
contractions  of  this  organ  may  paralyse  the  hand  which  carries  the  in- 
strument and  cause  it  to  escape,  or  its  point  to  wound  either  the  mother 
or  the  operator.  Their  employment  often  produces  serious  lesions 
in  the  body  of  the  foetus,  which  are  certainly  of  no  importance  when  it 
is  dead,  but  may  be  of  much  consequence  should  it  be  alive.  Then, 
again,  the  tissues  into  which  they  are  implanted  are  not  very  firm  or 
resisting,  so  that  only  a  moderate  degree  of  traction  can  be  expected 
from  them,  and  which  is  often  insufficient  to  overcome  the  resistance  that 
prevents  the  birth  of  the  foetus.  In  such  a  case,  if,  through  forgetful- 
ness  or  maladroitness  of  the  operator,  the  tissues  suddenly  give  way 
and  the  crotchet  slips  into  the  maternal  organs,  serious,  if  not  fatal, 
injuries  may  be  inflicted ;  or  the  hand  or  arm  of  the  operator  may  be 
the  part  to  suffer. 

These  are  undoubtedly  disadvantages  of  a  weighty  kind;  never- 
theless, the  veterinary  obstetrist  has  always  to  contend  with  disad- 
vantages in  cases  of  dystokia,  and  must  overcome  them  by  prudence, 
patience,  and  skill.  When  using  the  crotchet  the  same  qualities  must 
be  brought  to  bear.  His  hand  must  diligently  guide  it,  and  note  its 
effects  and  movements ;  while,  at  the  same  time,  he  must  vigilantly 
exercise  his  judgment  in  directing  his  assistants  as  to  the  amount  and 
direction  of  the  force  they  are  to  use,  so  as  to  proportion  it  according 
to  the  resistance  of  the  tissues  in  which  the  crotchet  is  fixed,  and  to 
desist  from  traction  as  soon  as  there  is  a  likelihood  of  the  instrument 
breaking  away  or  slipping.  With  the  evidence  before  us  as  to  the 
numerous  and  incontestable  advai:itages  offered  by  these  appliances, 
and  the  knowledge  that  their  disadvantages  can  be  overcome  by  intelli- 
gent watchfulness,  there  is  every  reason  to  recommend  their  adoption 
in  those  cases  which  call  for  their  employment. 

"  In  all  cases  where  the  head  of  the  foetus  is  back,"  Cartwright  says, 
"  I  am  very  partial  to  using  the  long  sharp-pointed  hook  in  the  orbit ; 
even  if  the  head  is  at  the  extreme  distance,  with  care  we  can  insert  it  in 
the  orbit  and  get  the  head  in  the  passage.     Of  course,  it  requires  great 


MECHANICAL  EXTRACTION  OF  THE  FCETUS.  515 

care  in  watching  that  the  hook  does  not  break  loose  and  do  mischief. 
I  have  found  that  Nve  may  pull  by  the  hook  in  the  orhit  witli  great  force, 
without  tearing  the  skin  of  the  Calf,  providtd  the  latter  is  not  in  a  de- 
composed state.  From  my  experience,  1  can  speak  highly  of  the  hooks; 
indeed,  you  cannot  get  the  head  up  without  them  sometimes."  And  in 
embryotomy  they  may  be  most  usefully  resorted  to  for  many  purposes. 
Reference  will  now  be  briefly  made  to  the  parts  of  the  fcL'tus  upon 
which  the  crotchets  can  be  most  effectively  employed,  and  the  manner 
of  employing  them. 

Pauts  into  which  the  Crotchets  may  be  implanted. — The  parts 
into  which  the  crotchets  may  be  implanted  are  numerous,  but  those 
which  are  selected  by  the  obstetrist  will  not  only  depend  upon  the 
luiture  of  the  malpresentation  or  malposition,  but  alsoupon  the  simplest 
indications  for  the  adjustment  of  these.  ^Vhen  the  desirable  part  has 
been  reached,  the  point  of  the  crotchet  is  inserted  in  such  a  way  that 
the  instrument  is  directed  towards  the  source  of  traction — the  assistant. 
When  blunt  crotchets  are  employed,  except  in  cavities,  it  will  be  ucces- 
aai'y  to  make  an  incision  through  the  skin  before  they  can  be  inserted. 
Cartwright  states  that  sometimes  the  sharp  crotchets  cannot  be  used 
without  making  these  preliminary  incisions  ;  but  then  the  instruments 
must  be  rather  blunt.  The  best  parts  for  implantation  are  (1)  the 
muscular  tissues,  (2)  the  head,  (3)  the  spine,  and  (4)  the  jiel vis. 

1.  The  Muscular  2'issues. — These  tissues  are  not  advantageous  for  the 
employment  of  the  crotchets,  for  although  they  are  easily  inserted,  they 
are  as  easily  torn  out.  Nevertheless,  these  instruments,  when  lixed  in 
certain  muscular  regions,  such  as  the  croup,  thighs,  loins,  and  neck — 
more  especially  the  latter,  may  render  useful  service  in  rectifying  devia- 
tions, as  the  skin  offers  a  good  amount  of  resistance.  But,  from  the 
fragile  and  yielding  nature  of  the  textures,  it  must  be  borne  in  mind 
that  the  hand  of  the  obstetrist  should  never  leave  the  crotchet  while 
traction  is  made  on  it,  and  that  its  position  in  them  must  be  most 
attentively  noted,  in  order  to  guard  against  accidents  arising  from  its 
tearing  away. 

2.  The  Head. — The  head  offers  many  good  points  for  implanting  the 
crotchets — such  as  the  symphysis  of  the  lower  jaw,  the  palate,  and  tlie 
orbit ;  as  well  as  the  ear  and  angle  of  the  inferior  maxilla,  on  particular 
occasions. 

It  must  be  observed,  however,  that  all  these  points  are  not  of  equal 
value.  The  7naxillar>/  si/ynphi/sis  is  convenient,  but  not  very  firm  ; 
moderately  strong  traction  will  rupture  it,  and  damage  may  then  occur. 
Still,  there  are  times  and  occasions  when  this  part  may  be  advan- 
tageously seized  by  the  crotchet,  which  may  be  inserted  in  two  ways : 
the  point  of  the  instrument  may  be  passed  from  below  the  chin  into  the 
mouth,  or  from  the  cavity  of  the  latter  through  the  mucous  membrane 
beneath  the  tongue,  to  below  the  chin.  The  first  is  generally  preferable. 
When  traction  begins,  the  operator  must  be  on  the  look-out  for  tearing 
away  of  the  two  branches  of  the  jaw. 

The  orbital  cavity  is  the  best  part  of  the  head  for  a  solid  hold.  Some 
authorities  have  expressed  doubts  as  to  the  propriety  of  fixing  a 
crotchet  in  the  ocular  cavity  of  a  living  fcc-tus,  from  a  belief  that  the 
eyeball  must  be  damaged,  and  Rainard  goes  so  far  as  to  advise  that  it 
should  only  be  done  when  the  creature  is  dead ;  though  he  adds  that, 
if  there  is  no  other  means  of  remedying  a  deviation  of  the  head  in  the 


516 


OBSTETRICAL  OPEIIATIONS. 


^ 


living  Calf,  it  is  well  to  attempt  it,  "  as  it  is  better  to  have  a  living,  if 
blind,  Calf,  than  a  dead  one  with  both  its  eyes  intact." 

But  it  is  rare  indeed  that  the  eyes  are  seriously  damaged  by  fixing 
the  crotchet  in  their  socket ;  and  innumerable  instances  testify  that, 
if  the  foetus  is  alive,  the  ocular  globe  is  retracted  to  the  bottom  of  the 
cavity  when  the  instrument  begins  to  be  inserted,  and  so  escapes 
injury.  Schaack,  who  has  freely  resorted  to  this  mode  of  adjusting 
the  head  or  neck — in  the  Sheep  and  Goat  more  particularly  (the  small- 
ness  of  the  pelvis  not  allowing  any  other  means  to  be 
employed) — describes  his  manner  of  operating  as  follows  : 
"  The  crotchet  I  use,"  says  he,  "  is  a  solid  (or  long)  one  ; 
the  point  is  blunt  and  slightly  flattened  (Fig.  183).  When 
it  is  desired  to  pull  at  the  head  of  the  foetal  Goat  or  Lamb, 
the  left  hand  at  first  seizes  the  nose,  and  the  crotchet  is 
fixed  in  the  right  orbit ;  with  the  right  hand  the  other 
instrument  is  passed  into  the  left  orbit,  the  thumb  of  the 
left  hand  keeping  the  hook  in  the  other  orbit  by  pressing 
the  stalk  against  the  cheek.  In  this  way  I  can  pull  with 
the  two  hands  on  both  orbits,  so  as  to  keep  the  nose  in  a 
good  direction."  He  has  never  seen  the  point  of  the  crotchet 
cause  the  slightest  injury  to  the  globe  of  the  eye,  although 
he  has  had,  in  the  majority  of  cases,  to  pull  very  hard.  The 
means  has  answered  very  well.  And  Cartv/right  states 
that  "it  is  astonishing  how  wounds  heal  up  in  the  cheek 
where  hooks  have  been  in  the  orbit.  I  have  had  two  or 
three  men  pulling  at  the  rod  (of  the  crotchet),  and  the  hook 
did  not  break  out." 

This  immunity  from  injury  in  the  case  of  the  living  foetus, 
does  not,  however,  absolve  the  operator  from  exercising  all 
due  care  in  fixing  and  pulling  at  the  crotchet.  The  inner 
aspect  of  the  orbital  cavity  is  the  most  favourable,  and  if 
the  foetus  is  alive,  the  blunt  instrument  must  be  first  tried, 
the  sharp-pointed  one  being  kept  in  reserve  until  this  has  failed  ;  or  it 
may  be  used  at  first  when  the  young  creature  is  dead. 

^he,  joalatine  arch  afi'ords  a  very  solid  and  useful  hold  for  the  crotchet, 
and  many  obstetrists  have  successfully  utilized  it  in  extracting  the 
foetus  ;  some  authorities — among  them  is  Schaack — asserting  that  hook- 
ing this  part  is  easier,  and  the  results  more  certain  and  direct,  than 
fixing  the  instrument  in  the  orbit.  The  stalk  of  the  crotchet  is  some- 
what long;  the  hook  end  is  passed  sideways  into  the  mouth  of  the 
foetus,  and  over  the  tongue  until  it  gets  beyond  the  palate,  when  it  is 
turned  point  upwards  and  seizes  the  base  of  the  vomer.  A  very  strong 
degree  of  traction  can  be  made  on  this  part  without  inconvenience  to 
the  young  creature.  It  appears  to  be  an  excellent  situation  to  plant 
the  crotchet  in  the  Calf — particularly  if  it  be  dead,  and  it  is  desired  to 
effect  extraction  as  quickly  as  possible.  It  may  be  also  employed  in 
the  Foal,  the  only  risk  being  more  or  less  disunion  of  the  palate,  which 
may  render  sucking  difficult  or  imperfect  for  a  short  time  after  birth. 

Of  course,  the  head  must  be  in  a  good  position  either  in  the  inlet  or 
in  the  genital  canal  before  the  crotchet  can  be  placed  behind  the 
palate.  Traction  must  also  be  moderate  and  steady,  and  the  usual  pre- 
cautions observed. 

3.  The  Spine. — When  embryotomy  is  practised,  or  the  foetus  is  dead^ 
the  bodies  of  the  vertebrse  or  their  transverse  processes,  or  the  ribs. 


Fig.  183. 

Schaack's 
Crotchet. 


MECHANICAL  EXTRACTION  OF  THE  F(ETUS.  r,17 

afiforJ  excellent  hold  for  hooks,  thouj^h  caro  must  be  observed  in  placing 
them  securely,  and  guarding  them  when  they  are  beinj;  pulled  at. 

4.  The  Pelris.— 'In  posterior  presentations,  when  cords  cannot  be 
employed  to  tlie  hind-limbs,  the  loins,  or  the  croup,  or  when  they  have 
not  surticient  power,  then  crotchets  must  be  resorted  to  ;  and  with  this 
view  the  fct'tal  pelvis  offers  several  very  advantageous  points.  After 
removal  of  one  or  both  hind-limbs,  the  cotijloid  cavities,  by  their  depth 
and  the  hardness  of  their  walls,  are  admirably  adapted  for  receiving 
the  hooks  and  withstanding  energetic  pulling.  If  both  limbs  arc 
amputated  from  the  hip-joints,  then  a  hook  may  be  placed  in  (sach 
cavity  ;  if  ablation  of  only  one  limb  has  been  effected,  then  one  hook 
will  be  most  useful. 

1\\e  pubic  arch  and  the  oval  foramina  of  the  pelvis  are  likewise  well 
suited  for  crotchet  traction  in  the  posterior  presentation,  when  the 
fo-tus  is  dead.  In  some  cases  the  shari)-pointed  crotchet  may  be  passed 
directly  through  the  rectum,  and  pushed  forward  so  as  to  seize  the 
border'of  the  pubis,  the  margin  of  one  of  the  oval  foramina,  the  base 
of  the  sacrum,  or  the  shaft  of  the  ilium  ;  care  being  taken  that  the 
l)oint  does  not  pass  through  the  skin.  Or  the  crotchet  may  be  passed 
from  without  inwards — the  safest  method — after  the  pelvic  bones  have 
been  denuded  as  much  as  possible  of  their  soft  tissues.  This  is, 
perhaps,  the  most  practicable  method,  if  the  hind-limbs  have  been 
already  removed.  But  if  they  have  not,  then  all  the  soft  tissues  of  the 
foetus— from  the  root  of  the  tail  to  the  ischial  arch— should  be  largely 
incised,  and  the  hand  passed  through  the  incision  into  the  pelvis,  to 
remove  the  viscera.  The  crotchet  is  then  pushed  into  it,  and  planted 
either  on  the  brim  of  the  pubis  or  in  the  oval  foramen. 


SECTION  IV.— CROTCHET-FORCEPS  AND  FORCEPS. 

The  introduction  of  forceps  into  human  obstetricy  marked  a  new  era 
in  the  accoucheur's  art,  and  has  been  productive  of  the  greatest  benefit 
in  difficult  cases  of  parturition  in  women.  But  they  have  not  yielded 
much  service  to  the  veterinary  obstetrist,  except  with  the  smaller 
animals;  notwithstanding  that  llurtrel  d'Arboval,  at  the  commence- 
ment of  this  century,  asserted  of  the  forceps  that  there  are  circum- 
stances in  which  great  advantages  might  be  derived  from  them,  and  that 
their  use  is  perhaps  the  best  means  of  completing  parturition  when  it 
cannot  be  terminated  naturally,  etc.  Attempts  have  been  made  at 
various  times  to  introduce  them  into  general  use  for  the  larger 
domesticated  animals,  and  various  models — more  or  less  modifications 
of  the  human  patterns — have  been  proposed,  but  with  very  little,  if 
any,  success. 

The  forceps  used  by  the  accoucheur  of  woman  are,  as  is  well  known, 
composed  of  two  branches  or  blades,  which  are  nearly  or  quite  alike, 
and  form  levers  of  the  first  order  ;  they  are  united  at  the  middle  by  a 
fixed  or  sliding  joint,  and  one  end — the  "  bow,"  or  widest  part — which 
is  intended  to  grasp  the  foetus,  is  fenestrated,  or  perforated  by  a  wide 
opening  ;  at  the  other  end  is  the  handle. 

The  reason  why  forceps  have  never  come  into  general  use  in  veterinary 
obstetrical  operations — except  with  the  smaller  animals — is  not  so  much 
from  a  prejudice  against  novelties  and  innovations,  as  because  they 
are   really  not  adapted    for  this  kind  of   practice,   unless   in   a  very 


518 


OBSTETRICAL  OPERATIOXS. 


modified  form,  to  be  presently  noticed.  Eainard^  remarks  :  "  Medical 
men  will  be  astonished  that  I  have  not  mentioned  the  forceps,  from 
which  they  derive  such  great  advantages.  This  instrument,  which  can 
seize  a  round  head,  like  that  of  a  child — when  each  "blade  fits  exactly 
throughout  its  whole  length — will  have  much  less  hold  on  that  of 
animals,  which  is  elongated,  flattened  at  the  sides,  and  otherwise  but 
little  yielding.  When  the  forceps  is  applied  to  the  Foal  or  Calf,  it  slips 
and  is  useless.  Otherwise,  the  readiness  with  which  cords  can  be 
attached  to  the  head  and  limbs  renders  these  in  every  way  preferable 
to  this  instrument.     What  the  forceps  cannot  do,  the  cords  can  ;  and 


Fig.  1S4. 
Simple  Short  Crotchet-Forceps. 

they  have  the  additional  advantage  that  they  scarcely  occupy  any  space 
in  the  pelvic  canal.  The  pelvis  of  our  animals  is  nearly  rectilinear ; 
with  the  cords  we  pull  in  a  straight  line  ;  what  more  could  the  forceps 
do  ?  The  entire  hand  can  be  introduced  freely  into  the  pelvis,  and 
moved  about  easily.  This  cannot  be  done  in  human  accouchements." 
There  is  no  known  forceps  capable  of  affording  such  a  solid  purchase, 
and  at  the  same  time  one  so  harmless,  as  good  cords  fixed  on  the 
pasterns,  or  a  halter  properly  placed  on  the  head. 


Fig.  185. 
Long  Simple  Crotchet-Forceps. 

Though  an  instrument  resembling  the  human  forceps  is  not  at  all 
adapted  for  extracting  the  foetus  in  such  animals  as  the  Mare  or  Cow, 
and  though  in  the  cords  and  halter  an  excellent  substitute  is  found  ; 
yet  modified  forceps,  which  might  be  designated — if  not  from  their 
shape,  at  least  from  their  action — crotchet-forceps,  have  been  long 
employed  by  veterinary  obstetrists,  and  with  much  advantage  in  certain 
cases.  The  simplest  of  these  consists  merely  of  two  short  crotchets, 
the  points  opposite  each  other,  and  a  cord  passing  through  both  eye- 
lets (Fig.  184).  The  hooks  can  be  inserted  near,  but  opposite  to,  each 
other,  on  each  side  of  the  spine,  pelvis,  head,  flanks,  etc.,  the  cord, 

1  0;j.  cit.,  vol.  ii.,  p.  98. 


MECHANICAL  EXTRACTION  UF  THE  FiETUS. 


'.19 


when  tightened,  bringing  them  closer  together,  and  so  concentrating 
the  traction.  A  longer  crotchet-forceps  (Fig.  185),  with  a  wider  curve 
at  the  points,  is  not  infrequently  used  with  success  in  breech  presenta- 
tions with  the  hind-limbs  retained;  the  points  are  inserted  towards 
each  flank,  penetrating  as  far  as  the  shaft  of  the  ilium. 

Giinther  has  spoken  highly  in  favour  of  a  long,  blunt  crotchet-forceps 


r;\c|E 

Fig.  iSti. 
GC.nthkr's  Long  Crotchkt-Fobcbps. 


Fig.  187. 
Jointed  Cbotchkt-Forckps. 


to  answer  the  same  purpose,  and  which  has  what  is  considered  an 
advantage — a  series  of  notches  on  each  side  towards  the  traction-rope, 
on  which  runs  a  clip  that  binds  them  together,  and  prevents  their  flying 
outwards  while  the  assistants  are  pulling  (Fig.  18G).  The  two  crotchets 
A  B,  C  D  are  brought  together  at  A  C  by  the  cord  E,  which  passes 


Fig.  188. 
Nelson's  Blunt  Crotchkt-Forckps. 


Fig.  189. 
Nklson's  Skbratki)  Crotchkt-Fgrckpb. 


through  their  eyelets  ;  d  is  the  clip  on  the  ratchet  c  c ;  f  J\  the  curve  of 
the  crotchets ;  and  g  g,  their  blunt  points. 

To  render  their  hold  more  secure,  these  crotchet-forceps  are  some- 
times jointed;  and  in  this  form  they  are  preferred  by  some  practitioners. 
Fig.  187  represents  a  very  useful  model,  the  points  being  sharp,  and 
one  point  hes  in  a  slight  notch  on  the  opposite  one,  to  render  their 
introduction  into  the  uterus  more  safe,  and  also  to  prevent  accidents. 


520 


OBHTETRWAL  OPERA  TIONS. 


should  the  tissues  in  which  the  points  are  implanted  give  way.  A  cord 
passes  through  eyelets  at  the  extremities  of  the  blades,  as  in  the  other 
models ;  but  sometimes  the  eyelets  are  in  opposite  directions,  and  the 
ends  of  the  branches  in  which  they  are  pierced  are  bent  towards  each 
other ;  this  variation  is  supposed  to  be  accompanied  by  certain  advan- 
tages, as  in  Nelson's  blunt  and  serrated  forceps  (Figs.  188,  189),  some 
of  the  uses  of  which  have  already  been  noticed. 

Some  of  the  models  of  crotchet-forceps  have  a  spring  introduced 
between  the  branches,  and  behind  the  joint,  as  in  Talhch's  short  instru- 


Fig.  190. 
Tallich's  Short  Bent  Crotchet-Forceps. 

ment  (Fig.  190),  the  jaws  of  which  are  bent  to  one  side,  and  toothed  ; 
it  is  intended  to  secure  a  hold  of  the  foetus,  and  make  traction  on  parts 
to  which  neither  cords  nor  crotchet  can  be  applied — as  the  skin  of  the 
cheek,  or  the  nose  or  ear,  when  the  head  is  thrown  back  towards  the 
flank  in  the  anterior  presentation. 

Another  instrument  of  this  description  has  been  devised  by  a  Belgian 
veterinary  surgeon,  Andre,  which  he  designates  a  pince-forceps  or 
accroche-fcBtus.     This  is  not  unlike  the  instrument  fixed  in  the  nose  of 


Fig.  191. 
Andre's  Crotchet-Forceps. 


a  Bull  in  order  to  lead  the  animal.  The  points  of  the  jaws  are  bevelled 
to  fit  into  each  other,  the  bevel  being  grooved.  In  one  of  the  jaws  is 
a  small  hole,  into  which  is  fixed  a  string  that  passes  through  the  eye- 
let at  the  end  of  the  opposite  branch,  and  which  is  pulled  at  when  it  is 
desired  to  open  the  forceps.  The  two  branches  behind  the  joint  are 
very  short,  and  through  the  eyelet  of  each  passes  a  strong  cord,  the  two 
ends  of  which  soon  unite  into  a  single  piece  (Fig.  191).  When  this  is 
pulled  at  the  jaws  close,  as  in  the  other  jointed  examples,  and  they 
remain  all  the  more  firmly  closed  as  the  traction  is  great.  In  order  to 
use  the  instrument,  it  is  passed  by  the  hand  into  the  uterus  ;  the  jaws 


MECHAXICAL  KXTHAi'T/oX  OF  THE  FlETVS.  521 

are  fixed  on  the  part  to  be  drawn  iit,  by  first  pullinj^,  outside  the  vulva, 
at  the  strhi^'  which  opens  them,  pushing,'  the  points  a^^ainst  or  over  the 
part  ;  then,  wlien  this  is  betwemi  the  points,  drawing  at  thi^-  single  cord 
which  closes  them.  This  is  acknowledged  to  be  rather  an  instrument 
for  holding  or  fixing  a  certain  region,  and  not  for  exercising  tractile 
force  upon.  Andre  has  often  applied  it  successfully  to  the  lower  and 
upper  jaw,  or  to  the  ear,  to  bring  the  head  into  a  good  position ;  to  the 
tcmlo  Achillis  in  order  to  raise  a  hind-limb,  which  the  hand  alone  could 
not  do ;  to  the  fore-limbs,  etc. 

With  regard  to  the  smaller  animals,  such  as  the  Bitch,  Sow,  Sheep, 
or  Goat,  in  them  we  may  often  use  the  crotchet,  small  ordinary  forceps, 
or  a  small-sized  model  of  the  human  forceps,  with  advantage.  Various 
patterns  are  in  use,  some  of  them  fenestrated,  others  not ;  some  I'esemble 
polypus-forceps,  while  otliers  again  are  grooved,  serrated,  or  toothed  at 
the  ends  of  the  blades.  An  essential  which  should  not  be  lost  sight  of 
in  tlie  forceps  for  such  small  animals  as  the  Bitch  or  Cat,  is  that  the 
blades  should  be  sufliciently  long  to  seize  not  only  the  head,  but  much, 
if  not  all  of  the  body  of  the'fa;tus.  If  they  are  short  in  the  blades,  tliey 
cannot  be  made  to  grasp  sufficient  of  the  fa'tus  to  remove  it ;  while  the 
joint  being  close  to  the  vulva,  or  even  within  the  vagina,  is  likely  to 
pinch  the  mucous  membrane  and  cause  the  mother  considerable  pain. 

A  useful  instrument  is  a  small  and  slightly  modified  form  of  the 
human  forceps  for  Bitches ;  there  is  a  spring  between  the  branches  of 
the  handle  (Fig.  192). 

Weber  has  proposed  a  forceps  for  these  small  animals,  and  it  has 
been  preferred  by  some  authorities  to  the  ordinary  model.  It  is  a 
modification  of  one  for  a  long  time  employed  by  Lel)lanc,  which  again 
was  fashioned  after  an  instrument  designed  by  Hunter.  This  is  com- 
posed of  an  iron  stalk  about  ten  inches  in  length,  with  a  wooden  handle 
at  one  end,  and  two  blades  or  bows  at  the  other.  On  this  stalk  glides 
a  long  enveloping  metal  tube,  which,  near  the  handle,  has  a  wide  ferule 
or  shield  that  allows  it  to  be  pushed  along  by  the  thumb  of  the  hand 
holding  the  instrument,  and  thus  to  bring  the  blades  tog(rther.  A  nut 
or  female  screw,  running  on  a  screwed  portion  of  the  stalk  near  the 
handle,  is  intended  to  assist  the  pressure  of  the  thumb,  when  this  is  in- 
sufficient (Fig.  193).  A  finger  of  the  other  hand  introduced  into  the 
vagina,  guides  the  instrument,  and  allows  the  part  of  the  fcctus  to  be 
seized  to  be  reach(,'d  by  the  ojjcrator,  either  with  the  view  of  extracting 
the  young  creature  or  changing  its  position,  according  to  indications. 

But,  it  must  be  observed,  it  is  very  difiicult  to  a})ply  an  instrument 
of  the  shape  of  those  employed  in  human  practice  ;  it  ought  to  be  some- 
thing like  that  described  by  Palfin.  It  is  most  diffiicult,  Defays  truly 
says,  to  apply  an  instrument  in  shape  like  the  accoucheur's  ordinary 
forceps,  owing  to  the  neck  of  the  ftetus  in  Carnivora  being  so  thick,  and 
the  difference  in  volume  between  it  and  the  head  far  less  than  in  the 
human  foetus.  So  that,  when  the  forceps  is  used,  the  bow  of  the  blades 
presses  on  the  neck,  slips  under  the  throat,  and  the  head  escapes  from 
them.  To  remedy  this  imperfection,  he  has  made  forceps  with  the  ex- 
tremity of  the  blades  notched  or  hollowed  out  (Fig.  194),  while  the  end 
of  one  of  the  branches  has  a  piece  of  metal  with  a  slot  in  it  attached 
by  a  hinge,  and  which  is  intended  to  hold  the  blades  together  when  the 
fa^tus  is  seized. 

Though  this  forceps  has  sometimes  proved  of  service,  yet  cases  occur 
in  which  it  is  not  so  useful. 


522 


OBSTETRICAL  OPERATIONS. 


When  the  Bitch  is  large,  or  of  moderate  size,  forceps  may  be  em- 
ployed with  advantage,  though  they  must  be  of  various  dimensions. 


Fig.  192. 
Bitch  Forceps. 


Fig.  193.  Fig.  194. 

Webek's  Forceps.     Defats'  Forceps. 


But  when  the  animal  is  very  small,  as  is  usually  the  case  in  difficult 
parturition  in  this  species,  the  space  occupied  by  the  bows  of  the  forceps 
— if  they  are  ever  so  thin — so  increases  the  volume  of  the  mass  which 


THE  EMPLOYMEXT  OF  FORCE  IN  DYSTOKIA.  r)*23 

has  to  pass  through  the  pelvic  canal  that  this  instrument  cannot  be 
used. 

As  was  pointed  out  when  studyinj^  the  anatomy  of  this  region,  thii 
pelvis  is  cylindrical  in  Carnivora,  and  if  we  suppose  its  diameter  to  be 
three  inches,  and  that  of  the  head  of  the  foetus  a  trille  less,  it  will  be 
seen  tliat  birth  must  necessarily  be  ditlicult ;  and  this  dithculty  will  be 
increased  if  the  vaf^ina  is  narrow  and  ri^id.  When  the  forceps  is  used, 
the  ditliculty  is  further  exaggerated  ;  for  wlien  tlie  blades  are  passed  on 
the  head,  the  fcvtus  is  then  augmented  in  size  by  a  quantity  equal  to 
their  breadth  multiplied  by  their  thickness — the  whole  constituting  a 
mass  greater  than  the  pelvic  cavity  will  permit  to  pass  through  it  ;  so 
that  delivery  becomes  impossible.  Forceps,  therefore,  in  small  Bitches 
increase  the  ditliculties  of  parturition,  and  these  difliculties  are  all  the 
more  embarrassing  as  the  animal  is  diminutive.  Recourse  to  this  in- 
strument is  consequently  contra-indicated,  and  if  delivery  is  to  be  effected, 
a  means  must  be  substituted  which  presents  less  inconvenience.  As  a 
rule,  the  loss  of  one  or  two  Puppies  is  not  a  matter  of  much  moment, 
the  principal  object  being  to  save  the  mother  by  bringing  tlie  act  of 
parturition  to  a  prompt  termination.  Therefore  it  is  that  Defays'  or 
Breulet's  apphances  (p.  507)  are  to  be  preferred  in  nearly  all  cases. 


C  PI  AFTER  IV. 
The  Employment  of  Force  in  Dystokia. 

In  connection  with  obstetrical  operations,  a  rather  important  question 
to  be  considered  is  the  employment  of  force  in  the  artificial  extraction 
of  the  fa3tus.  For,  as  has  been  shown,  more  or  less  energetic  traction 
is  very  frequently  needed  to  remove  it  from  its  parent ;  and  those  who 
do  not  understand,  or  are  inexperienced  in  animal  obstetrics,  are  some- 
times astonished,  if  not  horrified,  at  hearing  of  the  amount  of  pulling 
which  the  fcetus  has  to  undergo  and  the  parent  sustain,  before  delivery 
can  be  effected  in  some  cases.  Yet  force  is,  as  a  rule,  absolutely  neces- 
sary, even  in  embryotomy  ;  and  though  some  of  the  various  points  with 
regard  to  it  are  not  yet  sutliciently  ascertained,  and  differences  of  opinion 
exist  with  regard  to  them,  yet  it  is  a  subject  well  deserving  the  attention 
of  the  obstetrist,  and  especially  the  junior  practitioner. 

The  indications  for  forced  extraction  have  been  given  in  preceding 
chapters  ;  they  are  chiefly  to  l)e  found  in  tlie  smallness  or  deformity  of 
the  maternal  genital  canal ;  excessive  development  of  the  fcntus — wholly 
or  partially,  or  distortion  ;  malposition  of  parts  wliich  cannot  be 
remedied  ;  or  morbid  conditions  that  hinder  birth.  Forced  extraction 
is  usually  preferable  to  embryotomy  and  Caesarian  section  in  those 
cases  in  wliich  the  passage  of  the  fcetus — whether  alive  or  dead — appears 
to  be  possible  without  serious  injury  to  the  mother ;  and  because  of  the 
greater  width  of  the  pelvis  of  the  Mare,  it  is  more  likely  to  be  successful 
in  that  animal  than  in  the  Cow. 

The  direction,  intcnsitif,  and  nature  or  means  of  developing  tlie  force 
to  be  cniploj/ed,  have  first  to  be  considered,  after  which  it  will  be 
desirable  to  compare  manual  with  nicclianical  force,  and  point  out  their 
respective  advantages  and  disadvantages  from  an  obstetrical  point  of 
view. 


524 


OBSTETRICAL  OPERA  TIOXS. 


SECTION  I.— DIRECTION  OF  TRACTION. 

Since  the  forceps  was  introduced  into  human  obstetric  practice,  the 
direction  which  the  foetus  should  be  made  to  follow  in  the  pelvic  cavity 
of  woman  has  been  continually  discussed,  and  has  been  acknowledged 
to  be  a  very  difficult,  as  well  as  a  very  important  problem  to  solve.  This 
difficulty  is  mainly  due  to  the  fact  that  the  pelvic  canal  in  the  human 
female  is  not  uniform  in  its  dimensions,  and  that  the  head  of  the  foetus 
must  pass  through  it  by  always  offering  its  gi-eatest  diameter  to  that  of 
the  cavity.  Consequently,  it  must  execute  during  its  passage  a  rotation 
movement  in  one  or  other  direction,  according  to  the  presentation — a 
movement  necessitated  by  the  different  planes  of  the  cavity.  In  addition, 
the  canal  is  curvilinear,  its  axis  not  being  represented  by  a  straight,  but 
by  a  curved  line,  the  form  and  direction  of  which  are,  besides,  modified 
by  those  deformities  of  the  pelvis  that  are  so  frequent  and  varied  in 
woman,  and  which  constitute  one  of  the  principal  indications  for  the 
use  of  the  forceps.  So  that  the  difficulty  in  the  question  is  to  determine, 
in  a  rigorous  manner,  the  direction  in  which  to  exercise  traction  with 


Fig.  195. 
Diagram  of  the  Pelvic  Axis. 

this  instrument ;  though  it  is  generally  agreed  that  it  should  be  made 
according  to  the  pelvic  axis. 

With  animals,  the  problem  is,  of  course,  much  less  complicated,  as 
their  pelvis  is  somewhat  cylindrical ;  and  its  axis — almost  rectilinear — 
can  readily  be  determined  by  a  hne  passing  from  the  centre  of  the 
anterior  circumference  to  the  centre  of  the  vulva,  or  somewhat  towards 
the  middle  of  the  line  uniting  the  two  superior  ischiatic  tuberosities. 
Traction  should  therefore  be  made  in  the  direction  of  this  axis 
(Fig.  195,  A  B) ;  and  this  line  of  traction,  happily  for  the  veterinary 
obstetrist,  and  thanks  also  to  the  flexibility  of  the  cords  which,  in  his 
practice,  take  the  place  of  the  forceps,  offers  no  serious  difficulty.  At 
p.  261  it  was  shown  that  this  direction  can  vary,  and  may  be  modified 
according  to  the  presentation — and  more  particularly  the  position — of 
the  foetus,  and  also  according  to  the  period  of  labour. 

SECTION  II.— DEGREE  OF  TRACTION. 

When  passing  through  the  pelvic  cavity,  the  foetus  undergoes  a  certain 
amount  of  compression,  proportionate  to  the  uterine  contractions  or  the 


THE  EMl'Li>y.ME.\T  OF  FOIiCE  IX  I>YSToKIA.  525 

external  traction  which  determines  its  progression  outwards ;  at  the 
same  time,  tliis  compression  produces  a  kind  of  reaction  in  the  body  of 
the  fcL'tus,  and  gives  rise  to  an  eccentric  pressure  against  the  walls  of 
the  passage,  related  to  that  which  itself  experiences.  The  question  is, 
therefore,  limited  to  the  amount  of  force  necessary  to  overcome  the 
resistance  that  prevents  the  onward  progress  of  the  fcetus,  without 
injuring  either  the  latter  or  the  parent.  In  veterinary  obstetrics  we  have 
no  lixed  data  to  rely  upon  ;  but  the  experiments  of  Joulin,  Delore,  and 
PouUet,  alluded  to  by  Saint-Cyr,  may  ailord  some  idea  of  the  resistance 
oflered  by  the  pelvic  girdle  to  the  eccentric  pressure.  These  authorities 
found  that  if  a  rounded  body — a  ball,  for  instance,  to  represent  the  head 
of  a  fa'tus — is  attempted  to  be  pulled  through  the  pelvis  of  a  woman,  it 
requires  a  force  represented  by  375  to  441,  and  even  as  much  as  G3o 
pounds  (estimated  by  the  dynamometer),  to  produce  such  serious 
lesions  as  fracture  in  the  bones  or  disunion  of  the  symphyses.  But  it 
must  not  be  concluded,  from  this  result,  that  such  powerful  traction  can 
be  practised  with  impunity  in  woman.  In  the  first  place,  the  child  could 
not  be  extracted  alive,  for  its  existence  appears  to  be  compromised  if  the 
degree  of  traction  by  the  forceps  exceeds  from  132  to  154  pounds  ;  and 
in  order  that  the  pelvis  of  woman  could  resist  such  pressure,  certain 
conditions  are  required  which  we  never  meet  with  in  ordinary  practice; 
for  instance,  the  pressure  should  be  equally  applied  to  every  part  of  the 
bony  girdle  in  contact  with  the  head  of  the  fcjutus.  But  tliis  does  not 
take  place  with  the  ordinary  forceps,  which,  even  in  the  hands  of  the 
most  expert  accoucheur,  not  only  acts  as  a  traction  agent,  but  at  a 
given  moment  is  unfortunately  transformed  into  a  lever  of  the  first  or 
second  kind,  whose  power  is  incalculable,  and  which,  resting  on  two 
opposite  points  of  the  pelvic  circumference,  may  burst  it,  without  the 
dynamometer  showing  anything  more  than  a  relatively  feeble  degree  of 
traction. 

Otherwise,  it  is  not  only  the  bones  which  have  to  be  considered,  but 
also  the  soft  parts,  which,  pressed  between  the  fa'tal  head  and  the  hard 
pelvic  circumference,  may  be  bruised,  crushed,  or  lacerated  to  a  variable 
degree,  if  the  compression  exceeds  a  certain  limit.  This  pressure,  how- 
ever, is  always  considerable ;  for,  according  to  Chassagny,  when  a 
tractile  force  of  fifty  kilogrammes  is  exercised  on  the  head  of  a  fcetus 
seized  by  the  ordinary  forceps,  we  may  calculate  that  each  square  centi- 
metre of  surface  of  the  pelvic  walls  sustaius  a  pressure  of  1,H0()  grannnes, 
even  in  the  most  favourable  conditions  ;  though  it  may  be  as  much  as 
six  kilogranmies  or  more,  according  to  circumstances. 

These  obser\ations,  though  doubtless  valuable  and  significant  for  the 
accoucheur  of  woman,  are  only  very  indirectly  applicable  to  veterinary 
obstetricy.  Without  taking  into  account  the  strength  of  the  pelvic 
osseous  girdle,  so  much  greater  in  the  Mare  and  Cow  than  in  won)an, 
several  other  circumstances  enable  us  to  understand  why  this  bony  circle 
may,  in  these  animals,  resist  an  amount  of  strain  which  would  appear 
to  be  altogether  unreasonable,  if  judged  according  to  the  principles  which 
should  guide  the  practice  of  the  human  obstetrist.  But  tlic  veterinarian 
is  in  possession  of  means  of  traction  which  give  him  a  great  advantage 
in  this  respect — an  advantage  which  the  accoucheur  has  not  yet  been 
able  to  avail  himself  of ;  we  allude  to  the  cords  the  former  so  frequently 
employs  as  traction  agents,  and  which  can  never  be  transformed  into 
levers,  like  the  forceps. 

In  woman,  as  with  animals,  the  foetus,  in  passing  through  the  pelvic 


526  OBSTETRICAL  OPERATIONS. 

cavity  is  pressed  upon  by  its  walls,  and  in  turn  it  presses  upon  them, 
in  the  manner  of  a  wedge  which  tends  to  tear  them  asunder.  But  there 
is  a  great  difference  in  woman  and  animals.  On  the  one  hand,  it  is  a 
hard,  bony,  and  little  reducible  region — the  head — which  presses  against 
the  pelvic  walls,  to  which  it  transmits,  almost  undiminished,  the  pressure 
itself  receives  ;  on  the  other  hand,  it  is  a  bony  cage — the  chest — formed 
of  numerous  very  movable  parts,  and  which  can  submit  without  injury 
to  much  distortion,  in  addition  to  its  being  covered  by  soft  and  readily 
compressible  tissues ;  consequently,  we  can  easily  comprehend  how  much 
in  the  latter  case — that  of  animals — the  eccentric  pressure  produced  by 
the  passage  of  the  foetus  should  be  attenuated.  In  addition,  the  head 
of  the  infant  is  spherical,  and  therefore  comes  in  contact  with  the  interior 
of  the  mother's  pelvis  by  a  circle  or  narrow  zone  ;  the  surface  of  the 
pelvis  in  contact  with  the  foetal  head  has  been  estimated  at  sixty  square 
centimetres,  and  it  is  to  this  limited  space  that  the  head  transmits  the 
pressure  it  sustains.  Chassagny,  from  a  series  of  experiments,  estimates 
that,  for  a  traction  of  sixty  kilogrammes — exerted  under  the  most  favour- 
able circumstances  by  his  forceps  on  the  head  of  the  human  foetus — each 
square  centimetre  of  the  surface  of  the  pelvis  in  contact  with  it  should 
support  a  pressure  of  about  500  grammes ;  in  less  favourable  conditions 
it  may  even  be  much  more. 

From  some  measurements  made  by  Saint-Cyr,  the  pelvis  of  the  Mare 
and  Cow,  which  is  nearly  cylindrical,  may  be  reckoned  at  1,600  square 
centimetres  (248  inches)  of  internal  surface ;  and  it  is  on  this  expanse 
that  is  distributed,  in  a  nearly  uniform  manner,  the  eccentric  pressure 
which  the  chest  of  the  foetus  transmits  to  the  walls  of  the  genital  canal, 
to  which  it  is  very  closely  applied  during  its  passage  outwards.  If,  then, 
it  be  admitted  that  the  total  of  this  eccentric  pressure  amount  to  about 
one-half  the  tractile  force  expended  on  the  foetus,  it  will  be  easy  to  find, 
by  a  simple  calculation,  the  pressure  on  each  square  inch.  Supposing 
the  traction  to  be  equal  to  1,540  pounds — the  estimated  strength  of 
seven  or  eight  men  pulling  with  all  their  force  at  the  cords — the 
pressure  on  each  square  inch  would  be  about  7f  ounces ;  or  one-half  that 
exerted  on  the  same  extent  of  surface  with  a  tractile  force  of  132  pounds, 
in  woman ! 

Saint-Cyr  does  not  pretend  that  these  calculations  give  a  rigorously 
exact  measure  of  what  really  takes  place  during  parturition ;  but  he 
believes  they  may  assist,  up  to  a  certain  point,  in  explaining  certain  facts 
in  comparative  obstetrics  which  otherwise  would  remain  obscure — how, 
for  instance,  natural  birth,  which  is  always  so  painful  in  woman, 
is  comparatively  painless  in  the  lai'ger  animals  ;  and  why  traction, 
the  very  idea  of  which  alarms  the  accoucheur  of  woman,  is  in  the 
majority  of  instances  so  well  sustained  by  the  veterinary  surgeon's 
patients. 

It  must  be  confessed,  however,  that  we  have  as  yet  no  certain  data  by 
which  we  can  estimate  the  exact  amount  of  force  necessary,  or  which 
may  be  employed  without  danger;  and  on  this  point  the  opinions  of  the 
best  authorities  are  widely  divergent.  Some  declare  for  moderate 
traction — tv>'o,  three,  or  four  men  at  the  most,  pulling  simultaneously 
at  the  cords  with  all  their  force,  are,  in  their  opinion,  quite  sufficient  in 
all  cases,  if  well  managed  ;  and  they  assert  that  it  is  rash  and  dangerous 
to  employ  more.  Others  do  not  hesitate  to  have  recourse  to  more 
energetic  traction,  and  are  not  afraid  of  employing  the  combined  strength 
of  six,  eight,  or  ten  strong  men ;  being  convinced  that  the  parent  suffers 


THE  EMPLOYMENT  OF  FOIiCE  LV  DYsTnKIA.  527 

more  from  protracted  labour  than  from  powerful  traction — and  not 
infrequently  their  success  justities  their  boldness. 

Donnarieix  admits  that  three  assistants  are  usually  suflicient  with  the 
Cow — one  at  the  head,  another  at  the  tail,  and  tlie  third  to  aid  the 
operator  ;  while  ten  are  needed  for  the  Mare — one  at  the  head,  another 
holdinf^  the  rope  which  confines  the  limbs  of  the  animal  and  prevents  its 
doing  damage,  a  third  to  hold  the  tail,  a  fourth  to  assist  the  operator, 
and  the  other  five  or  six  to  pull  at  the  foetus  when  necessary.  Zundel, 
however,  is  of  opinion  that  these  numbers  are  somewhat  exaggerated  ; 
very  often  more  than  three  assistants  are  required  for  the  Cow,  and  if 
more  than  six  are  needed  for  the  Mare  it  is  better  to  have  recourse  to 
mechanical  means  ;  as  too  many  assistants  hamper  the  operator,  and  are 
often  in  each  other's  way,  while  tlieir  united  strength  cannot  be  usefully 
applied. 

The  assistants  should  be  strong,  and  have  had  some  experience  in 
handling  animals  ;  some  of  them  maintain  the  creature  in  a  favourable 
position,  while  the  others  aid  the  attempts  at  extraction,  under  the 
orders  of  the  operator.  Precautions  should  be  adopted  to  prevent 
accidents — especially  to  the  assistants — from  the  struggles  or  defensive 
movements  of  the  animal ;  and  if  the  traction  is  severe,  the  latter 
should  be  supported  against  it  by  assistants  pressing  on  the  but- 
tocks, by  holding  a  rope  or  band  against  these — or  even  by  placing  the 
hind-quarters  against  the  half-door  of  the  stable.  The  tractile  efforts 
should  be  made  simultaneously  without  jerking,  in  a  continued  and 
energetic  manner,  and  always  in  the  direction  of  the  axis  of  the  pelvis 
— in  a  straight  line  behind  the  animal.  The  direction  of  the  traction 
may,  however,  be  a  little  downward  in  the  anterior  presentation, 
lumbo-sacral  position,  until  the  withers  have  passed  through  the  inlet ; 
as  by  this  means  the  top  of  the  withers  is  depressed,  and  this  part 
enters  the  pelvis  before  the  sternum.  The  operator  stands  behind  the 
mother,  his  hands  on  the  sides  of  the  vulva,  which  he  depresses  with 
the  cubital  border  of  one  hand,  while  with  the  back  of  it  he  separates 
the  lips,  and  prevents  their  being  abraded  by  the  cords.  It  is  better 
to  engage  only  one  shoulder  of  the  foetus  at  a  time,  if  possible  ;  and 
when  the  sternum  and  one  shoulder  have  been  carried  into  the  passage, 
then  the  other  shoulder  is  brought  forward  by  directing  the  assistants 
to  pull  a  trifle  towards  the  opposite  side.  By  acting  in  this  way  with 
care,  and  by  slow  though  continued  efforts  while  the  parent  is  straining, 
delivery  will  be  effected,  if  this  be  possible  by  traction.  The  operator 
must  not  act  hurriedly  or  brusquely,  and  his  hand  should  carefully 
attend  the  advance  of  the  foetus  :  facilitating  its  passage,  and  aiding 
the  progress  of  the  haunches  by  passing  his  open  hand  between  them 
and  the  maternal  pelvis. 

In  the  posterior  presentation,  when  at  least  one  assistant  must  be 
told  off  to  each  cord,  the  traction  should  be  moderate,  or  even  gentle 
at  first,  until  the  operator's  hand  has  adjusted  the  fa-tus  as  much  as 
possible.  In  addition,  the  latter,  besides  directing  his  assistants,  must 
frequently  himself  guide  the  traction  by  the  disengaged  hand,  and 
personally  exert  himself  in  the  extraction  of  the  young  creature — 
separating  the  lips  of  the  vulva,  and  pressing  them  towards  the  pelvis 
when  they  are  pushed  outwards  by  the  advancing  foetus ;  lubricating 
the  latter  and  the  genital  canal  when  necessary,  etc. 

With  the  smaller  animals  the  operator  himself  applies  the  needed 
force,  though  an  assistant  is  usually  necessary  to  hold  the  creature. 


528 


OBS  TETRICA  L  OPERA  TIOAS. 


Generally,  very  little  traction  can  be  made  because  of  the  danger  of 
tearing  the  foetus  in  pieces,  and  what  is  employed  should  be  gentle  and 
sustained ;  indeed,  the  foetus  should  be  held  steady,  traction  only 
made  during  the  expulsive  efforts  of  the  mother,  and  then  lightly  and 
steadily. 

SECTION  III.— MEANS  FOR  DEVELOPING  THE  NECESSARY  FORCE. 

Hitherto  the  employment  of  human  or  manual  force  in  the  extraction 
of  the  foetus  has  only  been  considered,  and  this,  of  course,  is  that  which 
is  generally  resorted  to  at  first.  But  it  is  not  the  only  force  that  may 
be  employed,  and  especially  if  it  is  desirable  to  exercise  very  powerful 
traction.  It  is  true  that  empirics  and  amateurs  have  often  adopted 
the  barbarous  expedient  of  attaching  the  cords  fixed  on  the  foetus  to  a 
Horse  or  Ox,  and  by  making  the  latter  exert  its  strength,  to  tear  the 
young  creature  through  the  maternal  passage.  Eainard  mentions  that 
in  the  Camargue,  those  who  have  the  charge  of  droves  of  Mares,  not 
having  the  services  of  a  veterinary  surgeon,  yoke  another  Mare  to  the 
cords  they  fasten  on  the  foetus,  and  deliver  the  parturient  animal  in 


Fig.  196. 
Obstetric  Pulleys. 


this  cruel  fashion.  Being  destitute  of  anatomical  knowledge,  they  act 
blindly ;  and  not  understanding  how  to  adjust  a  malposition,  the  Foal 
is  nearly  always  extracted  dead,  and  only  too  frequently  the  mother 
perishes. 

With  the  object  of  extracting  the  foetus  by  force  when  manual 
traction  is  not  suificient,  the  ivmdlass,  capstan,  wheel,  cart,  and  pulleys, 
have  frequently  been  used,  and  with  great  benefit.  Many  veterinarians 
consider  the  employment  of  machines  as  barbarous  as  Ox  or  Horse 
traction,  but  this  opinion  is  scarcely  just.  They  say  such  machines 
are  blind  instruments  which  cannot  be  directed  at  will,  and  they  prefer 
increasing  the  number  of  men  indefinitely  rather  than  resort  to  them. 

But  many  of  the  most  intelligent  and  experienced  veterinary 
obstetrists  speak  of  the  great  utility  of  these  machines ;  and  some  of 
them  state  that  whenever  the  combined  strength  of  six  men  is  not 
sufficient  to  extract  the  foetus  from  the  larger  animals,  they  do  not 
hesitate  to  employ  one  of  these  articles.  Not  only  can  a  greater  tractile 
force  be  developed  by  them,  but  this  force  may  be  diminished  or  in- 
creased at  will,  and  as  gradually  as  circumstances  may  require.  In 
this  direction,  though  the  windlass,  capstan,  or  wheel  may  be  utilised, 


Tin:  EMPLOYMKXT  (>F  FORCE  IX  DVSTOKIA.  529 

yet  for  convenience  in  application,  portability,  and  steady  graduated 
traction,  nothing  can  approach  the  light  obstetric  pulley,  the  manner 
of  using  which  is  shown  in  the  annexed  drawing  (Fig.  19G). 

When  very  powerful  traction  is  required,  whether  manual  or  machine, 
there  is  the  risk — particularly  if  the  animal  is  standing — of  dragging 
it  backwards  until  it  falls,  or  doing  it  some  injury  utdess  the  precaution 
is  adopted  of  lixing  it  in  some  way.  It  is  obvious  that  there  is  great 
danger — indeed  cruelty — in  attaching  it  merely  by  the  head  or  neck, 
and  allowing  this  to  bear  all  the  strain.  It  is  necessary  to  render  the 
creature  immovable  by  passing  cords,  bands,  or  a  sack  behind  the  thighs 
and  above  the  hocks,  bringing  the  ends  towards  the  animal's  shoulders, 
and  maintaining  them  there  either  by  assistants,  or  by  attaching  them  to 
the  manger  or  any  other  part  sufliciently  strong.  A  wooden  bar  placed 
behind  the  thighs  and  secured  to  the  stall-posts,  is  also  serviceable  ;  as 
is  likewise  an  ordinai'y  harness  breeching,  the  front  parts  being  secured 
to  rings  in  the  wall  or  manger.  In  some  cases,  vigorous  assistants,  by 
placing  their  back  against  the  haunches  of  the  animal,  will  offer 
sullicient  resistance  to  its  displacement.  Many  practitioners  prefer 
throwing  the  animal  down,  if  it  is  standing,  in  order  to  avoid  the 
dangers  of  being  dragged  ;  Schaack  even  asserts  that  the  body  when 
lying  on  the  ground  increases  the  expulsive  efforts,  and  keeps  the  ftt'tus 
in  the  plane  of  the  pelvis.  Donnarieix  is  not  afraid  of  seeing  the  animal 
dragged  a  little,  and  recommends  that  the  traction  should  not  cease  in 
consequence.  Nevertheless,  during  decubitus  the  operator  is  more 
quickly  fatigued,  besides  being  restrained  in  his  movements ;  the  neces- 
sary manu'uvres  are  more  difficult  to  perform,  and  the  weight  of  the 
foetus  is  often  an  additional  obstacle.  And  even  when  the  creature  is 
lying,  if  the  traction  is  very  strong,  it  is  often  necessary  to  prevent  the 
body  being  drawn  backwards. 

All  these  inconveniences  being  recognised  by  Baron,  in  1858  he  in- 
troduced an  obstetrical  machine  in  the  form  of  an  apparatus  for  pro- 
ducing sustained  traction  {apparcil  a  traction  soutenuc)  in  the  extraction 
of  the  fcctus.  This  apparatus  presses  against  the  hind-quarters  of  the 
parturient  animal,  and  owing  to  its  construction  it  can  not  only  develop 
a  very  energetic  extractive  force  in  the  gentlest  and  most  inoffensive 
way  possible,  but  itself  produces  the  counter-extension  in  an  exactly 
proportionate  degree. 

The  principal  parts  of  the  machine  are  :  a  kind  of  horse-collar 
(Fig.  197,  A)  with  three  stalks  (B,  C,  D)  intermediate  between  this 
collar  and  a  broad,  fixed,  female  screw  (E),  which  receives  a  movable 
screw  rod  (II)  that  bears  a  revolving  hook  and  chain  (K)  at  one  end  ; 
the  other  end  of  the  chain  has  also  a  hook  to  which  the  cord  or  cords 
fixed  on  the  fa-tus  are  attached.  The  collar  is  made  of  several  pieces 
of  light  wood  superposed,  and  bound  together  by  an  iron  band  applied 
to  its  posterior  surface.  This  band  is  perforated  by  three  screwed 
holes  placed  in  a  triangular  position,  and  which  receive  the  iron  stalks. 
The  anterior  face  of  the  collar  is  so  fashioned  as  to  fit  closely  on  the 
liind  parts  of  the  animal,  the  space  for  the  passage  of  the  fatus  being 
about  twenty  inches  in  diameter.  The  intermediate  stalks  (B,  C,  D) 
serve  to  transmit  to  the  collar  the  pressure  exercised  by  the  female 
screw  ;  they  are  about  forty  inches  long,  and  each  is  composed  of 
two  pieces,  one  of  these  being  hollow  (4,  o,  6),  the  other  solid  (1,  2,  3)  : 
consequently,  one  fits  into  the  other,  and  the  end  opposite  the  collar 
enters  one  of  the  openings  in  the  flange  of  the  female  screw  (10) ;  a 

34 


530 


OBSTETRICAL  OPERATIONS. 


small  thumb-screw  (7,  8,  9)  secm-es  the  two  portions  of  the  stalk. 
The  female  screw  is  of  iron  or  copper,  the  flange  being  of  wood,  and 
its  circumference  provided  with  two  handles  to  hold  it  firmly  when  the 
machine  is  in  use.  The  male  screw  (H)  is  of  iron,  and  screwed  to  the 
right ;  one  extremity  articulates  with  the  turning-hook  (I)  ;  it  is 
screwed  in  the  contrary  direction  to  the  principal  portion,  so  as  not  to 
become  unscrewed  during  the  operation ;  the  other  end  has  a  four- 
branched  windlass  which  can  be  removed  at  will. 

To  use  the  machine,  the  animal  is  made  to  lie ;  the  cords  are 
attached  to  the  foetus  in  the  usual  manner ;  the  windlass  handle  is  put 
on  its  place  ;  the  screwed  stalk  (H)  is  introduced  into  the  female  screw 
to  about  as  far  as  J  ;  the  collar  is  applied  to  the  animal's  croup,  and 
the  three  long  stalks  are  fixed — one  end  in  the  collar,  the  other  in  the 


Fig.  197. 
Baron's  Obstetric  Machine. 


flange.  An  assistant  keeps  the  machine  in  equilibrium  by  placing  one 
of  his  hands  on  one  of  the  forked  handles  of  the  flange,  while  the  other 
handle  rests  firmly  on  the  ground.  Another  assistant,  the  coi-d  attached 
to  the  foetus  being  fixed  in  the  hook  at  the  end  of  the  chain  (K),  slowly 
turns  the  windlass  in  such  a  direction  as  will  bring  the  extremity  of  the 
stalk  (I)  towards  the  flange,  while  the  operator  superintends  the  extrac- 
tion. It  will  thus  be  seen  that  a  strong  traction  is  exerted  on  the  foetus, 
while  a  proportionate  pressure  is  transmitted  to  the  croup  of  the  parent 
through  the  three  long  rods — the  machine  producing  extension  and 
counter-extension  at  the  same  time,  while  it  also  allows  a  sustained 
traction  to  be  obtained — without  jerks  or  checks,  and  as  powerful  as 
may  be  desired. 

This  machine  has  been  well  tested  in  France,  and  received  the  highest 
praise. 


THE  EMJ'Loy.VEXT  OF  FOIiCE  IX  DYSToKIJ.  .'31 

SECTION  IV.— COMPARISON  BKTWEKN  MANUAL  AND  MKC'IIANICAL 

FORCE. 

The  employment  of  machines  which  multiply  force  for  the  artiticiul 
extraction  of  the  foetus,  can  be  traced  to  a  somewhat  distant  period  ; 
and  the  use  of  the  windlass,  the  wheel,  and  the  cart  by  rude  empirics  is 
of  ancient  date. 

Resorted  to  by  ignorant  people  destitute  of  that  knowledge  which 
alone  can  ensure  safety  and  success,  these  appliances  must  have  been 
productive  of  great  injury  and  loss.  It  was  probably  from  witnessing 
these  results  that  the  early  French  veterinarians  were  almost  unanimous 
in  their  condemnation  of  their  use,  and  designated  them  as  "  cruel  " 
and  "  murderous."  "  It  is  cruel,"  says  Fromage  de  Feugre,  "  to  tie  a 
cord  to  a  Calf,  and  to  pull  at  it  by  the  windlass  or  capstan,  or  by  horses 
attached  to  it.  It  is  umch  better,  the  Cow  being  tied  by  its  liorns,  to 
make  men  pull  at  the  cord,  so  that  force  may  be  emploj-ed  with  more 
precaution  and  management."  And  Hurtrel  d'Arboval  remarks:  "  There 
are  people  who  would  go  so  far  as  to  pull  at  the  cord  whicli  is  attached 
to  the  Foal  or  the  Calf  by  the  windlass,  the  capstan,  or  pulleys  ;  this 
procedure  is  not  only  cruel,  but  its  violence  usually  kills  the  fu.'tus,  and 
often  causes  lacerations,  serious  injury,  and  displacement  of  the  uterus." 
Other  writers  have  written  in  equally  strong  terms  against  the  use  of 
traction  machines,  and  in  favour  of  manual  force — which,  they  argue,  is 
an  intelligent  force  that  may  be  graduated  at  will,  and  its  direction 
modified  according  to  circumstances,  so  as  always  to  act  in  the  most 
favourable  way — i.e.,  in  the  axis  of  the  pelvis. 

Nevertheless,  since  1S38,  when  Lecoq  spoke  in  favour  of  mechanical 
appliances,  many  of  the  most  experienced  practitioners  have  expressed 
themselves  in  their  favour.  "  I  propose  the  pulley,"  says  Lecoq, 
"  because  it  affords  much  more  gentle  and  steady  traction  than  that 
obtained  by  strength  of  arm.  .  .  .  This  opinion  is  shared  by  the  majority 
of  the  veterinary  surgeons  in  our  part  of  the  world."  "  The  employ- 
ment of  the  pulley,"  writes  Darreau  in  l8o2,  "  gives  a  more  regular 
and  sustained  traction  than  that  of  assistants,  no  matter  how  vigor- 
ous and  intelligent  these  may  be  ;  in  turning  it  slowly,  we  obtain  a 
gradual  and  continuous  traction  ;  the  shoulders  and  the  body  of  the 
f(jtus  are  elongated,  the  sides  are  flattened  by  the  pressure,  and  delivery 
is  effected  in  the  majority  of  cases  without  an  accident.  .  .  .  By  this  pro- 
cedure, we  succeed  in  eight  cases  out  of  ten."  Ayrault  writes  ■}  "I 
have  decided  to  employ  a  means  which  I  have  often  very  severely 
qualified  when  in  the  hands  of  empirics,  and  which  can  be  only  barbar- 
ous and  brutal  by  reason  of  the  ignorance  of  those  who  apply  it :  I 
spt>ak  of  the  windlass,  and  wheel  and  axle.  ...  It  is  now  amply  demon- 
strated to  me  that  this  obstetrical  means,  so  little  enticing  at  first  sight, 
is  the  first  among  all  the  means  for  producing  traction  which  the  veter- 
inary surgeon  has  at  his  disposal — provided  always  that  he  watches  its 
operation  with  much  attention  ...  so  that  no  part  of  the  foetus  wedges 
against  the  sides  of  the  pelvis  ;  for  the  windlass  does  not  know  of  any 
obstacle  which  it  cannot  overcome."  And  Gan-eau,-  commenting  on 
Baron's  obstetric  machine  just  described,  reports,  "  From  what  lias 
been  said,  it  results  from  an  examination  of  every  part  of  this  apparatus 
that  it  is  simple,  and  works  well  and  easily  ;  that  its  power  is  at  least 

'  Rfcuf'd  (h  M^decine  VeUriiuiire,  1857. 

-  Report  a  la  Socieie  CentraU  de  Afidfcine  Veltrinaire,  1858. 


532  OBSTETRICAL  OPERATIONS. 

equal  to  that  of  the  pulleys,  windlass,  or  capstan  ;  that  its  action  is 
based  on  mechanical  laws  ;  that  the  traction  it  produces  is  so  gentle, 
slow,  and  regular,  that  it  is  without  danger  for  the  mother ;  that  its 
employment  altogether  leaves  behind  all  the  other  means  used  for  the 
production  of  the  necessary  counter-extension  in  fcetal  extraction  ;  that 
the  collar  transmits,  in  a  regular  manner,  and  to  the  whole  of  the 
inferior  and  posterior  parts  of  the  maternal  pelvis,  the  pressure  it 
receives  from  the  female  screw ;  that  this  pressure,  disseminated  over 
the  entire  hind-quarters  of  the  female,  is  proportionately  less  severe  and 
painful  during  traction  of  a  given  intensity.  ' 

Many  more  references  could  be  given  to  other  very  competent 
authorities  in  favour  of  mechanical  over  manual  traction  ;  but  the  evi- 
dence may  be  summed  up  by  stating  that  mechanical  traction  is  prefer- 
able to  that  produced  by  manual  power,  inasmuch  as  it  is  slower, 
more  regular,  its  action  is  more  sustained,  and  it  is  more  powerful  and 
efficacious,  without  imposing  increased  strain  on  the  parent  or  foetus. 
Manual  traction  is  unsteady  and  jerking,  especially  when  several  men 
are  pulling  ;  all  the  men  do  not  pull  alike,  or  at  the  same  time  ;  there- 
fore even  during  traction,  however  steady  it  may  aim  to  be,  the  strain 
varies,  as  men  soon  become  fatigued;  whereas  the  machine  can  maintain 
the  traction  for  any  length  of  time  without  increasing  or  diminishing  it. 

One  of  the  objections  urged  against  machine  traction  is  that  its  direc- 
tion cannot  be  so  easily  varied  upwards,  downwards,  or  to  one  side  or 
the  other,  as  manual  traction.  But  this  is  a  very  trifling  objection, 
and  it  may  be  nearly,  if  not  altogether,  overcome  by  making  assistants 
press  against  the  cord  or  cords,  so  as  to  give  these  the  necessary 
direction. 

"When  powerful  traction  is  required,  whether  it  be  manual  or 
mechanical,  great  attention  is  necessary  in  guiding  the  foetus  through 
the  genital  canal,  so  as  to  prevent  injury  to  the  parent.  The  traction 
should  cease  in  the  intervals  between  the  labour-pains,  and  the  efforts 
ought  not  to  be  continuous  ;  the  animal  should  be  allowed  intervals  of 
rest,  and  time  be  given  for  the  genital  canal  to  dilate  and  adapt  itself 
to  the  passage  of  the  foetus.  Severe  and  injudicious  traction  may  be 
productive  of  the  n:iost  serious  results.  Even  when  the  operation  is 
nearly  terminated,  care  will  be  requisite  in  order  to  prevent  inversion  of 
the  uterus.  Tliis  accident  may  be  obviated  by  careful  manipulation, 
and  abundant  injection  of  emollient  fluids. 


CHAPTEE   V. 
Embryotomy. 

Embryotomv,  or  emhri/ulcia,  is  the  name  given  to  every  operation  which 
has  for  its  object  the  reduction  in  volume  of  the  foetus  at  parturition,  by 
mutilating  or  dividing  it ;  so  as  to  allow  it  to  be  extracted  by  portions 
when  it  cannot  be  delivered  whole.  It  is  a  generic  term  for  a  number 
of  operations  very  different  in  their  character,  and  performed  on  the 
foetus  either  while  it  is  wholly  retained  in  the  uterus,  or  more  or  less 
engaged  in  the  genital  passage. 

The  operations    may   be  practised  on  various  parts  of   the   young 
creature — head,  limbs,  or  body — and  they  facilitate  the  removal  of  one 


EMBRYOTOMY.  533 

or  more  parts,  so  that  the  remainder  can  bo  removed  from  tlie  uterine 
cavity.  Of  course,  the  life  of  the  fcctus,  if  it  be  aUve,  is  sacrificed  in 
every  case  ;  and  this  sacrifice  is  only  made  to  prevent  a  j,'reater  loss — 
the  death  of  the  parent.  But  in  resorting  to  embryotomy,  the  veteri- 
nary obstetrist  is  not  hampered  by  those  grave  considerations  which, 
from  a  legal,  moral,  and  religious  point  of  view,  have  so  long  embar- 
rassed the  action  of  the  accoucheur  of  woman. 

The  question  with  the  veterinary  surgeon,  should  the  foetus  be  living, 
is  as  to  the  respective  value  of  parent  and  offspring,  and  which  of  these 
should  be  preserved  in  the  interest  of  the  owner. 

In  nearly  every  instance  the  response  is  entirely  in  favour  of  the 
parent,  this  being  of  most  commercial  value  ;  and  this  fact,  together 
with  the  absence  of  legal  and  moi'al  objections,  will  account  for  embry- 
otomy being  much  more  frequently  practised  in  vetci'inary  than  in 
human  obstetrics.  Nevertheless,  the  destruction  of  the  living  foetus  in 
the  case  of  the  domesticated  animals  should  not  be  lightly  entertained  ; 
it  is  the  duty  of  the  veterinarian,  in  the  interest  of  his  client,  to  preserve 
the  life  of  the  young  creature,  as  well  as  that  of  the  parent,  by  every 
means  in  his  power  ;  and  it  is  not  until  these  means  have  been  fairly 
tried,  or  are  deemed  insufficient  after  due  deliberation  and  without 
trial,  that  the  necessary  mutilation  should  be  undertaken.  And  it 
must  not  be  forgotten  that  embryotomy  is  not  always  without  danger 
for  the  parent ;  on  the  contrary,  it  is  nearly  always  serious,  and  its 
consequences  have  often  to  be  dreaded,  while  to  the  operator  it  is  in  the 
great  majority  of  cases  a  heavy  and  fatiguing  task. 

When  the  fa-tus  is  alive,  then,  it  is  only  the  most  urgent  necessity 
that  should  impel  the  obstetrist  to  resort  to  embryotomy  ;  though 
when  the  creature  is  dead  there  is  no  need  for  hesitation,  and  the 
operation  may  be  undertaken  at  once,  if  the  operator  is  satisfied  that 
extraction  cannot  be  effected  otherwise. 

The  conditions  which  generally  require  recourse  to  embryotomy  have 
been  indicated.  They  are:  dcfonnitics  of  the  maternal  pelvis — either 
congenital  or  acquired,  constitutional  or  accidental — which  prevent  ex- 
traction of  the  intact  ftt'tus,  this  condition  being,  however,  very  rare  in 
animals;  hyslcroccle ;  (Uaproportion  hctu-ecn  the  size  of  the  fa:  t  us  and  the 
fjenital  canal ;  certain  kinds  of  vtonstrositi/ ;  T^a.rt\cu\iir  malprcsentatio7is 
and  malpositions  of  limbs  or  body,  as  well  as  irreducible  distortions  of 
the  foetus  ;  death  of  the  frtus,  when  its  retention  in  the  uterus  has  given 
rise  to  intense  emphysema  which  hinders  delivery  ;  certain  diseases  of 
the  foetus,  as  hydrocephalus,  ascitis,  (rdoma,  etc.  Indeed,  embryotomy 
is  indicated  in  every  case  when  parturition  cannot  be  accomplished  by 
the  other  measures  already  mentioned,  without  seriously  compromising 
the  life  or  future  usefulness  of  the  parent. 

It  has  been  stated  that  division  of  the  foetus  is  very  often  a  heavy  and 
fatiguing  task  ;  and  it  may  now  be  remarked  that,  however  easy  it  may 
be  to  lay  down  rules  and  give  directions  as  to  how  the  operation  should 
be  conducted,  only  those  who  have  had  experience  of  it  can  testify  that 
it  is  much  easier  to  write  and  to  speak  than  to  act,  and  that  some  of  the 
mancpuvres  so  complacently  recommended  by  those  who  have  but  little 
knowledge  of  the  practical  part  of  veterinary  obstetrics,  cannot  be  carried 
out. 

The  fact  that  only  one  hand  can  be  employed  in  the  uterus,  that  this 
organ  is  applied  close  to  the  fcctus  when  the  "  waters"  have  escaped 
for  some  time,  that  the  membranes  are  adhesive   and   cling   to   the 


534  OBSTETRIOAL  OPERATIONS. 

fingers,  and  that  the  flaccid  tissues  of  the  young  creatures  ghde  away 
from  the  cutting  instrument — as  they  can  only  be  rendered  tense  in 
certain  circumstances  by  the  cords  or  crotchets — all  this  testifies  that, 
combined  with  the  straining  of  the  mother,  the  removal  of  the  foetus  by 
instalments  in  the  larger  animals  imposes  a  severe  strain  on  the  veter- 
inary surgeon's  physical  and  mental  powers. 

It  must  be  stated  that  embryotomy  cannot  be  restricted  to  definite 
rules  which  shall  be  applicable  to  every  case  ;  the  operation  must  vary 
according  to  circumstances,  and  these  are  often  of  the  most  diverse 
kind.  In  very  many  instances,  before  the  veterinarian  is  called  in  rude 
and  misguided  hands  have  greatly  complicated  the  case,  and  caused  so 
much  injury  and  swelling  to  the  maternal  organs  that  the  difficulties  are 
increased  manifold. 

But,  as  in  everything  else,  there  is  a  right  way  and  a  wrong  way  of 
operating — apart  from  the  collateral  difficulties  of  the  operation  ;  and 
though  no  fixed  rules  can  be  laid  down  for  every  case  which  requires 
embryotomy,  yet  there  are  directions,  based  on  the  results  of  practical 
experience,  which  afford  a  general  and  trustworthy  summary  of  the 
most  important  points  to  be  observed — by  the  young  practitioner  more 
particularly.  These  directions  will  now  be  alluded  to,  in  treating  of  the 
incision,  excision,  or  ablation  of  those  parts  of  the  foetus  which  are 
selected  for  operation — these  being  the  head,  limbs,  and  body.  But  the 
instruments  in  actual  use,  or  which  are  recommended  for  performing 
embryotomy,  must  first  be  noticed. 

Embnjotovuj  Instruments. 

The  performance  of  embryotomy  necessitates  the  use  of  surgical 
appliances  for  the  division,  puncture,  or  removal  of  certain  parts  ;  and 
as  these  operations  have  to  be  effected  either  in  the  genital  canal  or  in  the 
cavity  of  the  uterus,  the  manipulation  of  cutting  instruments  in  such  a 
confined  space  by  one  hand,  under  all  the  disadvantages  of  distance  from 
the  operator,  the  struggles  and  paralysing  straining  of  the  mother,  and 
without  the  aid  of  vision  to  guide  and  direct,  renders  the  task  peculiarly 
difficult  and  dangerous.  These  diificulties  and  dangers  have  stimulated 
the  inventive  faculties  of  veterinarians  for  a  long  time,  in  devising 
instruments  by  which  they  might  operate  quickly  and  safely,  and  so 
obviate  fatigue  and  danger  to  themselves,  and  exhaustion  and  risk  to 
the  parturient  animal. 

It  is  needless  to  remark  that  many  of  these  instruments  have  never 
come  into  general  use,  either  because  they  did  not  fulfil  the  require- 
ments claimed  for  them,  or  because  they  were  too  complicated  or  ex- 
pensive. Sometimes,  also,  prejudice  rather  conflicts  with  the  introduc- 
tion of  any  novelty  in  this  direction ;  while  long  experience  often  enables 
the  practitioner  to  achieve  the  desired  end  with  instruments  which 
would  be  useless,  if  not  dangerous,  in  the  hand  of  a  less  expert 
obstetrist. 

So  it  is  that,  for  nearly  all  cutting  operations,  an  ordinary  pocket- 
knife  or  bistoury  is  sometimes  the  only  instrument  employed ;  the 
operator  being  satisfied  if  the  spring  is  sufficiently  strong  to  prevent 
the  blade  shutting  up  in  the  handle  when  it  is  used  in  the  uterus. 
Eainard  preferred  an  ordinary  knife  with  a  blunt  point  and  a  convex 
cutting  edge ;  others  use  a  bistoury  cache.  Even  small  pocket-knives 
of  various  sizes  are  utilised  for  this  purpose,  and  one  of  Mr.  Cartwright's 
embryotomy  knives  is  not  unlike  a  gardener's  large  pruning-knife.     In 


KMi:i:Y(iT(i}[y.  r.35 

the  use  and  preference  for  knives,  much  must  depend  upon  custom  and 
the  expertness  of  the  operator. 

Nevertheless,  convenience,  safety,  and  the  absence  of  long  experience, 
demand  that  proper  instruments  be  devised  for  this  operation.  One  of 
the  earliest  to  introduce  a  convenient  and  etlicient  embryotom  was 
(liinther,  who,  in  his  work,  published  in  1830,  figures  an  instrument 
which  is  fixed  on  the  finger  by  a  ring ;  the  cutting  edge  of  the  blade — 
which  is  about  two  inches  long — being  somewhat  concave.  This  em- 
bryotom lias  been  slightly  modified  in  various  ways  by  dill'erent  practi- 
tioners— sometimes  having  two  narrow  rings,  so  as  to  grasp  more  of  the 
finger  ;  at  other  times  having,  in  addition,  a  small  button  on  the  back 
of  the  blade  for  the  finger  to  press  upon;  while  the  blade  itself  has  been 
made  more  cun'ed,  straighter,  longer,  or  like  the  blade  of  a  fieam. 
This  instrument  is  the  prototype  of  the  ring  scalpel  invented  by  Dr. 
Simpson,  of  St.  Andrews,  for  opening  the  head  of  the  human  fcctus. 
Two  of  these  embryotoms  which  have  been  used  in  this  country,  are 
shown  in  the  annexed  figures  (198,  199).  An  improvement  in  this 
instrument  is  having  a  hole  at  the  opposite  end  of  the  blade  (Fig.  199), 
through  which  a  piece  of  cord  or  tape  can  be  passed  and  tied  round 
the  wrist,  to  prevent  the  knife  slipping  from  the  finger  and  falling 
into  the  cavity  of  the  uterus.    Indeed,  this  is  a  wise  precaution  with  all 


Fig.  198.  Fig.  \W. 

Straight  Embbvotom.  Cikvkd  Embuyotom. 

the  short  instruments  introduced  into  the  genital  organs,  as  the  contrac- 
tions of  the  uterus,  struggles  of  the  animal,  and  the  position  of  the 
hand,  as  well  as  the  slipperiness  caused  by  the  presence  of  mucus,  etc., 
only  too  often  render  the  hold  of  the  instrument  very  insecure.  The 
middle  finger  of  the  operating  hand  is  passed  through  the  ring  and  the 
other  fingers  enclose  the  blade,  which  is  in  this  way  safely  conveyed  to 
the  part  of  the  foetus  which  is  to  be  incised.  The  finger-knife  is  the 
most  useful  instrument  in  embryotomy. 

Giinther  also  at  that  time  introduced  another  form  of  embryotom. 
which  has  likewise  continued  in  use,  and  has  been  more  or  less  altered 
or  improved  in  shape.  Tliis  consists  of  a  blade  that  can  be  made  to 
slide  out  and  in  a  handle,  by  the  thumb  of  the  hand  holding  it.  It  can 
therefore  be  introduced  into  or  withdrawn  from  the  genital  passage 
without  risk  of  injury  to  the  maternal  organs.  The  annexed  figure 
(200)  exhibits  an  improved  model  of  Giinther's  second  embryotom  ;  the 
original  pattern  had  double  cutting  edges.  It  may  be  remarked  that 
Zundel  and  Saint-Cyr  give  Thibeaudeau  the  credit  of  inventing  this 
sliding  bistoury  ;  but  the  instrument  was  only  described  by  the  latter 
in  1831  ;  'whereas  an  exactly  similar  knife  is  figured  in  Giinther's  work,^ 
published  at  Hanover  in  1830. 

'  Recufil  dfi  Mtdtrinc  Ve'ttrinaire,  1831,  p.  I.'i2. 

■■'   fjf.hrbuch  der  Praktitchtn  Veterinar-Geburtshiil/e,  Hanover,  1S30. 


536 


OBSTETRICAL  OPERA  TIOXS. 


Another  kind  of  embryotom  is  one  not  unlike  an  ordinary  large 
scalpel,  on  one  side  of  which  glides  a  blade-guard  that  can  also  be  moved 
backwards  or  forwards  by  the  thumb  of  the  hand  that  holds  it.  This  is 
a  very  convenient  knife  (Fig.  201) ;  there  is  also  a  similar  embryotom, 
projected  from  the  handle  by  pressure  of  the  finger  on  a  button  when 
the  incision  is  to  be  made,  and  which  is  perhaps  preferable  to  any 


Fig.  200. 
Guxther's  Embryotom  :  Improved  Pattern. 

others.  Unsworth's  embryotom  (Fig.  202)  is  somewhat  similar,  the 
blade  being  projected  from  the  side  of  the  handle  by  means  of  a  spring 
pressed  upon  by  the  finger. 

Embryotoms  have  also  been  proposed  by  Brogniez,  Hubert,  Contamin, 
Obermayer,  and  others,  but  they  all  are  more  or  less  imitations  of  the 
foregoing  models. 


Fig.  201. 
Colin's  Scalpel  Embryotom. 

Giinther  figures  an  embryotom  fixed  on  a  handle,  and  which  may  be 
of  any  convenient  length — about  thirty  inches  is  recommended  (Fig.  203); 
the  blade  is  semicircular,  the  concave  border  and  point  being  very 
sharp.  This  instrument  is  extolled  for  it  usefulness  in  cutting  through 
the  muscles  subcutaneously,  and  especially  in  separating  the  limbs  from 
the  trunk.     The  same  authority  gives  the  figure  of  a  "  Scheerenmesser,'' 


Fig.  202. 
Unsworth's  Spring  Embryotom. 


or  "  secator,''  as  it  has  been  termed.  This  is  an  instrument  about 
thirty-six  inches  in  length,  composed  of  two  branches,  held  together 
by  two  short  sheaths,  through  which  the  one  glides  on  the  other.  Each 
of  the  branches  has  a  blade  placed  at  a  right  angle  to  the  stalk  ;  these 
blades  are  opposite  each  other,  the  opposing  edges  being  sharp,  and 
they  are  brought  in  contact  by  a  rachet  arrangement  and  screw  moved 


EMliRYoToMY 


:.37 


by  a  handle  at  the  other  extremity.     This  instrument  is  very  powerful, 
and  can  divide  bones  as  well  as  soft  tissues. 

Subcutaneous  embryotomy  is  at  times  very  necessaxy,  but  after  the 
skin  has  been  incised  great  dilhculty  is  often  experienced  in  separating 
it  from  the  textures  beneath,  by  tearing  through  the  connective  tissue. 
This  is  found  to  be  the  case  more  particularly  in  amputating  the 
shoulder,  when  the  lingers  become  fatigued  in  trying  to  pass  them 
beneatli  the  skin.     To  facilitate  this  part  of  the  operation,  dillerent- 


Fig.  203. 

GI'NTHKR's    LoNT.-H.VXDLEI) 

Embryotom. 


Fig.  204. 

Cabtwright'.s  ScnCLT.\NKOCS 
Spatcla. 


i 


Fig.  205. 


Car-stks  Harm's 
Spatcla. 


shaped  spatulas  have  been  devised,  which  do  the  work  of  the  fingers  in 
liberating  the  skin  from  the  parts  it  covers.  One  of  these  spatulas  has 
been  used  by  Cartwright ;  it  is  merely  a  thin  but  rigid  blade  of  iron, 
about  seven  inches  long  and  one  or  one  and  a  quarter  inch  wide,  the 
edges  being  smooth  and  rounded,  and  one  end  fixed  in  a  wooden  handle 
(Fig.  204). 

Carsten  Harms  employs  a  double  spatula  about  three  feet  in  length ; 
the  blade  at  each  end  is  about  an  inch  wide  and  two  inches  long,  the 


)38 


OBSTETFJCAL  OPERATIONS. 


intermediate  portion  being  simply  a  round  rod  about  half  an  inch  thick  ; 
one  end  is  a  little  bent  to  one  side  (Fig.  205).  This  instrument  can 
be  used  with  both  hands,  and  is  more  firmly  held  than  a  one-hand 
spatula. 

Ungefrohrn    proposes    another,    but     somewhat     differently-shaped 


u 


Fig.  206. 

Ungkfrohrx's 
Spatula. 


Fig.  207. 

Cartwright's 
Bone-chisel. 


Fig.  208. 

Cartwright's 
Bone-saw. 


Fig.  209. 

Swedish 
Chain-saw. 


spatula.  This  measures  about  twenty-five  inches,  the  stalk  being  about 
three-eighths  of  an  inch  thick,  and  the  blade  two  inches  long  and  some- 
what crescent-shaped ;  the  convex  border  is  most  useful  in  raising  the 
skin,  particularly  in  parts  where  the  connective  tissue  is  close  and 
resisting.     The  blade  must  be  pretty  strong  and  slightly  convex  on  one 


/■:M/!/:yi>T(>My.  53t> 

side,  concave  on  the  other.  The  other  end  has  a  wide  eyelet  as  a 
handle  (Fig.  -206). 

The  section  of  hones,  though  not  often  necessary,  is  nevertheless 
sometimes  required  to  be  made,  and  it  is  found  to  be  no  easy  matter — 
with  the  larger  bones  especially.  For  this  purpose  chisels,  saws,  and 
forceps  have  been  proposed  and  employed.  Cartwright  has  a  model  of 
an  instrument  for  slitting  up  the  skin  of  a  limb,  which  may,  on  occa- 
sions, be  made  useful  as  a  bone-chisel.  Including  the  handle,  it  is 
about  thirty-two  inches  in  length  ;  the  chisel  portion  is  a  little  more 
than  two  inches  long,  and  one  or  one  and  a  half  inch  broad  ;  only  the 
middle  portion  at  the  end  is  sharp,  the  two  corners,  which  project  a 
little,  being  blunt  and  rounded,  as  are  also  the  sides  (Fig.  207). 

Margrafl's  "  Stemmeisen,"  or  chisel,  is  not  unlike  a  joiner's  chisel  in 
shape  ;  the  instrument  itself  is  seven  or  eight  inches  long,  and  at  its 
cutting  edge  (end),  which  is  very  sharp,  it  is  one  to  one  and  a  quarter 
inch  broad.  The  sides  are  well  rounded,  and  the  instrument  gradually 
tapers  as  it  reaches  the  handle,  into  which  it  is  fixed.  This  handle 
is  a  round  piece  of  hard  wood  about  three  feet  long  and  about  two 
inches  in  diameter,  with  a  ferrule  at  the  end  into  which  the  chisel 
is  fixed,  as  in  the  ordinary  carpenter's  chisel.  The  cutting  end  of  the 
instrument  is  carried  l)y  the  right  or  left  hand  to  the  part  of  the  fcetus 
to  be  incised,  while  the  handle  is  held  by  the  other  hand.  The  two 
hands  can  in  this  way  be  employed  :  that  in  the  uterus  guiding  the 
movements  of  the  chisel,  while  that  holding  the  handle  applies  the 
necessary  force.  This  simple  instrument  has  been  found  most  service- 
able in  dividing  the  vertebra?  when  the  head  of  the  fcetus  had  to  be 
bisected,  dividing  the  liead,  or,  in  double-headed  monstrosities,  the  two 
heads ;  as  well  as  slitting  up  the  skin.  It  has  been  suggested  that  if 
the  cutting  edge  were  made  slightly  concave  the  chisel  would  be  more 
useful. 

For  the  same  purpose  a  saw  has  been  proposed.  Such  an  article  has 
been  successfully  employed  when  the  occasion  demanded  it,  though 
some  authorities  consider  it  to  be  of  little  value.  Cartwright's  saw  is 
figured  liere  (Fig.  208).  The  stalk  (of  iron)  is  sixteen  inclies  in  length, 
the  saw  four  inches  long,  and  the  handle  six  inches.  The  saw-blade 
should  be  of  the  same  thickness  throughout,  the  end  and  back  being 
well-rounded  and  smooth. 

Sjostedt'  draws  attention  to  the  value  of  the  ordinary  surgical  chain- 
saw,  which  a  veterinary  surgeon  at  Stromsholm  (Petersen)  had  suc- 
cessfully employed.  That  which  he  recommends  is  about  a  foot  in 
length,  and  an  inch  wide.  Each  end  has  a  ring  to  which  a  cord  is 
attached,  and  to  the  cord  may  be  fixed  a  short,  transverse  wooden 
handle  (Fig.  209).  The  chain-saw  has  the  advantage  of  being  perfectly 
flexible,  and  can  therefore  be  passed  around  bones,  joints,  etc.,  and  the 
necessary  movements  performed  in  cutting  through  these — by  pulling 
alternately  at  each  cord — without  endangering  the  organs  of  the  mother. 
One  hand  of  the  operator  must,  of  necessity,  guide  the  saw  and  ascer- 
tain its  progiess. 

Bone-forceps  might  be  used  advantageously,  but  we  are  not  aware 
that  they  have  been  employed  in  veterinary  obstetrics.  They  should  be 
made  with  the  jaws  bent,  so  that  the  cutting  edge  would  be  concave, 
and  they  could  be  made  sufliciently  strong  in  jaws  and  handles  to  cut 
through  the  largest  bones.  A  screw  at  the  end  of  the  handles  would 
*  Handbok  i  FOrlo^ninfji  Komten  Jor  och  upp/iidare  af  Hundjur. 


540  OBSTETRICAL  OPEEATIONS. 

bring  these  together  with  sufficient  force  to  divide  the  strongest  pieces 
of  bone. 

In  the  foregoing,  allusion  has  only  been  made  to  the  instruments  which 
are  generally  approved  of ;  many  more  might  have  been  described,  but  no 
particular  advantage  could  have  been  derived  by  doing  so.  A  multitude 
of  instruments  can  only  be  embarrassing  to  the  veterinary  obstetrist. 
Besides,  it  must  be  confessed  that  too  little  attention  has  been  devoted 
to  the  perfecting  of  those  already  in  use,  or  to  devising  others  more 
simple  and  efticient  to  supplant  them.  There  is  here  a  wide  field  still 
open  for  those  who  desire  to  cultivate  a  most  important  department  of 
veterinary  surgery. 

Instruments  necessary  for  particular  operations  will  be  referred  to  as 
these  are  described. 

Preliminary  Arrangements  for  Embryotomy. 

There  is  not  much  to  arrange  before  commencing  embryotomy.  The 
operator  is  supposed  to  have  made  an  exploration  of  the  genital  passage, 
and  to  have  ascertained  the  state  of  affairs  ;  he  may  even  have  attempted 
everything  possible  in  the  way  of  extraction  and  failed.  Being  satisfied 
that  nothing  remains  to  be  done  to  preserve  the  life  of  the  parent  but  re- 
moving the  foetus  piecemeal,  he  has  to  decide,  from  the  nature  of  the 
case,  how  this  is  to  be  effected.  The  necessary  instruments  he  may 
have  with  him,  or  they  may  be  devised  on  the  spot ;  if  the  case  is  more 
difficult  than  usual,  they  may  have  to  be  sent  for.  But,  as  a  rule,  the 
operator  must  utilise  to  the  best  of  his  ability  whatever  is  to  hand ;  as 
he  usually  finds  his  patient  greatly  exhausted,  either  from  protracted 
labour  or  the  mischievous  meddling  of  untutored  hands. 

The  animal  must  be  detached  from  the  manger  or  rack,  and  kept,  if 
possible,  in  a  standing  attitude  :  this  position  being  the  one  best  suited 
for  such  an  operation,  or  it  may  be  tied  by  the  head  to  a  stake,  by  a 
rather  long  head-rope.  A  rope,  or  better  still,  a  rug  or  blanket,  should 
be  passed  round  the  hind-quarters,  a  little  above  the  hocks,  the  ends 
being  held  by  assistants  standing  towards  the  shoulders  of  the  animal. 
This  precaution  is  required  to  steady  the  creature,  to  keep  it  in  a  stand- 
ing position,  and  to  assist  it  in  resisting  the  traction  generally  employed 
in  removing  the  foetus.  It  may  be  necessary,  if  the  animal  is  much 
exhausted  or  suffering  much  pain,  to  administer  a  stimulant,  meal  or 
flour  gruel,  or  an  anodyne  draught. 


Ckaniotomy  or  Cephalotomy, 

Every  operation  which  has  for  its  object  the  diminution  in  size  of  the 
cranium,  when  that  part  offers  an  obstacle  to  the  passage  of  the  foetus, 
is  designated  by  these  names.  Hydrocephalus  is  the  condition  which 
most  frequently  calls  for  the  operation  in  the  larger  animals  ;  though 
certain  malformations  and  monstrosities,  and  even  an  exaggerated 
volume  of  the  head  of  the  foetus  in  the  Bitch  or  Cat,  may  also  re- 
quire it. 

Craniotomy  comprises  several  distinct  operations,  which  may  be 
performed  independently  or  simultaneously.  These  are  simple  pnncturej 
incision,  or  crushing  of  the  cranial  parietes  {Ceplialotripsy). 


EMBRYOTOMY.  541 

Puncture  of  the  Cranium. 

In  order  to  allow  the  escape  of  fluid  from  tlie  cranium — as  in  hydro- 
cephalus— and  thus  permit  the  birth  of  the  foetus,  a  simple  puncture  is 
often  all  that  is  necessary.  The  lluid  having  escaped,  the  thin  fra<,Mle 
bones  of  the  cranium  readily  collapse  from  the  pressure  they  undergo  in 
the  pelvic  cavity  ;  so  that  the  head  and  body  can  be  removed  by 
traction. 

Supposing  the  presentation  to  be  anterior,  it  is  first  necessary  to 
fix  the  head,  unless  it  is  firmly  wedged  in  the  passage  ;  this  fixation 
may  be  etYected  by  using  a  head-stall,  Schaack's  head-stall  forceps,  or 
even  a  cord  on  the  lower  jaw  :  exercising  suflicient  traction  on  the  cord 
to  prevent  the  head  from  slipping  from  under  the  hand  of  the  obstetrist 
during  the  operation. 

The  head  may  be  punctured  by  a  scalpel,  straight  bistoury,  finger- 
knife,  or  even  the  finger  in  certain  cases.  If  a  long-bladed  instrument 
is  used,  there  is  sometimes  a  good  deal  of  risk,  so  far  as  the  maternal 
organs  are  concerned ;  ic  is  advisable  to  wrap  twine,  tow,  or  tape, 
around  a  good  portion  of  the  blade  towards  the  handle. 

The  best  instrument,  if  it  is  at  hand,  is  a  long,  medium-sized  trocar 
and  cannula,  the  end  of  the  latter  fitting  closely  on  the  stalk  of  the 
trocar,  which  should  be  very  shax'p.  It  is  introduced  safely  into  the 
genital  canal  by  drawing  the  point  sulViciently  far  back  into  the  cannula 
to  be  entirely  concealed.  This  end  is  then  seized  between  the  lingers 
and  thumb  in  such  a  way  that  the  index-finger  extends  a  little  beyond 
the  extremity  of  the  cannula  ;  the  other  three  fingers  holding  it  in  the 
palm  of  the  hand,  while  the  right  hand  sustains  and  guides  the  instru- 
ment. Should  the  trocar  not  fit  the  cannula  tightly,  the  play  between 
the  two  renders  their  introduction  somewhat  dilVicult,  and  the  point 
may  glide  through  and  wound  the  operator.  The  trocar  may,  in  such 
a  case,  be  pushed  quite  through  the  cannula,  and  the  point  fixed  in  a 
cork,  which  can  readily  be  knocked  ofi"  by  one  of  the  fingers  when  the 
instrument  has  reached  the  head  of  the  foetus.  Having  an-ived  at  this 
part,  the  proper  spot  for  puncture  is  selected,  and  then  the  instrument 
is  applied  to  it — perpendicular  to  its  surface  if  possible,  to  prevent 
slipping.  The  trocar  is  made  to  penetrate  slowly  by  a  slight  rotatory 
motion  from  side  to  side,  and  when  all  resistance  ceases  the  cranium  is 
perforated.  This  perforation  should  not  be  made  at  the  sutures,  if  they 
can  be  avoided,  as  they  overlap  and  close  the  opening.  The  cannula  is 
now  held  firmly  in  its  place  by  the  left  hand,  the  trocar  is  withdrawn  ))y 
the  right,  and  the  fluid  escapes.  The  instrument  should  be  sutViciently 
long  for  the  end  to  be  near,  or  even  outside  the  vulva,  when  the  point 
is  on  the  cranium  of  the  foetus. 

There  is  no  difficulty  in  performing  this  operation  when  the  head 
presents  first,  even  though  it  should  not  have  entered  the  inlet,  so  long 
as  it  is  easily  accessible  to  the  hand.  With  the  posterior  presentation, 
however,  the  operation  is  troublesome  ;  as  owing  to  the  body  of  the 
fcctus  occupying  the  passage,  it  is  extremely  difficult  to  pass  the  hand 
armed  with  the  trocar  so  far  as  the  head.  Nevertheless,  it  may  bo  accom- 
plished in  many  cases  by  patience  and  tact.  There  is  no  reason  why  the 
trocar  and  cannula  should  not  be  passed  through  the  mouth  of  the  fcrtus 
in  some  cases,  and  made  to  penetrate  the  cranium  at  the  base  of  the 
skull,  when  the  frontal  region  cannot  be  attained.  If  the  head  cannot 
be  reached  in  this  presentation,  then  the  body  of  the  young  creature 
must  be  divided,  and  the  parts  removed  until  the  head  can  be  manipulated. 


542  OBSTETPJCAL  OPERATIOXS. 

Craniotomy. 

Craniotomii  is  resorted  to  when  puncture  has  not  sufficiently  reduced 
the  size  of  the  head.  It  is  an  operation  of  great  antiquity  in  human 
obstetrics,  and  various  instruments  have  been  introduced  to  facilitate 
its  performance ;  but  very  few  of  them  have  been  utilised  in  veterinary 
obstetrics,  and  indeed  for  the  larger  domesticated  animals  they  are  of 
no  use.  A  simple  straight  or  curved  bistoury,  Giiuther's  sliding 
embryotom  (Fig.  200),  finger-scalpel  (Figs.  198,  199),  the  long-handled 
embryotom  (Fig.  203),  scalpel  embryotom  (Fig.  201),  bone-chisel  (Fig. 
207),  or  saw  (Fig.  208),  may  one  or  all  be  employed,  according  to  cir- 
cumstances. It  cannot  be  denied,  however,  that  the  operation  is  very 
difficult  to  execute,  and  is  not  without  serious  danger  for  the  parent. 
Even  in  woman,  with  all  those  advantages  and  appliances  of  which  the 
veterinary  obstetrist  cannot  avail  himself,  craniotomy  is  always  a  for- 
midable undertaking.  The  cephalotrihc  and  cranioclast,  so  useful  in 
human  obstetricy,  cannot  be  employed  with  our  animals,  it  would 
appear  ;  but  there  is  no  reason  why  modifications  of  these  instruments 
might  not  be  devised  to  answer  the  same  end. 

Hurtrel  d'Arboval  recommends  that  craniotomy  be  performed  with  a 
convex  probe-pointed  bistoury  (sharp  on  the  convex  border),  the  middle 
of  the  cranium  being  incised ;  then  the  fingers  compress  the  bones,  and 
so  effect  delivery. 

Eainard  advises  two  incisions  on  each  side  of  the  head,  in  the  parietal 
region.  Giinther  mentions  that  if,  after  puncture,  the  operator  cannot 
■crush  the  bones  of  the  cranium  with  the  hand,  they  should  be  cut  by 
his  secator,  and  removed  piecemeal.  Carsten  Harms  states  that  when 
the  head  is  an  obstacle,  it  should  always  be  crushed,  if  possible,  the 
bones  being  broken  beneath  the  skin.  Sometimes  it  is  sufficient  to 
remove  the  lower  jaw  ;  and  in  order  to  effect  this,  the  jaw  is  first  fixed 
by  a  cord,  the  skin  is  then  cut  through  on  each  side — from  the  com- 
missure of  the  mouth  to  the  temporo-maxillary  articulation,  the  masseter 
muscles  and  the  ligaments  being  divided ;  a  transverse  section  of  the 
skin  is  now  made  between  each  joint,  the  finger  separating  it,  and  then 
two  or  three  assistants  pulling  at  the  cord,  the  jaw  is  removed.  If  it  is 
the  transverse  diameter  of  the  head  which  forms  the  obstacle,  the  divi- 
sion must  be  longitudinal,  and  great  service  may  be  derived  from  the 
use  of  the  bone-chisel — either  Cartwright's  or  Margraff's  pattern.  As 
much  of  the  skin  should  be  left  as  possible,  in  order  to  cover  the  jagged 
ends  of  the  bones. 

With  the  smaller  animals,  puncture  and  craniotomy  are  not  at  all 
difficult  operations,  the  bones  being  fragile  and  easily  perforated  or 
crushed. 

Decapitation  and  Decollation. 

Decapitation,  an  operation  which  consists  in  separating  the  head 
completely  from  the  body,  so  as  to  allow  these  parts  to  be  removed  one 
after  the  other,  is  not  very  often  required  ;  and  fortunately  so,  as  it  is 
not  without  great  danger  to  the  parent.  More  frequently  the  head  is 
partially  removed,  the  fore-limbs  amputated,  or  evisceration  of  the  chest 
or  abdomen — or  both — practised,  rather  than  resort  to  decapitation. 

Decollation  is  necessary  when  the  neck  is  distorted  and  cannot  be 
straightened,  and  has  to  be  divided  at  the  point  of  curvature,  the  head 
and  portion  of  neck  attached  to  it  being  then  extracted. 


EMBRYOTOMY.  548 

Decapitation  is  indicated  when  a  double-headed  monstrosity — 
nionosomian  or  sysomian — is  presented,  and  in  certain  irreducible  mal- 
positions of  the  head  or  limbs — especially  in  Heifers,  wliun  the  head  of 
the  Calf  is  in  the  genital  canal,  and  can  neither  be  advanced  nor  pushed 
into  the  uterus. 

The  operation  is  more  or  less  ditVicult,  according  to  the  situation  of 
the  head — if  entirely  in  the  uterus  or  fixed  in  the  passage,  or  if  it  is  at, 
or  can  be  brought  near  or  beyond  the  vulva.  In  the  latter  case,  it  is  easily 
accomplished  ;  although,  except  in  the  case  of  double  monstrosities,  it 
is  rarely  very  useful,  as  when  the  head  is  in  this  situation  it  is  not  an 
obstacle  to  birth,  and  its  removal  deprives  the  operator  of  a  most 
powerful  means  of  exercising  traction  on  the  parts  wliich  are  firmly 
retained  in  the  maternal  organs.  When  wedged  in  the  canal,  however, 
the  head  may  prove  a  troublesome  obstacle  to  the  performance  of  those 
mancDUvres  necessary  for  the  reduction  of  other  parts ;  as  it  may  not 
be  possible  either  to  advance  or  repel  it,  nor  yet  to  pass  the  hand 
between  it  and  the  pelvic  walls  to  search  for  a  deviated  limb,  for  example, 
or  to  bring  that  limb  into  a  proper  position. 

The  passage  must  therefore  be  freed  from  the  obstacle,  and  this  can 
be  accomplished  in  various  ways,  the  most  common  of  which  is  as 
follows  :  The  fore-limbs,  if  present,  are  corded  and  pushed  as  far 
towards  the  uterus  as  possible  ;  then  the  head  is  secured  by  cording 
the  lower  jaw,  a  pointed  hook  fixed  in  each  orbit,  or  a  head-collar  over 
the  head  if  it  can  be  placed.  Four  or  five  assistants  now  pull  at  the 
head  by  these  appliances,  so  as  to  bring  it  as  near  the  vulva  as  circum- 
stances will  permit ;  while  another  assistant  keeps  the  labia  apart,  in 
order  to  expose  as  much  of  the  head  as  he  can,  and  prevent  injury  to 
the  organs  of  tlie  parent.  The  operator,  with  a  convenient  knife  (the 
curved  finger-scalpel  is  very  useful),  incises  the  skin  around  the  neck — 
first  one  side,  then  the  other — close  to  the  occiput,  passes  his  fingers 
between  it  and  the  muscles  beneath,  and  pushes  it  well  back  on  the 
neck — the  assistants  pulling  at  the  head  at  the  same  time,  facilitate 
this  separation.  A  few  cuts  now  divide  the  soft  tissues  down  to  the 
vertebric,  and  nothing  more  remains  to  be  done  than  to  produce  dis- 
articulation by  vigorous  traction  and  a  twisting  movement  of  the 
head  at  the  same  time ;  the  ligaments  gradually  yield  and  tear,  the 
head  extends  and  at  last  comes  away,  and  the  body  of  the  foetus 
recedes  more  or  less  suddenly  into  the  abdominal  cavity.  If  the  limbs 
have  been  previously  secured,  they  are  brought  into  the  passage  by  the 
cords  attached  to  them  ;  or  if  they  are  not  so  accessible,  they  must  be 
sought  for  in  the  way  already  indicated,  and  delivery  completed  ;  care 
being  taken  to  cover  the  exposed  bones  of  the  neck  by  the  surplus  skin, 
while  the  foetus  is  being  brought  through  the  passage. 

Another  method  is  to  make  an  incision  tiirough  the  skin  across  the 
forehead,  in  front  of  the  ears,  and  to  separate  it  by  means  of  the  fingers 
or  spatula,  as  far  as  the  occipital  articulation.  The  knife  divides  this 
joint,  as  well  as  the  soft  tissues  around  it,  and  particularly  the  liga- 
ments ;  traction  will  bring  away  the  head.  The  upper  part  of  the  neck 
is  covered  by  the  loose  skin — which  may  be  fixed  there  by  ligature — 
and  directed  into  the  middle  of  the  passage.  Crotchets  sliould  now  be 
placed  on  the  bodies  of  the  vertebra?,  or  even  on  the  ribs  if  they  can  be 
reached  ;  as  the  limbs  do  not  offer  sufJicient  resistance  when  they  alone 
are  pulled  at,  neither  do  they  bring  the  body  fairly  into  the  passage. 


544  OBSTETFJCAL  OPERATIONS. 

Traction  should  be  made  on  the  sternum,  not  the  withers,  as  the  latter 
ought  first  to  enter  the  inlet. 

A  third  method  consists  in  removing  the  lower  jaw,  and  excising  the 
head  from  below.  Or  this  incision  may  be  practised  from  the  mouth, 
the  chisel  being  used  to  divide  the  vertebras,  after  the  cheeks,  masseter 
muscles,  and  soft  tissues  behind  the  lower  jaw  have  been  cut  through. 

Decapitation,  under  the  most  favourable  circumstances,  is  often  a 
long  and  fatiguing  operation,  as  the  greatest  care  has  to  be  observed  in 
order  to  avoid  injuring  the  parent.  But  this  fatigue  and  anxiety  are 
vastly  increased  w^hen  the  head  is  deeply  buried  in  the  passage  or  the 
uterus.  Then  the  hand — moist  with  the  fluids  of  the  genital  organs, 
embarrassed  by  shreds  of  the  foetal  envelopes,  hampered  by  the  pre- 
sence of  the  limbs,  compressed  and  paralysed  by  the  uterine  contrac- 
tions— can  scarcely  hold  and  guide  the  cutting  instrument,  or  distinguish 
what  belongs  to  the  foetus  and  what  to  the  mother,  and  has  scarcely 
strength  to  divide  the  tissues,  which  are  all  the  more  difficult  to  cut  by 
reason  of  their  softness.  It  will  readily  be  understood  how  such  an 
operation  must  be  difficult  for  the  operator  and  dangerous  for  the 
mother.  It  might  also  be  deemed  impossible,  if  veterinarians  had  not 
attempted  it  and  succeeded ;  though  the  majority  of  them  have  said 
but  little  as  to  their  mode  of  procedure. 

It  is  always  preferable,  if  possible,  to  remove  one  of  the  fore-limbs, 
as  this  is  easier,  quicker,  and  less  dangerous. 

But  decapitation  must  sometimes  be  performed,  and  then  the  above 
instructions  will  be  found  useful. 

In  the  case  of  double-headed  monstrosities,  the  saw^  and  bone-chisel, 
or  a  pair  of  strong  bone-forceps,  will  be  valuable.  When  the  head  of 
the  foetus  is  retained  in  the  uterus,  and  bent  back  towards  the  shoulder 
or  flank,  then  it  may  be  decided  to  amputate  the  head  and  a  portion  of 
the  neck.  Disarticulation  may  be  commenced  at  the  most  convenient 
part  of  the  convexity  made  by  the  bend  of  the  neck,  cutting  through 
the  soft  tissues  down  to  the  vertebrae  on  that  side,  then  on  the  other  ; 
then  sawing  or  chiselling  through  the  bones,  and  afterwards  using  the 
crotchets  carefully. 

Amputation  of  the  Limbs. 

When  the  limbs  are  so  deviated  that  they  cannot  be  straightened,  or 
when  by  their  presence  in  the  genital  passage  they  prevent  the  neces- 
sary manoeuvres  for  the  adjustment  of  other  parts  of  the  foetus,  then 
it  may  be  necessary  to  amputate  or  disarticulate  one  or  more  of  the 
extremities.  Some  of  the  indications  for  the  operation  have  been 
referred  to  on  various  occasions ;  they  include  all  those  foetal  mon- 
strosities which  have  supernumerary  limbs  that  require  removal  before 
delivery  can  be  effected ;  those  cases  in  which  the  foetus  is  exaggerated 
in  volume,  either  normally,  or  through  having  become  emphysematous 
after  death  in  utero  ;  those  complicated  malpresentations — such  as  the 
abdominal,  hock,  thigh,  etc.,  and  certain  deviations  of  the  head  and 
neck  in  the  anterior  presentation.  In  the  latter  it  is  well  to  hesitate 
before  deciding  to  remove  the  limbs ;  for  if  it  is  true  that  their  ablation 
allows  more  space  for  manoeuvres,  and  more  facility  for  adjusting  the 
head,  it  is  not  less  true  that,  should  these  manauvres  fail,  by  the  loss 
of  the  limbs  we  are  deprived  of  a  powerful  means  of  traction  when  we 
are  compelled,  as  a  last  resource,  to  adopt  forced  extraction.     Besides, 


EMIinVuTitMY.  545 

it  must  not  be  fortjotten  that  eiubryotomy  is  itself  an  extreme  measure, 
which  should  only  be  adopted  when  every  other  fails  or  seems  to  be 
really  hopeless. 

One  or  both  of  the  fore  or  hind  limbs  may  be  required  to  be  ampu- 
tated, according  to  circumstance.  In  the  earlier  days  of  veterinary 
science,  the  obstetrist  was  content  to  pull  at  the  limb  of  the  fu'tus 
which  he  wished  to  remove,  either  by  meclianical  or  manual  power, 
until  it  was  torn  off  by  brute-force.  Fromage  de  Fcugri"-  mentions 
that  Texier  had  in  this  manner  torn  away  the  limbs  of  many  Foals 
which  he  could  not  extract — the  separation  of  the  limb  always  taking 
place  between  the  chest  and  scapula,  by  rupture  of  the  muscles  uniting 
these  two  parts  ;  and  he  asserts  that  by  this  procedure  he  was  able  to 
save  many  Mares — though  he  says  nothing  as  to  the  suffering  of  these 
before  the  limbs  could  be  torn  from  the  body. 

Subsequently,  it  was  discovered  tliat  the  skin  offered  most  resistance 
to  this  kind  of  avulsion — the  muscles  and  ligaments  being  much  more 
easily  torn.     Then  the  knife  was  employed  to  incise  the  skin,  and  thus 
get  rid  of  the  chief  dilliculty.     On  the  Continent,  in  amputating  a  fore- 
limb,   for  instance,   the   skin    and  muscles  were   divided  as  near  the 
shoulder  as  possible,  and  the  bones,   united  by  their  ligaments  and 
covered  by  the  skin,  separated  by  traction.     Skellet,^  in  his  crude  and 
imperfect  work  published  in  1807,  writes  :  "  Take  a  sharp  knife,  and  cut 
from  the  point  of  each  shoulder  of  the  Calf  to  the  muscular  or  tliick 
part  of  the  fore-leg ;  then  cut  round  it,  so  as  to  enable  the  operator  to 
skin  the  upper  part  of  the  shoulder.     A  knife  is  then  to  be  conveyed 
between  the  shoulder  and  brisket,  so  as  to  cut  the  muscles  which  unite 
them.     When  so  done,  the  leg  and  shoulder  may  be  easily  pulled  off 
from  its  body.     The  other  fore-leg,  etc.,  is  to  be  taken  off  in  the  same 
way."     But  the  subcutaneous  method  of  excision  was  greatly  facilitated 
by  the  directions  published  in  Giinthei-'s  work  in  18130,  and  also  by  the 
publication  of  the  procedure  of  Huvellier-  in  the  same  year  ;  while  the 
jiarent  was  protected  from  some  of  the  dangers  and  pain  which  attended 
the  old  plan.       Since  the  introduction  of    this   method,   it  has  been 
adopted  by  every  obstetrist  of  note,  who  has  either  kept  to  the  original 
procedure,  or  modified  it  to  suit  his  own  fancy  or  convenience. 

Ampiitatioyi  of  the  Fore-limbs. 

In  order  to  amputate  a  fore-limb,  it  must  be  more  or  less  advanced  in 
the  vagina,  or  partially  beyond  the  vulva.  So  that,  if  it  is  still  in  the 
uterus,  it  must  first  be  removed  therefrom  and  brought  into  the  canal. 
If  both  limbs  are  to  be  removed,  they  must  be  secured  by  cords  around 
the  pastern  in  the  ordinary  manner,  the  cord  of  the  one  which  is  to  be 
first  excised  being  pulled  at  by  two,  three,  or  four  assistants,  so  as  to 
draw  it  as  near,  or  as  much  beyond,  the  vulva  as  possible.  Another 
assistant  then  keeps  the  labia  wide  apart,  in  order  to  allow  the  operator 
more  room.  A  circular  incision  is  made  above  the  fetlock — or,  better 
still,  the  knee,  taking  care  not  to  go  deeper  than  the  skin.  From  this 
incision,  gliding  his  hand  into  the  vagina,  along  the  limb,  the  operator 
gradually  makes  a  longitudinal  one,  extending  higher  up  as  the  leg 
becomes  elongated  by  the  traction. 

Some  practitioners  make  this  incision  on  the  inner  aspect  of  the  limb, 

>  A  Prnctiral  Treadle  on  the  Parturition  of  the  Coir.     London,  1807. 
-  Htcueil  dt  Jlakcine  Vet(rinairc,  l:?30,  p.  449. 

35 


546  OBSTETRICAL  OPERATIOXH. 

others  on  the  outer  side.  On  the  latter  there  is  perhaps  less  danger  of 
wounding  the  maternal  organs,  and  it  may  be  more  convenient  for  the 
operator.  But  this  is  a  matter  of  minor  importance  ;  it  is  more  neces- 
sary to  be  careful  in  incising  the  skin  beyond  the  articulations,  so  as 
not  to  divide  the  ligaments  of  these,  as  this  might  lead  to  the  limb  being 
torn  away  at  the  wrong  place  ;  no  such  precaution  is  necessary  with  the 
muscles. 

This  longitudinal  incision  having  been  made,  the  skin  is  separated 
from  the  structures  beneath,  either  by  means  of  the  fingers  or  the 
spatula — pushing  it  up  towards  the  shoulder  as  it  is  detached,  until  at 
length,  as  the  leg  becomes  stretched,  the  incision  and  the  detached 
skin  are  as  high  as  the  shoulder.  The  dissection  being  then  deemed 
sufficient,  and  the  limb  being  only  retained  by  the  muscles  which  attach 
it  to  the  thorax,  the  operator,  either  by  his  hand  or  the  crutch,  makes 
pressure  on  the  foetus,  while  the  assistants  are  ordered  to  pull  energetic- 
ally at  the  cord  on  the  pastern,  and  in  a  kind  of  jerking  manner.  Soon 
slight  cracking  sounds  are  heard,  the  muscles  are  rupturing  and  giving 
way,  and  in  a  very  short  time  the  entire  limb — ^scapula  and  all — is 
removed. 

The  removal  of  one  limb  usually  leaves  a  considerable  space  in  the 
genital  canal,  and  this  allows  delivery  to  be  completed.  Sometimes, 
however,  and  particularly  when  the  head  is  deviated  towards  the  flank, 
it  is  necessary  to  remove  the  other  limb  ;  and  this,  when  effected, 
permits  the  head  to  be  sought  for  and  rectified,  version  accomplished, 
etc.,  according  to  the  requirements  of  the  case. 

Some  practitioners  operate  in  a  somewhat  different  manner  to  the 
foregoing.  Lecoq,  for  instance,  commences  his  incision  at  the  upper 
part  of  the  shoulder,  brings  it  down  over  the  head  of  the  humerus,  on 
the  side  of  the  forearm,  and  as  far  as  the  middle  of  the  cannon,  where 
he  makes  his  circular  incision ;  the  skin  is  separated  from  this  part  up- 
wards. In  some  cases  this  procedure  may  be  preferable  to  the  other, 
and  it  certainly  is  less  dangerous  for  the  parent ;  but  it  sometimes- 
happens  that  the  shoulder  cannot  be  reached. 

Giinther  pushed  back  the  fcjetus  as  far  as  possible  by  means  of  the 
crutch,  with  the  finger-scalpel  divided  the  skin  before  and  behind  the 
scapula,  then  across — below  and  above;  then  cutting  through  the  pectoral 
muscles,  and  extracting  the  limb.  Cartwright  operates  in  a  similar 
manner  to  Lecoq.  He  first  has  a  leg  drawn  out,  and  divides  the  skin 
as  far  as  possible;  or  he  introduces  his  hand,  containing  a  knife,  as  high 
as  he  can  on  the  side  of  the  scapula,  and  makes  an  incision  thence- 
down  the  whole  length  of  the  limb  to  the  pastern  bones  ;  the  skin  is 
separated  by  the  fingers  or  spatula  as  far  as  possible  from  the  entire- 
leg,  and  the  transverse  pectoral  muscles  cut  through.  The  limb  is  then 
disjointed,  either  at  the  pastei'n  or  fetlock  ;  the  foot  being  left  attached 
to  the  skin,  as  it  is  afterwards  found  to  be  useful  in  the  extraction  of 
the  body.  Cords  are  fastened  around  the  limb  above  the  fetlock-joint 
and  knee,  and  the  Cow  being  firmly  tied  by  the  head,  the  necessary 
force  is  applied,  and  the  whole  limb  drawn  away.  He  writes  :  "I  have 
known,  in  some  of  these  cases,  the  limbs  to  separate  at  the  shoulder 
joints,  and  yet  the  foetus  has  been  extracted^both  from  the  Mare  and 
Cow — with  the  shoulders  attached,  the  points  of  the  latter  having, 
fortunately,  not  caught  the  edge  of  the  pelvis.  The  great  danger  in 
these  cases  is,  that  the  shoulder-joints  may  catch  against  the  pelvis  and. 
thus  prevent  extraction." 


KMBllVoTuMY.  547 

Meyer  recoiiimeiuls  that  the  circular  incision  on  the  cannon  be  not 
made  until  the  skin  is  detached  above,  as  this  facilitates  avulsion. 

It  is  well  to  divide  as  many  of  the  nmscles  uniting  the  limb  to  the 
chest  as  possible,  and  also  to  apply  counter-extension  by  means  of  the 
arm  or  crutch  placed  a;^'ainst  the  chest  or  opposite  shoulder  of  tlie  futus  ; 
this  also  spares  the  mother  much  of  the  pain  and  exhaustion  attending 
extraction. 

Amputation  of  tlie  entire  fore-limb,  including'  the  scapula,  is  a  very 
useful  operation  in  the  most  serious  cases  of  dystokia ;  but  there  some- 
times occur  instances  in  which  the  whole  leg  need  not  be  excised — as 
when  the  logs  are  an  obstacle  rather  from  their  lengtli  than  their 
volume.  This  happens,  as  has  been  described,  in  the  abdominal  pre- 
sentation of  the  fcctus,  when  the  limbs  so  often  render  version  dillicult 
— all  of  them  being  perhaps  in  the  genital  canal,  frona  which  they  cannot 
be  advanced  or  pushed  back.  In  these  circumstances,  disarticulation 
of  the  limbs  at  the  knee  or  elbow  joints  is  often  practised — the  latter 
being  generally  preferred  ;  though  it  must  be  remembered  that  excision 
at  this  part  can  be  but  of  limited  value,  and,  in  fact,  is  only  useful  in 
the  presentation  just  alluded  to,  because  it  does  not  give  so  much  room 
as  removal  of  the  scapula  and  humerus. 

In  the  abdominal  presentation  with  four  legs  in  the  vagina,  Don- 
narieix  lays  down  the  following  procedure  :  Three  pieces  of  supple  twine 
are  got  ready,  as  well  as  a  strong  cord.  With  the  twine  the  pasterns  of 
three  of  the  limbs  are  firmly  bound,  while  the  cord  is  fixed  on  the  limb 
which  is  to  be  detached,  and  confided  to  five  assistants,  who  pull  at  the 
cord  while  the  other  limbs  are  pushed  towards  the  uterus.  The  knee, 
then  the  forearm  appear,  and  the  lips  of  the  vulva  being  kept  widely 
separated,  the  operator  makes  a  circular  incision  throu^'h  the  skin  at 
this  part ;  traction  is  again  applied,  tlie  nmscles  tear,  and  gradually  the 
joint  is  reached.  Tlie  tendons  and  ligaments  are  cut,  and  the  leg  being 
twisted  as  it  is  pulled  out,  another  cut  of  the  knife  finally  removes  it. 

With  the  Sheep  or  Goat,  amputation  of  the  fore-limbs  of  the  foetus  is 
very  rarely  indeed  required,  though,  if  necessary,  it  can  be  effected. 
The  same  remark  applies  to  the  Bitch  and  Cat. 

Amputation  of  the  Hind-Limbs. 

When  the  fcctus  makes  a  posterior  presentation,  and  a  hind-limb 
appears  at  the  vulva,  it  may  be  necessary  to  amputate  this  limb  ;  or 
with  the  hind-limbs  Hexed  at  the  hocks,  and  so  firmly  wedged  in  the 
canal  that  they  cannot  be  extended  backwards,  nor  yet  sufliciently  bent 
to  permit  delivery — which  is  far  from  being  rare  in  the  Mare — these 
joints  are  disarticulated. 

In  the  latter  case,  it  is  accomplished  by  passing  a  running  noose 
round  each  leg,  above  the  hock,  and  tying  it  firmly  there.  Powerful 
traction  made  on  one  of  the  cords  by  four  or  five  assistants,  will  bring 
the  point  of  one  of  the  hocks  to  the  vulva,  the  lips  of  which  are  sepa- 
rated, while  the  operator  divides  the  gastrocnemii  tendons  and  the 
lateral  ligaments  of  the  joint,  so  as  to  produce  complete  disarticulation. 
The  tibia  is  then  pushed  into  the  vagina,  the  other  limb  is  amputated 
in  the  same  way,  and  birth  is  accomplished  by  pulling  at  both  cords, 
which  remain  attached  to  the  lower  end  of  the  leg-bone. 

When  the  limbs  are  completely  retained  in  the  uterus  at  this  presen- 
tation, the  procedure  recommended  at  pp.  171  and  517  must  be  adopted. 
The  following  procedure  has  also  been  recommended  :  A  long  incision  is 


548  OBSTETRICAL  OPERATIONS. 

made  through  the  skin  and  muscles  behind  the  hip-joint ;  the  hand 
removes  all  the  muscles  around  the  upper  part  of  the  femur,  round 
which  a  cord  is  then  fixed  and  pulled  by  two  assistants,  while  the 
operator  cuts  through  the  attaching  muscles  and  ligaments — especi- 
ally the  capsular  ligament.  In  this  way  the  joint  is  disarticulated,  and 
a  circular  incision  through  the  skin  completes  the  task,  as  traction  will 
remove  the  limb. 

It  may  be  remarked  that  Carsten  Harms  recommends  symphsiotomy 
to  be  practised  on  the  foetus  when  the  buttocks  present  at  the  inlet — the 
symphysis  pubis  being  cut  through.  By  this  means,  the  two  borders  of 
the  symphysis  can  be  made  to  overlap,  and  the  transverse  diameter  of 
the  pelvis  is  thereby  diminished.  The  finger-scalpel  and  spatula  are  the 
instruments  he  prefers.     The  saw  might  be  advantageously  used. 

In  certain  kinds  of  monstrosity  in  which  the  posterior  parts  of  the 
foetus  are  double,  or  when  the  hind-limbs  are  in  the  vagina,  and  in  con- 
sequence of  the  narrowness  of  the  maternal  pelvis,  or  wudth  of  the 
croup  or  haunches  of  the  young  creature,  birth  cannot  take  place,  then 
amputation  of  the  legs  at  the  trunk  may  be  necessary.  Such  an  opera- 
tion can  be  rarely  required,  however.  It  is  performed  in  a  similar 
manner  to  that  for  removal  of  the  fore-limbs— subcutaneously.  K  cord 
is  fastened  to  each  pastern,  and,  one  after  another,  the  limbs  are  drawn 
towards  the  vulva  ;  a  circular  incision  is  made  through  the  skin  above 
the  hock  ;  then  a  longitudinal  incision  is  carried  as  high  as  possible  on 
the  thigh,  and  the  skin  separated  in  the  ordinary  way  by  means  of  the 
spatula — always  ascending  towards  the  croup ;  the  gluteal  and  other 
muscles  attaching  the  thigh  to  the  pelvis  are  cut  across,  and  the  limb 
is  at  last  torn  away  by  strong  and  sustained  traction. 

Amputation  of  the  hind-limb  is  a  much  more  onerous  and  fatiguing 
operation  than  the  removal  of  the  fore-extremity.  The  skin  adheres  very 
closely  to  the  subjacent  textures,  and  more  labour  is  needed  to  separate  it 
from  them  ;  the  muscles  attaching  the  limb  to  the  trunk  are  more  numer- 
ous and  powerful,  and  when  they  are  cut  through  there  remains  the 
resistance  of  the  pubio-  and  coxo-femoral  ligaments  (in  the  Foal — the 
pubio-femoral  ligament  is  not  present  in  the  Calf).  Harms  estimates 
that  if  three  assistants  can  pull  away  a  fore-limb,  four  men  will  not  in 
every  instance  remove  a  hind  one.  However,  the  difficulties  are  not 
always  insuperable,  and  many  cases  are  on  record  in  which  the  opera- 
tion has  been  successfully  performed. 

After  avulsion  of  the  limbs,  crotchets  should  be  fixed  in  the  cotyloid 
cavities  or  oval  foramina,  and  delivery  completed  according  to  the 
directions  already  laid  down. 

Detruncation  or  Division  of  the  Body  of  the  Fcetus. 

When  one  half  of  the  body  of  the  foetus  has  more  or  less  passed 
through  the  pelvic  canal,  and  the  other  half  is  retained,  so  that  it  is  im- 
possible to  extract  or  return  it,  it  is  recommended  to  cut  the  trunk  in 
two — division  or  detruncation.  It  has  been  shown  that  this  retention 
may  be  due  to  malposition  or  malpresentation,  excessive  development 
or  deformity  of  the  hind-quarters  of  the  foetus,  as  well  as  ascites,  anasarca, 
or  emphysema  {plijjsovietra). 

If  the  hind-parts  are  retained,  and  the  head  and  fore-limbs  are  not 
much  beyond  the  vulva — if  so  far — cords  should  be  placed  on  each 
pastern  and  a  head-stall  on  the  head,  and  slow,  gradual,  but  strong 
traction  exerted  on  them,  so  as  to  expose  as  much  of  the  body  of  the 


KMliJiViiToMV.  549 

younf(  creature  as  possible.  This  done,  the  operator,  with  a  sharp 
bistoury,  incises  the  body  in  a  circular  manner  as  close  to  the  vulva  as 
is  convenient  (the  labia  being  kept  well  away  by  an  assistant) — the 
incision  commencing  below,  which  allows  the  elongation  of  the  spine  ; 
then  the  skin  and  muscles  on  the  sides  are  divided.  When  the  vertebra,* 
are  reached,  the  bistoury  is  passed  between  them,  and  as  close  to  the  loins 
as  possible  ;  slight  pulling  and  twisting  will  then  complete  the  bisection. 

It  is  a  good  plan  to  incise  the  skin  at  some  distance  in  front  of  the 
place  wiiere  it  is  intended  to  divide  the  spine,  and  to  separate  and  push 
it  back  over  the  portion  of  trunk  in  the  genital  canal.  When  the  division 
of  the  body  is  effected,  this  supertluous  skin  is  pulled  over  the  remain- 
ing part  of  the  trunk  and  sewn  together,  so  as  to  enclose  the  latter 
completely,  thus  preventing  injury  to  the  parent  during  the  subsequent 
mancruvres. 

Should  the  hind-limbs  be  doubled  under  the  croup  in  the  passage,  or 
should  they  still  be  in  the  uterus,  they  ought  to  be  sought  for  and  corded 
at  the  pasterns,  the  cords  being  given  to  assistants.  Then  vigorous 
pressure  is  applied  to  the  divided  end  of  the  spine  in  the  remaining  part 
of  the  trunk,  while  the  assistants  pull  until  version  is  effected ;  extraction 
is  afterwards  easy.  In  some  cases  it  is  not  necessary,  nor  is  it  always 
possible,  to  secure  the  hind-limbs  before  the  trunk  is  pushed  into  the 
uterus,  version  taking  place  merely  by  the  I'etropulsion ;  and  sometimes 
when  one  limb  has  been  found,  there  is  much  difficulty  in  discovei'ing 
the  other.  In  such  a  case,  ami  when  version  cannot  be  effected,  the 
limb  which  has  been  secured  should  be  drawn  towards  the  vulva  and 
disarticulated  ;  this  will  enable  the  operator  to  find  the  other  leg. 

When  the  ftetus  is  altogether  in  the  uterus,  division  of  the  body  is  a 
formidable  business,  even  when  the  hand  can  reach  it  and  move  about 
it  easily  ;  it  is  still  more  formidable,  if  not  impossible,  in  large-sized 
animals  when  the  foetus  can  scarcely  be  touched. 

When  the  foetus  is  in  the  iiorizontal  dorso-lumbar  presentation, 
Saint-Cyr  suggests  that  the  maternal  straining,  if  too  violent,  should  be 
subdued.  The  hand,  armed  with  a  bistoury,  is  passed  between  the 
uterus  and  the  foetus,  and  the  latter  is  cut  down  through  the  back  to 
the  vertebrie  ;  then  the  knife  is  passed  into  tlie  body  between  the  last 
rib  and  ilium,  and  the  Hank  cut  through,  another  incision  upwards 
reaching  the  under  side  of  the  vertebraj — a  hook  fixed  in  the  abdominal 
walls  makes  this  region  more  tense  and  easier  cut,  while  it  brings  it 
nearer  the  hand.  A  cord  is  now  passed  around  the  exposed  vertebrjE 
to  bring  these  closer  to  the  operator,  who  divides  them  with  a  knife 
or  saw.  The  body  of  the  foetus  is  then  in  two  portions,  the  most  con- 
venient of  which  is  first  to  be  extracted,  while  the  other  is  pushed  out 
of  the  way.  In  extraction  the  crotciiet  and  cords  are  employed  ;  the 
first  portion  being  removed,  the  second  has  to  be  found,  secured,  and 
got  away  likewise,  care  being  taken  to  guard  the  maternal  organs  from 
injury  by  the  exposed  vertebra?. 

If  necessary,  the  body  may  be  divided  into  more  than  two  portions  at 
the  spine,  and  the  ribs  and  sternum  may  also  be  removed. 

In  other  presentations  the  details  of  the  operation  may  have  to  be 
modified,  but  the  principles  are  the  same. 

EviSCER.\TI0N, 

When  it  is  desired  to  reduce  the  volume  of  the  thorax  or  abdomen, 
or  both,   the  organs    they  contain  aie    removed.      This  procedure  is 


550  OBSTETRICAL  OPERATIOXS. 

generally  adopted  when,  after  removal  of  one  or  more  of  the  limbs,  the 
body  of  the  foetus  still  remains  fixed  in  the  genital  canal — as  in  sterno- 
abdominal  and  sterno-lumbar  presentations  ;  by  it  we  obtain  a  con- 
siderable diminution  in  the  dimensions  of  the  body,  more  room  for 
manipulation  and  version,  and  perhaps,  next  to  the  removal  of  the  limbs, 
it  is  the  most  useful  operation  in  embryotomy. 

As  we  have  said,  evisceration  of  either  of  the  cavities  may  be  practised, 
according  to  circumstances.  We  shall,  therefore,  describe  the  mode  of 
reducing  the  volume  of  both — thorax  and  abdomen. 

Thoracic  Evisceration. 

This  operation  is  sometimes  practised  in  the  anterior  presentation 
when  the  thorax  of  the  foetus  is  too  large,  and  may  be  performed  inde- 
pendently of  abdominal  evisceration.  The  chest  is  emptied  of  its  con- 
tents first,  when  the  anterior  part  of  the  foetus  is  in  the  passage.  The 
head  and  limbs  should  be  corded — if  one  of  the  latter  is  removed  all  the 
better ;  if  not,  the  cords  should  be  pulled  well  upwards,  in  order  to 
make  more  room  between  them.  Should  the  head  be  an  obstacle  to  the 
performance  of  the  operation,  it  may  be  amputated ;  but  if  it  is  back  in 
the  uterus,  then  it  may  be  left  there.  A  strong  scalpel  with  a  long 
handle,  the  fingei--scalpel,  or  either  of  the  two  embryotoms  shown  in 
Figs.  200,  201,  is  the  best  instrument.  It  is  passed  carefully  into  the 
vagina  until  the  hand  reaches  the  breast  of  the  foetus,  when  the  blade 
is  thrust  deeply  into  the  chest,  between  the  two  first  ribs,  and  as  close 
to  the  spine  as  possible,  cutting  down  towards  the  sternum  and  upwards 
to  the  vertebrae. 

The  knife  is  now  dispensed  with,  and  the  hand  being  re-introduced, 
the  fingers  are  pushed  into  the  chest  and  the  two  first  ribs  removed, 
thereby  allowing  sufficient  room  for  the  whole  hand  to  enter  the  cavity. 
The  lungs  and  heart  are  torn  away  from  beneath  the  spine,  and,  with 
the  thymus  gland,  removed  from  the  uterus.  The  chest  collapses  a 
good  deal,  but  if  the  foetus  cannot  yet  be  extracted,  the  hand  may  be 
pushed  through  the  diaphragm,  and  the  contents  of  the  abdomen  carried 
away  through  the  chest. 

Some  operators,  instead  of  opening  the  thorax  in  front,  incise  from 
two  to  five  of  the  ribs  close  to  the  sternum,  and  pass  the  hand  into  the 
chest  by  the  aperture  so  made.  Others  divide  the  ribs  on  both  sides, 
and  remove  the  sternum  as  well  as  the  viscera.  It  will  often  be  found 
that  the  contents  of  the  chest  and  abdomen  can  be  removed  without 
cutting  the  ribs. 

Abdominal  Evisceration. 

Evisceration  of  the  abdomen  may  be  effected,  as  just  stated,  through 
the  thorax,  by  tearing  away  the  diaphragm. 

But  in  the  posterior  or  adominal  presentations,  and  indeed  in  any 
presentation  or  position  in  which  this  region  is  accessible  to  the  hand, 
eventration  can  be  performed.  Nevertheless,  it  is  not  always  easy  ;  on 
the  conti'ary,  it  is  sometimes  most  difficult  and  dangerous. 

Either  of  the  embryotoms  used  for  evisceration  of  the  chest  may  be 
employed  for  the  abdomen. 

The  edge  of  the  instrument  is  applied  to  the  wall  of  the  cavity,  which 
is  incised  by  drawing  the  hand  towards  the  operator.  Then  the  whole 
of  the  viscera  are  torn  away,  and,  if  need  be,  that  of  the  chest  also, 
through  the  diaphragm 


/ 'Ad ISA  A  //  }'.s  TEKO TOM  Y 


CHAPTER  VI. 

Vaginal  Hysterotomy. 

At  p.  Sf)!  reference  was  made  to  induration  of  the  cei'vix  uteri  as  a  cause 
of  dystokia,  and  tlie  indications  for  overcominf^  the  obstacle  were  de- 
scribed more  or  less  fully  ;  allusion  was  also  made  to  the  manner  in 
which  these  indications  should  be  carried  out.  As  we  are  now  treating; 
of  obstetric  operations  for  the  extraction  of  the  fa'tus,  it  is  necessary 
that  we  describe  more  fully  the  operation  and  its  consequences,  as 
these  are  of  much  importance. 

Vaginal  hysterotomy  consists  in  incising  the  indurated  and  inextensible 
neck  of  the  uterus  in  such  a  manner  and  to  such  an  extent,  that  it  will 
allow  the  fcctus  to  pass  through  its  canal. 

For  this  purpose,  the  only  instrument  necessary  is  a  strong  probe- 
pointed  bistoury,  a  bistoury  cache,  or  one  of  the  tinger-scalpels  or  other 
embryotoms.  When  the  straining  of  the  animal  has  propelled  the 
cervix  uteri  towards  the  vulva,  with  partial  prolapsus  of  the  vagina,  the 
operation  is  simple,  as  the  eye  can  then  aid  the  hand.  All  that  has  to 
be  done  is  to  glide  the  instrument  into  the  os,  and  make  the  necessar) 
number  of  incisions  through  the  tissues  composing  the  cen-ix — the 
situation  and  depth  of  the  incisions  depending  upon  the  extent  of  the 
induration  and  the  atresia. 

In  other  cases  there  is  no  prolapsus  of  the  vagina,  which  is  quite  soft 
and  elastic.  Then  the  left  hand  may  be  passed  into  it,  and  the  index- 
Hnger  being  introduced  into  the  os,  draws  the  cervix  towards  the  vulva; 
the  labia  of  the  latter  are  separated  by  an  assistant,  and  the  operator 
passes  the  blade  of  the  instnmient — guiding  it  by  the  index-finger  of  the 
other  hand — into  the  os,  where  he  gradually  and  steadily  incises  the 
tissues. 

When,  however,  the  walls  of  the  vagina  are  involved  in  the  induration, 
this  retraction  of  the  cervix  cannot  be  effected,  and  the  part  must  be 
operated  upon  in  its  ordinary  situation  :  the  knife  being  carried  care- 
fully into  the  vagina,  passed  to  the  necessary  depth  in  the  os,  and  the 
incision  made.  Perhaps  the  bistoury  cach6  is  the  best  instrument  for 
such  cases. 

It  is  rare  indeed  that  one  incision  is  suflficient ;  generally  from  two  to 
four  are  required,  and  it  is  better  to  have  a  larger  number  than  make 
them  too  deep:  they  certainly  must  not  pass  through  the  entire  thick- 
ness of  the  cervix. 

The  situation  of  the  incisions  is  a  matter  of  some  moment.  The 
lower  portion  of  the  cer\-ix  should  be  avoided,  in  consequence  of  its 
proximity  to  the  floor  of  the  vagina,  which  is  in  immediate  contact  with 
the  bladder  and  urethra  :  should  these  be  wounded,  the  results  might 
be  serious,  if  not  fatal ;  and  if  the  peritoneum  is  cut  or  torn  during  the 
passage  of  the  fcetus,  fluids  and  discharges  will  escape  into  the  abdo- 
minal cavity,  and  give  rise  to  peritonitis.  There  is  less  danger  in 
incising  the  upper  part  of  the  cervix,  as  the  rectum  is  not  so  near  ; 
nevertheless,  in  induration  there  may  be  adhesions  between  them,  and 
an  accident  is  therefore  possible — though  it  must  be  rare. 

So  that,  if  only  two  incisions  are  required,  it  is  advisable  to  make 
one  on  each  side  of  the  cervix  ;  and  if  four  are  necessary,  to  have  them 
at  each  comer. 


552  OBSTETRICAL  OPERATIONS. 

Horsburgi  recommends,  if  atresia  is  complete,  to  pass  the  finger  or 
a  blunt  instrument  into  the  os,  then  introduce  a  stout,  sharp-pointed, 
curved  bistoury  about  four  inches  long — dividing  the  stricture  laterally 
by  two  incisions — always  drawing  the  bistoury  towards  the  operator  ; 
after  which  he  is  to  introduce  both  hands,  with  the  palms  towards  each 
other,  and  press  them  apart.  "  He  will  find  the  part  immediately 
dilate  to  the  proper  size,  and  labour  may  go  on  naturally ;  or  he  may 
then  proceed  to  extract  the  Calf  if  labour  has  been  protracted." 

The  object  in  making  the  incisions  only  to  a  comparatively  slight 
depth,  and  not  through  the  entire  thickness  of  the  os,  is  to  prevent 
extensive  lacerations  of  the  organ  during  the  passage  of  the  foetus.  It 
will  generally  be  found  that  these  partial  incisions  will,  with  a  little 
patience,  admit  the  hand ;  this  being  passed  into  the  uterus,  seizes  the 
presenting  part  of  the  young  creature,  places  it  in  a  favourable  position 
if  necessary,  and  then  begins  to  draw  it  gently  into  the  os. 

Sometimes  with  primiparaB  in  good  health  and  strong,  delivery  is 
afterwards  effected  spontaneously,  and  this  is  the  most  favourable 
result ;  but  in  the  majority  of  cases  labour  has  been  going  on  for  a  long 
time — perhaps  two  days  or  more,  the  parent  is  exhausted,  and  the 
uterine  contractions  are  either  suspended,  or  so  feeble,  as  to  preclude  all 
hope  of  their  expelling  the  foetus.  The  head  and  fore-feet  must  then  be 
corded,  and  delivery  accomphshed  in  the  ordinary  way. 

It  is  well  to  remember,  however,  that  the  traction  resorted  to  must 
be  judiciously  employed.  It  should  be  moderate,  gradual,  and  sustained, 
in  order  to  allow  the  tissues  of  the  cervix  time  to  accommodate  themselves 
to  the  eccentric  pressure  imposed  on  them  by  the  advancing  foetus.  To 
act  otherwise  is  to  incur  the  grave  risk  of  lacerating  the  uterus  beyond  the 
possibility  of  repair,  and  is  quite  as  reprehensible  as  making  deep 
incisions. 

"With  regard  to  the  consequences  of  vaginal  hysterotomy,  it  must  be 
admitted  that  it  is  not  without  danger,  and  that  death  not  infrequently 
results.  There  are  no  reliable  statistics  to  serve  as  a  guide  in  estimating 
the  amount  of  success  or  non-success  following  its  performance,  as  not 
all— or  perhaps  not  many — of  the  cases  are  published.  Saint-Cyr  has 
collected  forty  cases — all  published  in  France  and  Belgium  since  the 
commencement  of  the  century,  and  an  analysis  of  these  gives  the  follow- 
ing results : 

Mother  and  progeny  saved  in 14  instances. 

Mother  saved — fate  of  the  progeny  not  mentioned — in     9 
Mother  alone  saved  in        -         -         -         -         -         -     5 

Progeny  saved,  mother  died,  in  -         -         -         -         -     6 

Mother  succumbed — fate  of  progeny  not  mentioned — in  5 
Mother  and  progeny  perished  in  .         .         .         -     1 

So  that  of  40  Cows  operated  upon,  28  survived,  and  twelve — or  30 
per  cent. — succumbed ;  while,  with  regard  to  the  progeny,  14  Calves 
were  delivered  alive  and  continued  to  live,  and  6  were  dead  ;  nothing  is 
said  as  to  the  other  14. 

In  other  words,  of  80  lives  more  or  less  compromised,  18  at  least — or 

22i  per  cent. — were  not  saved  by  the  operation.     But   Saint-Cyr  is 

inclined  to  think  that  if  all  the  successful  cases  have  been  published, 

there  is  reason  to  believe  that  all  the  unsuccessful  ones  have  not ;  and 

^   Veterinarian,  vol.  xviii.,  p.  215. 


r.i'UXAi.  nvsTEiiitToMY.  r.r.3 

he  is  apparently  confiriiuHl  in  this  view  by  Bugniet,'  who  writes  : 
"  Distinguished  veterinarians  have  published  very  interesting  observa- 
tions on  this  important  question  in  obstetrics  ;  but  I  am  bound  to  say 
that  these  experienced  practitioners  have  been  more  fortunate  than 
myself,  for  I  have  had  notliing  but  misfortune,  and  in  the  interest  of 
science  I  do  not  hesitate  to  say  so."  Bugniet,  after  describing  three 
eases  in  which  he  operated,  and  in  which  death  of  the  mother  followed, 
as  evidence  that  his  procedure  was  not  at  fault,  remarks  :  "  Neverthe- 
less, I  acted  with  extreme  prudence  ;  when  the  incisions  were  made,  I 
pi'oceeded  to  complete  delivery  with  great  care  and  deliberation.  Incision, 
dilatation,  birth,  removal  of  the  placenta — all  conducted  with  knowledge 
and  circumspection  ;  and  yet  this  did  not  prevent  a  fatal  issue."  But  in 
opposition  to  this  experience,  there  is  that  of  other  practitioners  who 
liave  had  a  fair — indeed,  a  large — share  of  success.  Donnarieix,'-  for 
instance,  commenting  on  Bugniet's  report,  blames  the  latter  for  adopt- 
ing e.ipcctant  instead  of  active  treatment,  and  asserts  that  he  has  taken 
the  exception  for  the  rule.  From  his  own  experience,  extending  over 
thirty  years,  during  which  he  had  performed  vaginal  hysterotomy  in 
sixty  cases  with  only  one  death  (the  cause  of  which  was  not  apparent), 
he  concludes  (1)  that  incision  of  the  cei-vix  uteri  is  generally  curable, 
and  (2)  that  palliative  measures  are  more  injurious  than  beneficial,  when 
their  uselessness  is  demonstrated. 

There  is  no  doubt  that,  in  the  majority  of  instances  and  in  the  hands 
of  careful  obstetrists,  vaginal  hysterotomy  will  be  successful,  and  prove 
a  useful  operation. 

As  a  rule,  for  a  period  of  eight  or  ten  days  after  the  operation, 
there  is  a  muco-purulent  discharge  from  the  vulva  ;  but  the  Cow  eats, 
ruminates,  gives  the  usual  quantity  of  milk,  and  does  not  appear  to  be 
any  more  inconvenienced  than  after  normal  parturition. 

The  unfavourable  results,  however,  nmst  not  be  overlooked.  Serious 
injury  to  the  neighbouring  organs  by  the  knife,  or  by  the  extension  of 
the  laceration,  is  within  the  range  of  possibility.  \Vhen  the  cervix  is 
completely  divided,  either  by  incision  or  by  subsequent  laceration 
during  the  passage  of  the  foetus,  there  may  be  intense  peritonitis  arising 
from  escape  of  the  liquor  amnii  or  other  fluids  into  the  abdomen,  and 
speedy  death.  Or  excessive  hicmorrhage  may  lead  to  serious  con- 
sequences. 

in  every  case,  of  course,  there  must  be  more  or  less  bleeding  from  the 
incisions  ;  but,  as  a  rule,  this  is  of  no  importance,  and  it  ceases  after  a 
time.  In  less  frequeiit  cases,  however,  it  persists,  and  either  brings  on 
great  debility,  or,  if  excessive,  leads  to  a  rapidly  fatal  termination. 
This  result  is  most  to  be  apprehended  when  the  cervix  is  greatly 
degenerated,  and  its  tissues  extremely  vascular — as  in  carcinoma  and 
sarconia.  It  may  also  occur  from  rupture  of  bloodvessels,  in  lacera- 
tion of  the  cervix  or  body  of  the  uterus,  during  the  passage  of  the  Calf 
through  the  incised  os. 

When  serious  hiemorrhage  occurs,  cloths  or  sponges  steeped  in  cold 
water,  astringent  lotions  and  styptics — as  the  perchloride  of  iron — must 
be  applied  as  close  to  the  part  as  possible  ;  while  cold  water  irrigation 
should  be  maintained  on  the  loins. 

Another  result  is  metritis,  or  metro-vaginitis,  which  is  rapidly  fatal, 
and  in  which  we  find  the  usual  local  lesions  on  making  an  autopsy. 

^  Rerutil  (U  Miilecine  Veliriiiaire,  1873. 
'  Op.  ci(.,  1674,  p.  511. 


^>^>'^  OBSTETRICAL  OFERATIONS. 

SepticaRmia  is  also  to  be  apprehended ;  and  to  prevent  it,  it  is  well  to 
remove  every  source  of  putridity,  or  anything  likely  to  become  putrid, 
and  to  use  plentifully  a  weak  solution  of  carlDolic  acid  (1  to  100)  or  the 
permanganate  of  potass  in  the  interior  of  the  uterus,  and  particularly 
about  the  incisions  in  the  cervix — even  for  some  days  after  the  opera- 
tion. 


CHAPTEE  VII. 
Gastro-Hysterotomy,  or  Caesarian  Section.^ 

Gastro-hysterotomy,  Ca'sarian  section,  or  ahdommal  hysterotomy,  is 
an  operation  which  has  for  its  object  the  removal  of  the  foetus  or  foetuses 
from  the  uterus  of  the  parent — when  they  cannot  be  delivered  ^jer  vias 
naturales — by  making  an  opening  in  that  organ  through  the  abdominal 
walls,  and  thereby  extracting  them. 

This  is  a  formidable  and  a  serious  operation,  whether  it  is  practised  on 
the  human  female  or  on  animals.  In  the  obstetricy  of  woman,  it  has  been 
resorted  to  from  a  very  early  period ;  the  Greeks  knew  it  as  va-reporoiJ-oroKn] 
or  efifSpioeXKr],  though  it  is  supposed  that  they  only  performed  it  after  the 
mother  was  dead,  and  to  save  the  child.  Persons  thus  born  were 
sacred  to  Apollo,  and  ^sculapius  was  designated  the  son  of  that  god, 
because  it  was  believed  he  had  been  delivered  by  gastro-hysterotomy. 
Some  strange  notion  appears  to  have  been  attached  to  this  method  of 
delivery,  as  among  these  old-world  people  the  person  who  had  been 
born  by  means  of  the  operation  was  esteemed  remarkable  and  fortunate. 
Hence  Claudius  Ctesar,  Scipio  Africanus,  Cteso  Fabius,  Julius  Caesar, 
and  other  more  or  less  illustrious  personages  of  old  Rome,  received  the 
surname  of  "  Cffisones  "  from  being  extracted  by  abdominal  incision 
from  their  mother's  womb:  "Quia  caeso  matris  uteru  in  lucem  pro- 
discunt."  At  a  later  period  these  persons  were  designated  "  Caesares," 
— a  noble  title ;  though,  as  has  been  demonstrated,  it  is  a  mistake  to 
assert  that  it  owes  its  origin  to  Julius  Caesar- — this  being  merely  his 
patronym. 

Since  these  early  times,  abdominal  hysterotomy  has  been  often 
practised  on  woman  ;  but  when  it  was  first  attempted  on  animals  is  not 
quite  certain.  Haller  was  led  to  believe  that  the  Greek  veterinarians — 
Apsyrtus  and  Hierocles — knew  and  performed  the  operation  on  the 
domesticated  animals  ;  but  this  has  been  shown  to  be  a  mistake. 
Until  we  arrive  at  the  time  of  Bourgelat — the  illustrious  founder  of 
veterinary  schools,  in  the  latter  half  of  the  last  century,  we  appear  to 
have  no  evidence  that  such  an  operation  was  ever  proposed  for  animals. 
And  even  Bourgelat-  only  suggests  it  in  cases  in  which  the  dam  is 
attacked  by  a  dangerous  disease  when  the  period  of  gestation  has  nearly 
or  quite  expired,  and  its  life  may  be  beneficially  sacrificed  in  favour  of 
its  progeny,  which  is  to  be  quickly  removed  from  the  uterus.  In  1781, 
Brugnone-"^  intimates  that  this  operation  may  be  performed  on  Mares 
and  other  animals  which  could  not  bring  forth  ;  but,  hke  Bourgelat,  he 
does  not  state  whether  he  ever  practised  it. 

It  was  not  apparently  until  1813,  that  Morange,  and  in  1816  Goheir'* 

'  It  has  been  suggested  that  the  term  "laparotomy,"  or  "  laparo-hysterotomy,"  would 
be  a  better  term  for  this  operation. 

-  Traite  de  la  Conformation  Exterieure  du  Cheval,  1768. 

^   Trattato  delta  RazrA  di  Cavalli,  p.  406. 

■*  Memoires  siir  la  Chirnrgie  et  la  Medfcine  Veterinaire,  vol.  ii.,  p.  40. 


dASTROHYSTEnuTDM  V.  :.:..'. 

attempted  it  on  the  X\v\x\^  animal,  though  unsuccessfully.  Moranf:;e 
operated  on  a  Cow,  and  it  was  to  all  appearance  in  a  fair  way  to 
recovery,  when  it  succumbed  to  an  attack  of  indigestion  caused  by 
improper  feeding.  About  the  same  period,  Rohlwes^  operated  on  a 
Mare. 

Since  that  time  gastro-hysterotomy  has  been  practised  comparatively 
often,  both  in  this  country  and  on  the  Continent ;  and  there  can 
scarcely  be  a  doubt  that  it  was  mainly  indebted  to  its  general  intro- 
duction, as  an  obstetric  operation,  to  the  fact  that  the  abdomen  of 
animals  could  be  opened  with  impunity  in  such  operations  as  ovario- 
tomy (spaying)  in  Swine  and  other  creatures  ;  as  well  as  from  the 
experience  that,  in  abdominal  hernia  in  the  pregnant  animal,  the 
ftt'tus  had  been  often  extracted  in  this  way  and  the  mother  did  not 
succumb. 

Gastro-hysterotomy  has  been  practised  both  on  the  large  and  small 
<lomesticated  animals,  but  perhaps  with  most  success  on  the  latter.  In 
4S  cases  of  this  operation,  Franck  finds  that  25 — or  52  per  cent. — had  a 
fatal  termination.  Saint-Cyr,  from  a  smaller  number  makes  the  mortality 
71  per  cent.  Franck  can  only  note  three  instances  in  the  Mare,  and 
they  were  all  fatal,  though  the  Foals  were  saved.  For  the  Cow  he  has 
17  instances ;  G  of  these  recovered  (one  of  them,  however,  was 
.Morange's,  which  died  from  overfeeding  fifteen  days  after  the  opera- 
tion, and  another  was  Sacchero's,  which  was  sent  to  the  butcher  in  six 
days).  This  gives  35  per  cent,  saved,  and  G5  per  cent.  lost.  In  three 
Sheep  there  were  no  recoveries,  and  in  two  Goats  only  one.  With  the 
Pig  the  operation  appears  to  have  been  wonderfully  successful.  In  S 
instances  all  recovered — a  result  Franck  is  inclined  to  attribute  to  the 
■different  arrangement — or  rather  attachment — of  the  placenta,  which 
renders  this  animal  less  liable  to  septic  infection  through  injury  to  the 
uterus.  With  the  Bitch,  the  mortality  is  about  the  same  as  in  the 
Bovine  species  ;  in  15  cases  6 — 40  per  cent. — lived.  Franck  thinks  this 
percentage  might  be  much  increased  if  the  operation  were  performed  on 
the  right  side  and  antiseptic  treatment  adopted,  or,  if  necessary,  even 
•extirpation  of  the  uterus  ;  as  putrid  infection  readily  occurs  in  the  Dog. 

With  regard  to  saving  the  young,  the  operation  is  not  very  favourable. 
In  nearly  all  the  instances  in  which  the  parent  recovered,  the  progeny 
has  been  dead,  or  died ;  and  in  only  4  of  Franck's  cases  were  the  parents, 
and  one  or  more  of  the  young  creatures,  saved.  Three  of  these  cases 
were  Bitches,  and  the  other  was  a  Sow. 

With  the  Cow,  the  Calf  is  often  saved,  while  the  parent  dies.  Of 
7  instances,  the  Calves  were  extracted  alive  in  6. 

With  the  Mare,  the  operation  must  be  resorted  to  early  in  order  to 
save  the  Foal,  as,  for  the  reasons  already  given,  it  perishes  quickly. 

It  is  only  on  a  knowledge  of  the  length  of  time  the  foetus  may  live 
during  parturition,  or  after  the  death  of  the  parent,  that  the  operation 
can  be  undertaken  with  any  prospect  of  success — so  far  as  obtaining  it 
alive  is  concerned  ;  and  this  is  an  important  consideration  with  regard 
to  the  Bovine  species.  Kehrers,  in  his  obser^-ations  on  the  Bitch,  found 
that  three  minutes  after  death  the  fa-tus  began  to  show  symptoms  of 
asphyxia,  and  in  thirty-six  minutes  it  was  dead.  In  pregnant  Cows 
and  Sheep  which  were  slaughtered,  the  fa'tus  moved  about  in  a  very 
lively  manner  for  eight  to  ten  minutes,  but  death  ensued  soon  after. 

Sauer  observed  an  unusual  instance  of  fcetal  vitality  in  a  Bitch  which 

1  D<M  Ganze  der  Thierhfillunde,  1822,  p.  143. 


556  OBSTETIUCAL  OPERATIOXS. 

could  not  be  delivered,  and  was  poisoned  by  cyanide  of  potassium. 
Eight  minutes  after  death  the  fcetuses  were  observed  to  move  in  the 
abdomen,  and  this  and  the  uterus  being  opened,  they  were  extracted 
alive. 

After  fifteen  minutes,  Franck  has  found  in  slaughtered  Sheep  that 
the  foetus  was  usually  asphyxiated  ;  and  he  concludes  that  during  the 
first  eight  minutes  after  the  death  of  the  parent,  the  foetus  can  be  ex- 
tracted alive  ;  even  towards  fifteen  minutes  there  is  a  chance  o-f  preserv- 
ing it,  but  by  that  time  it  is  usually  dead.  When  extracted  late,  and 
in  the  first  stage  of  asphyxia,  though  it  may  rally  for  a  short  time,  yet 
it  usually  succumbs  to  inflammation  of  the  lungs — through  the  amniotic 
fluid  having  penetrated  into  the  air-passages  during  the  convulsive 
gasps  the  young  creature  makes. 

There  can  be  no  doubt  that  much  of  the  great  mortality  which  follows 
the  operation  is  due  to  the  circumstances  under  which  it  is  undertaken. 
It  is,  as  a  rule,  never  resorted  to  until  every  other  means  of  delivering 
the  animal  has  failed,  and  the  creature,  worn  out  by  suffering,  is  already 
almost  dead.  In  addition  to  this,  the  foetus  itself — subjected  to  long- 
continued  and  severe  manipulation — is  either  dying  or  dead  ;  indeed,  it 
may  have  perished  days  before,  and,  becoming  putrid,  has  already  in- 
fected the  parent. 

Death  is  usually  due,  when  not  immediate,  to  putrid  infection — to 
peritonitis  or  metro-peritonitis.  This  is  more  particularly  the  case  with 
the  Bitch,  in  which,  when  the  operation  is  performed  early  and  the 
young  are  extracted  alive,  recovery  generally  takes  place ;  though 
Franck  remarks  that  wherever  the  green  colouring  matter  of  the  placenta 
imparts  a  similar  tint  to  the  textures  it  comes  in  contact  with,  very 
often  septic  inflammation  begins  there.  The  same  authority  points  out 
that  there  is  no  great  reason  otherwise  why  death  should  be  a  frequent 
result  of  the  operation,  w4ien  we  consider  the  hundreds  of  similar 
operations  performed  in  the  study  of  embryology,  by  Bischofi'  and  others, 
on  Bitches,  Guinea-pigs,  and  Rabbits,  the  majority  of  which  did  not 
have  a  fatal  termination.  He  also  alludes  to  the  success  of  Nature's 
Caesarian  section,  when  we  have  mummification  and  maceration  of  the 
foetus,  consequent  on  occlusion  of  the  os  uteri,  and  the  remains  of  the 
creature  find  their  way  out  by  another  channel  without  much  disturb- 
ance to  the  mother. 

Certainly,  the  brilliant  results  obtained  from  antiseptic  surgery  in 
other  directions  give  reason  to  expect  more  successes  from  this  operation 
— at  least  in  the  case  of  the  smaller  animals. 

The  most  dangerous  cases  for  operation  are  those  in  which  the  foetus 
is  dead,  and  more  or  less  decomposed. 

Indications. 

The  operation  should  only  be  resorted  to  in  those  cases  in  which 
delivery  by  the  natural  passages — the  foetus  being  alive — is  altogether 
impossible,  or  so  difficult  and  dangerous  that  the  mother  incurs  nearly 
as  much  risk  as  from  gastro-hysterotomy  itself,  while  the  young  creature 
must  be  sacrificed ;  or  when  the  owner  prefers  having  the  latter  alive, 
instead  of  incurring  the  risk  of  losing  both — the  progeny  being  the  most 
valuable.  The  operation  is  therefore  likely  to  be  demanded  in  those 
deformities  of  the  pelvis  produced  by  fractures,  exostoses,  etc.,  which 
considerably  diminish  its  canal,  intra-pelvic  tumours,  hernia  of  the 
uterus,  extra-uterine  foetation,  certain  cases  of  uterine  torsion  irredu- 


<:a  s  tj:o-  n  i  's  rEiioTuMY'.  667 

cible  by  the  methods  Wf  have  described.  Atresia  of  tlie  os  sliould  be 
more  advrtnta<;eously  overcome  by  vaj^nnal  hysterotomy,  unless  the 
owner  is  desirous  of  savin<;  the  fietus  aud  sacrihcin^'  the  mother. 

The  operation  is  also  intlicated  when  an  animal,  near  tlie  termination 
of  pregnancy,  is  so  seriously  ill  or  injured  that  it  cannot  live  until  birth 
takes  place.  It  may  then  be  most  judicious,  if  the  progeny  is  valuable, 
to  kill  the  parent  and  extract  the  fix'tus  at  once.  If  the  parent  has  just 
died,  or  is  dying,  the  operation  may  also  be  practised. 

In  considering  the  adoption  of  the  operation,  the  species  of  animal 
will,  of  course,  weigh  a  good  deal.  Those  which  can  be  utilized  as  food 
there  need  be  no  hesitation  in  operating  upon  and  sacrificing  imme- 
diately afterwards ;  the  value  of  the  carcase  and  the  living  Calf  or 
Lamb,  diminishing  very  considerably  the  loss  which  would  otherwise 
be  sustained.  With  the  Mare,  as  we  have  said,  the  Foal  may  be  nmch 
more  valuable  than  the  parent. 

Witli  the  Bitch  and  Sow,  there  is  much  more  prospect  of  a  favourable 
result  from  the  operation  ;  and  as  dithcult  parturition  in  tliem  is  often 
so  serious,  it  is  advisable  to  operate  in  good  time.  Indeed,  in  all  cases 
when  the  operation  is  once  decided  upon,  no  delay  should  occur  in 
l)ractising  it,  if  it  is  desired  to  preserve  the  progeny  and  give  the  parent 
a  chance. 

We  have  seen  that  the  Foal  soon  perishes  when  it  cannot  be  born, 
and  though  the  ftetus  of  other  animals  retains  its  vitality  longer,  yet 
there  is  also  a  limit  here.  Besides,  it  must  be  remembered  that  the 
strength  of  the  parent  is  an  important  factor  in  the  case,  and  the 
longer  the  delay  so  the  less  chance  is  there  of  a  successful  result. 
It  is,  therefore,  most  important  that  the  obstetrist  lose  no  time  in 
making  his  diagnosis,  and  coming  to  a  conclusion  as  to  the  course  he 
must  pursue.  Embryotomy  will,  of  course,  present  itself  to  his  mind 
before  gastro-hysterotomy,  which  is,  after  all,  only  to  be  an  ultimate 
means  of  saving  either  mother  or  progeny,  or  both,  in  very  exceptional 
cases.  It  need  scarcely  be  pointed  out  that  in  irreducible  uterine  hernia, 
there  need  be  no  delay  in  deciding,  and  that  this  condition  gives  good 
hope  of  success — especially  in  the  smaller  animals. 

Operation. 

Looking  at  this  operation  from  a  purely  surgical  point  of  view,  there 
can  be  no  doubt  that,  so  far  as  the  larger  domesticated  animals  are 
concerned,  it  is  one  of  the  longest,  most  fatiguing,  and  most  difficult  in 
veterinary  surgery. 

There  is  also  the  gi-eat  extent  of  the  wound,  as  well  as  the  opening  of 
the  peritoneum,  the  hicmorrhage,  and  the  escape  of  blood  or  liquor 
anmii  into  the  peritoneal  cavity,  to  be  considered.  Besides,  the  animal 
is,  as  a  rule,  in  a  state  of  extreme  prostration,  and  the  results  of 
mischievous  interference  may  be  already  apparent  before  the  operation 
is  commenced,  or  even  before  the  veterinary  surgeon  is  called  in. 

The  after-treatment  of  the  mother,  too,  often  requires  much  attention, 
and  is  expensive  ;  and  recovery  requires  a  considerable  period,  as  con- 
valescence is  only  too  often  protracted. 

What,  however,  makes  the  operation  so  formidable,  if  the  mother  is 
to  be  saved,  is  tlie  quadrupedal  position  of  animals ;  for,  after  section 
of  the  abdominal  parietes.  the  mass  of  intestines  presses  heavily  on  the 
part  which  has  been  incised  ;  so  that  it  needs  much  careful  manage- 
ment and  supervision  to  effect  cicatrisation,  and  to  procure  such  a 


558  OBSTETRICAL  OPERATIONS. 

solid  adhesion  of   the  margins    of   the  wound   that  hernia   may  not 
result. 

If  the  mother  is  alive,  the  operation  is  a  painful  one,  and  of  long 
duration  in  some  cases,  while  the  pain  inflicted  causes  the  animal  to 
struggle  ;  this  inconveniences  the  operator  more  or  less,  and — not  to 
speak  of  the  humane  feelings  which  should  ever  be  predominant  on 
such  occasions — induces  him  to  avail  himself  of  the  advantages  of 
anaesthesia,  if  they  can  be  obtained.  Perhaps  no  agent  is  so  useful  in 
this  respect  as  chloral  hydrate,  though  chloroform  or  ether  may  be 
administered  in  the  usual  way — by  inhalation — and  produce  their 
effect.  The  objection  to  the  two  latter  substances,  however,  is  very 
great,  so  far  as  cattle  are  concerned  ;  as  they  taint  the  flesh,  should  it 
be  necessary  to  kill  the  animals,  and  utilise  their  flesh  as  food ;  where- 
as the  chloral  hydrate  has  not  this  objectionable  action.  The  latter  is 
perhaps  best  administered  in  enema  ;  for  Horses  and  Cattle,  the  dose 
may  be  from  fourteen  to  twenty-two  drachms  ;  about  two  or  three 
drachms  for  Dogs  (depending  on  the  size),  and  three  to  six  drachms  for 
Pigs.  It  is  best  given  in  mucilage  or  bland  syrup  of  any  kind.  In  a 
quarter  of  an  hour  or  so  the  animal  is  in  a  state  of  narcosis,  and  the 
operation  may  be  commenced.  Unfortunately,  the  drug  only  too 
frequently  causes  the  death  of  the  foetus — a  matter  of  some  importance 
when  this  is  of  more  value  than  the  parent,  but  not  to  be  considered 
when  the  life  of  the  latter  is  to  be  preserved. 

When  the  parent  is  doomed  to  be  killed — as  in  the  case  of  a  worthless 
Mare,  or  one  suffering  from  an  incurable  disease  or  accident — and  the 
young  animal  is  to  be  rescued,  the  best  course  to  follow  is  to  pierce  the 
medulla  oblongata,  and  operate  at  once,  as  Vollmar  has  done  with 
success.  By  this  means  insensibility  has  been  produced,  and  the  young 
creature  extracted  alive.  Giinther  recommends  dividing  the  posterior 
aorta  after  removal  of  the  foetus,  as  it  is  close  to  hand  in  the  abdominal 
cavity,  and  death  quickly  ensues. 

For  the  operation  but  few  instruments  are  needed.  They  consist 
chiefly  of  a  scalpel,  probe-pointed  bistoury,  scissors,  forceps,  muscle- 
hooks,  and  some  common  suture  needles,  pins,  and  sutures — silk  or 
catgut.  For  the  larger  animals  a  strong  suture  needle,  suture  wire,  and 
waxed  carbolised  thread,  catgut,  wire  or  twine,  teased  oakum,  tow, 
small  pieces  of  wood  or  whalebone  for  the  sutures,  and  large  pieces  of 
linen  are  required  in  addition,  as  well  as  a  body-bandage  made  by  fold- 
ing a  linen  or  cotton  sheet.  If  the  parent  is  not  to  be  preserved,  or  is 
already  dead  or  dying,  of  course  no  such  preparations  need  be  made  ; 
as  a  scalpel  and  probe-pointed  bistoury,  or  even  an  ordinary  pocket- 
knife  on  an  emergency,  and  used  with  care,  will  sutfice. 

The  operation  should,  if  possible,  be  performed  with  all  antiseptic 
precautions. 

The  incision  in  the  abdomen  may  be  made  in  either  of  two  regions— 
at  the  linca  alba  or  the  riciht  flank.  If  it  is  desired  to  preserve  the 
parent,  the  flank  operation  is  certainly  to  be  preferred  with  the  larger 
animals  and  the  Sow,  as  no  sutures  can  resist  the  weight  of  the  intes- 
tines when  the  incision  is  at  the  inferior  part  of  the  abdomen.  Even 
with  the  Bitch  the  flank  operation  should  be  adopted  for  the  same 
reason,  and  also  because  wounding  the  mammas  is  avoided — an  im- 
portant consideration  in  more  respects  than  one.  It  is  true  that 
Bourgelat,  describing  how  gastro-hysterotomy  ought  to  be  performed 
in  the  Mare  in  order  to  obtain  the  living  foetus,  says  that  the  animal 


O ASTRO  NVSTEJiOK >M  J '.  559 

should  be  carefully  thrown,  placed  on  its  back,  and  tliere  secured. 
"  Then  a  crucial  incision  is  to  be  made  at  the  middle  of  the  lower  part 
of  the  abdomen,  and  it  should  be  about  a  foot-and-a-half  in  lenj^'th — 
terminating  at  the  pubis.  If  the  large  intestine,  forced  outwards  by 
the  struggles  of  the  animal,  appears,  it  should  be  carried  to  one  side, 
when  the  uterus  will  soon  be  seen  ;  then  an  opening,  corresponding  to 
the  other,  must  be  made  with  the  greatest  circumspection,  so  as  not  to 
wound  the  foal ;  the  membranes  are  to  be  opened,  the  '  waters  '  they 
contain  escape,  and  the  young  creature  is  to  be  immediately  removed. 
The  success  of  the  enterprise  depends  upon  the  attention  paid  in  order 
to  prevent  the  death  of  the  Mare ;  the  more  time  lost,  so  the  more  is 
the  fix'tus  weakened ;  the  less  time  is  there  to  spare  if  the  Mare  is  dead, 
for  then  it  is  certain  that  the  Foal  will  not  live  longer  than  a  few 
moments."  The  umbilical  cord  was  to  be  ligatured  at  four  or  live  inches 
from  the  body  of  the  Foal ;  "  after  which  it  is  only  a  question  of  providing 
means  for  rearing  the  young  animal,  until  it  can  attend  to  itself." 

But  Hainard  points  out  that  notliing  is  said  as  to  closing  and  ban- 
daging the  incision,  or  the  after-treatment  of  the  Mare — thus  indicating 
that  preserving  the  Foal  only  was  in  view. 

With  the  Mare  or  Cow  the  operation  is  sometimes  attempted  in  the 
standing  attitude  ;  but  it  is  obvious  that  there  must  be  great  inconveni- 
ence and  danger  in  this.  It  is  much  better,  therefore,  to  place  the 
Mare,  Cow,  Sheep,  or  Goat,  on  the  left  side — right  side  uppermost ; 
either  side  sutlices  for  the  Bitch  or  Sow. 

If  the  aninuil  is  narcotised  and  insensible,  then  it  is  not  necessary  to 
secure  the  limbs  ;  but  if  it  is  only  partially  or  not  at  all  unconscious, 
then  means  of  contention  must  be  adopted,  for  the  safety  of  the  animal 
as  well  as  the  operator.  The  right  hind-leg  should  be  firmly  fixed 
backwards,  so  as  fully  to  expose  the  region  to  be  operated  upon,  t!ie 
other  three  limbs  being  secured  together  in  the  ordinary  manner.  A 
small  animal  can  be  held  by  one  or  two  assistants. 

The  incision,  as  has  been  said,  is  made  in  the  right  flank,  rather 
below  and  in  front  of  the  anterior  spinous  process  of  the  ilium,  so  as 
to  avoid  wounding  the  circumflex  artery — an  accident  which  might 
embarrass  the  operator;  if  this  or  any  other  artery  is  wounded,  it  must 
be  tied  immediately.  If  there  is  no  great  hurry,  and  the  hair  is  long, 
this  had  better  be  clipped  off.  The  incision  should  pass  downwards 
and  forwards,  in  the  direction  of  the  fibres  of  the  small  oblicjue  muscle 
of  the  abdomen  (no  muscle  should  be  cut  across)  ;  it  ought  to  extend 
through  the  skin  to  the  muscles,  and  even  if  it  passes  into  these  there 
is  no  danger  to  be  apprehendetl. 

The  length  of  the  wound  will,  of  course,  depend  upon  the  si/e  of  the 
animal — for  the  Mare  or  Cow,  it  may  be  from  twelve  to  fourteen  inches. 
The  layers  of  muscles  are  to  be  gently  cut  tlirough  until  tlie  peritoneum 
is  reached,  and  into  it  a  small  opening  is  to  be  made ;  but  in  doing  this 
the  greatest  care  is  to  be  exercised,  so  as  not  to  wound  the  viscera. 
The  two  first  fingers  of  the  left  hand  are  passed  through  this  opening, 
the  back  of  the  hand  downwards ;  the  blade  of  the  probe-pointed 
bistoury  is  placed  between  these  fingers,  and  carried  along — cutting 
through  the  peritoneum  and  muscles  until  the  opening  is  of  the  same 
length  as  that  in  the  skin.  An  intelligent  assistant  should  be  at  hand 
to  prevent  the  escape  of  the  intestines  through  this  large  aperture. 

The  arm  of  the  operator  is  now  pushed  into  the  abdominal  cavity  in 
search  of  the  uterus,  which,  when  found,  is  brought  opposite  the  inci- 


560  OBSTETRICAL  OPEEATIONS. 

sion,  should  it  not  be  there  at  first.  Two  assistants  compress  the  sides 
of  the  wound,  so  as  to  maintain  them  closely  against  the  uterus  ;  this 
the  operator  cuts  through  slowly,  layer  after  layer,  using  all  diligence 
so  as  to  escape  wounding  the  foetal  membranes. 

Two  fingers  are  insinuated  between  the  walls  of  the  organ  and  these 
membranes,  and  the  bistoury  is  again  employed  to  dilate  the  opening, 
as  in  the  peritoneal  incision,  so  as  to  give  it  nearly  the  same  direction 
and  extent  of  that  in  the  abdominal  wall.  Should  the  membranes  be 
still  intact,  they  are  to  be  torn,  and  the  "  waters"  allowed  to  flow — 
but  only  outside  the  abdomen,  if  possible.  The  operator  now,  plunging 
his  arm  at  once  in  the  cavity  of  the  uterus,  seizes  the  first  parts  of  the 
foetus  that  come  to  hand— fore-legs,  head,  or  hind-quarters,  if  possible 
— and  removes  it  quickly ;  the  umbilical  cord  is  torn  or  tied,  and  the 
young  creature  given  to  those  who  will  dry  and  rub  it,  wrap  it  in  a 
warm  blanket,  and  otherwise  attend  to  it. 

The  obstetrist  immediately,  if  the  parent  is  to  be  preserved,  removes 
the  foBtal  membranes — an  easy  task  comparatively  in  the  Mare,  much 
more  tedious  and  difficult  in  the  Cow,  as  all  the  adhering  cotyledons 
must  be  separated  one  by  one.  Then,  by  means  of  a  sponge,  all  the 
fluid  remaining  in  the  organ  is  to  be  cleared  out,  as  well  as  any  that  may 
have  escaped  into  the  abdomen.  It  might  be  well  to  damp  the  interior 
of  the  uterus  with  a  very  weak  solution  of  carbolic  acid,  or  potassium 
iodide  (1  to  500  or  700).  This  accomplished,  the  great  wound  is  to  be 
closed. 

Nothing  is  done  to  the  uterus,  as  a  rule ;  the  organ  soon  diminishes 
very  considerably  in  volume,  and  it  would  appear  that  the  wound  in  it 
is  not  long  in  cicatrising.  The  borders  of  the  wound  in  the  abdomen, 
however,  must  be  speedily  and  solidly  united.  The  best  means  of 
union  is  undoubtedly  the  quilled  suture,  which  is  to  be  applied  accord- 
ing to  the  ordinary  rules  of  surgery  ;  care  must  be  taken  to  make  the 
sutures  enter  at  a  good  distance  from  the  border  of  the  wound,  and  to 
include  the  muscles  as  well  as  the  skin.  If  the  cord  fixing  the  out- 
stretched hind-limb  is  slackened  a  little,  it  wall  facilitate  closing  the 
wound.  A  small  corner  should  be  left  open  at  the  lower  end  of  the 
incision,  to  allow  the  products  of  inflammation  and  suppuration  to 
escape.  External  to  the  wound,  either  a  layer  of  fine  tow  or  lint, 
slightly  carbonised,  or  oakum,  may  be  placed.  Over  this,  long  narrow 
strips  of  canvas  covered  w^ith  melted  glue  may  be  fixed,  to  support  the 
sutures  and  retain  the  dressing  ;  then  on  these  another  thin  layer  of 
carbolised  tow  or  oakum,  and,  lastly,  the  wide  body-bandage  around 
the  abdomen  and  loins  of  the  creature.  Though  it  is  somewhat  diffi- 
cult to  apply,  yet  it  is  essential  that  this  bandage  or  compress  be  put 
on  before  the  animal  is  allowed  to  rise.  Afterwards  the  bandage  may 
be  adjusted  and  tightened  if  necessary. 

When  the  incision  is  made  at  the  linca  alba  the  procedure  is  some- 
what similar  ;  but,  as  we  do  not  recommend  it  for  the  reason  above 
stated,  we  need  not  allude  to  it  further. 

The  after-treatment  of  the  wound  is  that  followed  for  all  such  serious 
traumatisms.  If  possible  it  should  be  kept  perfectly  dry,  and  dressed 
with  antiseptic  powders — such  as  boric  acid. 

The  diet  should  be  light  and  sloppj'  for  a  short  time,  unless  the 
animal  is  very  feeble,  when  nourishing  food  must  be  given. 

With  the  smaller  animals  the  operation  is  similar,  but  with  the 
multiparas  the  cornu  containing  the  young  is  drawn  partially  outside 


SYMI'IlVSlitTiiMV.  561 

tlie  wouiul,  opeiicil,  and  each  faHus  and  its  membranes  removed 
separately.  The  after-treatment  will  be  the  same.  For  enlarging  the 
abdominal  and  peritoneal  incisions,  small  sharp  scissors  will  be  found 
very  useful  and  safe,  the  blade  with  the  blunt  point  being  introduced. 

The  bad  results  to  be  apprehended  from  the  operation  are  septic 
metritis,  or  peritonitis,  or  both  ;  abscess  at  the  seat  of  the  incision,  or 
adhesion  of  the  abdominal  organs  to  this  part. 


CH.\PTER  VIII. 
Symphysiotomy. 

Sv.Mi'HVSiOTOMv,  as  the  name  implies,  consists  in  dividing  the  ischio- 
pubic  symphysis  throughout  ;  so  that,  by  allowing  the  bones  to  sepa- 
rate somewhat  in  the  pubic  region,  the  pelvic  cavity  may  be  enlarged, 
and  the  passage  of  the  foetus  through  it  rendered  possible.  But  even 
in  woman,  with  every  advantage  and  appliance,  and  after  a  most  serious 
mutilation,  the  separation  procured  between  the  bones  is  intinitesimal, 
and  therefore  can  have  but  little  influence  on  the  progress  of  the  foetus. 
And  when  we  remember  that  in  woman  the  mortality  is  more  than 
^•^2  per  cent.,  while  among  those  which  survive  many  ai'e  permanently 
disabled,  and  those  which  recover  often  require  months  before  conva- 
lescence is  established,  it  will  be  understood  that  the  operation  can 
never,  with  our  present  knowledge,  be  reckoned  among  those  which  the 
veterinary  obstetrist  can  successfully  practise.  It  may  also  be  suflicient 
to  notice  the  fact  that  in  animals  the  symphysis  pubis,  as  a  rule,  soon 
becomes  ossified.  The  operation  does  not  appear  to  have  been  resorted 
to  in  veterinary  obstetricy,  and  it  would  require  a  bold  operator  to 
attempt  it. 


CHAPTER  IX. 
Artificial  Premature  Birth. 

At  p.  294  it  was  explained  that,  in  order  to  obviate  some  of  the  difli- 
culties  occurring  in  pregnancy  and  parturition  in  animals,  artificial 
labour  might  be  induced — /.<'.,  birth  ctTected  when  the  fa;tus  has 
attained  such  a  stage  of  development  as  to  be  viable,  but  before  the 
period  of  normal  parturition  has  been  reached.  Such  a  procedure  may 
be  necessary  when  there  is  deformity  of  the  maternal  pelvis,  or  tumours 
thereon  or  therein  ;  excessive  size  of  the  foetus — absolute  or  relative  ; 
protracted  gestation  ;  serious  paraplegia  ;  eclampsia  ;  cerebral  conges- 
tion ;  ante-parturient  exhaustion  from  the  presence  of  too  many  fa'tuses; 
prolapsus  of  the  vagina  and  uterus  ;  transverse  presentations,  etc. 

This  measure  is  often  resorted  to  in  the  human  female,  and  with 
gi-eat  advantage,  for  by  it  both  parent  and  offspring  may  be  saved  ; 
whereas  if  not  adopted,  one  or  both  might  perish  when  pregnancy  came 
to  an  end. 

It  has  even  been  suggested  that  in  animals  it  might  be  made  available 
in  those  cases  in  which  they  have  become  pregnant  when  too  young, 
when  the  male  has  been  disproportionately  large,  or — as  is  often  the  case 
with  Dogs — belonged  to  a  large-headed  breed. 

When  the  foetus  is  expelled  from  the  uterus  before  it  is  viable — before 

36 


562  OBSTETRICAL  OPERATIOXH. 

it  can  maintain  an  independent  existence  apart  from  the  parent,  this 
constitutes  abortion.  In  the  Mare  this  would  be  the  case  if  the  accident 
occurred  before  the  300th  day  of  pregnancy ;  in  the  Cow  before  the 
200th  day ;  in  the  Sheep  before  the  130th  day  ;  in  the  Sow  before 
the  109th  day  ;  and  in  the  Bitch  before  the  50th  day.  So  it  is  estimated 
that  the  foetus  would  be  viable,  and  yet  notably  less  in  size  and  weight 
than  when  born  at  full  term,  if  removed  from  the  Mare  20  to  40  days 
before  that  period  ;  from  the  Cow  15  to  30  days  ;  and  from  the  Bitch 
10  to  15  days. 

Opekation. — The  operator  has  merely  to  induce  labour,  Nature  carry- 
ing on  and  finishing  parturition  in  the  usual  manner  ;  so  that  he  has 
only  to  dilate  the  os  uteri  somewhat  to  effect  this  ;  then  the  "water- 
bag  "  is  extruded,  the  uterus  commences  to  contract,  the  animal  also 
begins  to  strain,  dilatation  of  the  os  is  completed,  and  the  foetus  is 
expelled. 

The  different  ways  in  which  the  os  may  be  dilated  have  been  already 
described  in  treating  of  sterility,  and  rigidity  of  spasm  of  the  cervix  ; 
but  it  may  be  remarked  that,  in  the  case  of  the  larger  animals,  and 
especially  if  near  the  end  of  pregnancy,  the  hand  alone  may  be  used  to 
open  the  os,  slightly  detach  the  chorion  from  the  uterus  around  that 
canal,  and  even  perforate  that  membrane  a  little  to  hasten  the  forma- 
tion of  the  "  water-bag. "1 

In  the  smaller  animals  the  sponge  tent,  a  long  probe,  or  uterine 
douches,  will  suffice. 


CHAPTEE  X. 

Supplementary  Observations  regarding  Mother  and  Progeny. 

The  condition  of  the  mother  after  obstetrical  manipulations  and  opera- 
tions generally  demands  attention — all  the  more  if  these  have  been 
severe  and  protracted.  In  trifling  cases,  it  is  true,  no  care  beyond  that 
usually  given  after  normal  parturition  is  required;  for  as  soon  as 
delivery  is  completed,  she  w'ill  seek  her  offspring — if  it  be  alive — and 
manifest  her  interest  in  it,  though  she  may  have  suffered  considerably 
before  it  was  born.  But  in  the  great  majority  of  difficult  cases,  such  as 
have  been  described  in  the  preceding  chapters,  the  animal  is  much  pros- 
trated from  prolonged  suffering  and  straining — so  much  so,  indeed,  as 
to  lie  extended  in  a  comatose  condition,  or  apparently  dead,  from 
nervous  exhaustion.  Though  the  Mare  can  endure  very  much  suffering 
during  parturition,  yet  this  state  of  collapse  is  not  infrequently  observed. 
So  stout-hearted  is  this  animal,  that  when  she  has  rallied  from  the 
effects  of  parturition  and  evinced  maternal  solicitude  for  the  Foal,  she 
begins  to  eat  and  drink  ;  when  she  does  not  do  so,  it  may  be  regarded 
as  a  very  grave  sign. 

To  render  the  mother  comfortable  and  restore  her  strength  should  be 

'  Andre  (Annales  de  Medecine  Veterinaire,  1877,  p.  156)  was  called  to  see  a  Mare, 
eleven  months  pregnant  and  verj'  heavj-,  which  could  not  be  got  up,  and  had  been  lying 
so  long  that  her  sides  were  contused.  He  had  her  placed  on  an  inclined  plane,  with  the 
front  of  the  body  higher  than  the  hind-quarters.  Then  by  means  of  a  finger,  and  after- 
wards by  the  whole  hand,  he  succeeded  in  dilating  the  os,  and  soon  a  large  living  Foal 
was  born.  The  Mare  was  kept  quiet  and  nursed  for  two  hours  afterwards,  when  she 
got  up  without  difficulty  and  suckled  the  Foal,  which  was  well  and  lively. 


i-Alih:  OF  MnTlli:i:  AM)  J'A'nt; /:\y.  563 

the  first  consideration.  The  body  ought  to  be  rubbed  and  dried,  and 
covered  \vith  warm  clothing ;  stimulants  must  be  given,  as  well  as  warm 
gruel  and  tepid  water  to  drink.  If  resting,  she  ought  not  to  be  dis- 
turbed ;  though,  in  the  case  of  the  larger  animals,  some  authorities 
assert  that  if  recumbent  they  ought  to  be  got  up  if  possible,  as  the 
internal  generative  organs  then  assume  their  natural  position  more 
readily.  But  unless  there  is  apprehension  of  inversion  of  the  uterus,  it 
is  generally  the  best  course  to  allow  repose. 

For  Cows  much  exhausted  in  calving,  it  has  been  recommended  to 
give  a  subcutaneous  injection  of  veratrine  (i  to  5  grammes  in  alcoholic 
solution,  1  to  25),  which  soon  rallies  them.  When,  after  delivery  has 
been  effected,  animals  remain  lying  or  are  restless,  and  apparently 
suffering  pain,  they  should  receive  soothing  medicine,  especially  opium 
or  its  tincture,  either  in  gruel  or  enema — or  morphia  subcutaneously. 

If  the  young  animal  is  alive  and  able  to  suck,  it  should  be  put  to  the 
teat ;  if  it  is  dead  or  unable  to  suck,  then  the  mother  must  have  the 
milk  taken  from  the  mammary  gland. 

Any  contusions  or  injuries  to  the  maternal  generative  organs  should 
be  attended  to  next ;  the  treatment  to  be  adopted  will  depend  on  the 
nature  and  seat  of  the  lesions,  but  it  ought  to  be  antiseptic  whenever 
possible.  This  must  also  be  the  rule  when  the  foetus  has  been  extracted 
in  a  decomposed  state  ;  the  uterine  cavity  must  be  well  syringed  out 
with  warm  water,  and  subsequently  irrigated  with  some  antiseptic 
fluid — I  have  used  pei-manganate  of  potass  with  good  results  in  these 
cases. 

With  regard  to  the  young  animal  when  it  is  extracted  alive,  the 
damage  it  has  received  should  be  ascertained  ;  this  can  be  done  when 
the  cords  are  removed.  The  slighter  injuries  are  usually  simple 
wounds  and  soon  heal ;  but  fractures  of  bones  are  more  serious,  and 
generally  necessitate  slaughter  of  the  animal.  If  looking  healthy,  yet 
it  cannot  get  up  or  stand  when  lifted  up,  this  is  in  all  probability  owing 
to  strain  of  the  limbs,  and  passes  off  in  the  course  of  a  few  days. 

When  apparently  dead,  besides  the  measures  already  mentioned  for 
this  condition,  veratrine  has  also  been  given  with  great  advantage  sub- 
cutaneously, one  or  two  centigrannnes  being  the  dose.  In  other  cases 
in  which  the  Calf  could  not  respire — though  the  heart  was  contracting 
rapidly  and  violently — it  has  been  placed  near  the  open  door,  with  the 
head  pendent,  in  order  to  send  blood  to  the  bi-ain,  while  the  limbs  were 
vigorously  rubbed  and  the  chest  compressed  and  relaxed  alternately  ; 
these  measures  not  succeeding,  a  small  quantity  of  brandy  carefully 
administered  has  produced  the  desired  effect,  and  respiration  was  soon 
established. 

Sometimes  it  happens  that  the  Calf  has  been  retained  in  the  genital 
canal  for  some  hours,  with  its  head  partially  out  of  the  vulva,  and  owing 
to  the  pressure  on  the  neck  there  is  much  swelling  of  the  head,  especially 
of  the  tongiie,  which  is  turgid  and  projects  from  the  mouth.  When 
extracted,  the  creature  can  scarcely  breathe  because  of  the  tumefied 
ton^nie,  and  asphyxia  is  imminent.  Scarifications  of  the  organ,  or 
leeches  applied  to  it,  with  turpentine  or  mustard  nabbed  on  the  limbs, 
soon  bring  relief. 


564  ACCIUEKTS  AFTER  PAliTURITIOX. 

BOOK  IV. 

ACCIDENTS  AFTEE  PAETURITION. 

The  accidents  occurring  subsequently  to  parturition  are  rather  diverse, 
and  not  infrequently  complicate  the  difficulties  already  alluded  to  as 
hindering  natural  birth.  They  may  occur  either  during  parturition, 
immediately  after  delivery,  or  within  a  few  days  subsequent  to  that 
event. 

In  addition  to  the  accidents,  there  are  diseases  which  appear  during 
the  puerperal  period ;  though  the  distinction  between  them  and  the 
former  is  not  always  easy  to  establish. 

Some  of  the  complications  just  alluded  to  may  succeed  a  perfectly 
normal  delivery,  or  an  accidental  abortion,  as  well  as  a  difficult  birth. 

The  accidents  consecutive  to  or  accompanying  parturition,  may  be 
enumerated  as  follows  :  (1)  Betentionof  tJie  fci'tal  envelopes  in  the  uterus, 
and  its  consequences ;  (2)  Post  j^di'tum  hcemorrhage  from  the  genital 
organs;  (3)  Displacement  or  hernia  of  one  or  more  of  the  internal  genital 
organs  through  the  vulva;  (4)  Traumatic  lesions  of  the  genital  or  neigh- 
bouring organs. 

Some  of  these  accidents  are  either  very  serious  in  themselves  or  in 
their  consequences,  and  require  the  greatest  skill  to  remedy ;  or  they 
are  comparatively  trifling,  and  easily  repaired. 


CHAPTEE  I. 
Retention  of  the  Fcetal  Envelopes. 

The  retention  of  the  foetal  envelopes,  placenta,  "secundines,"  or  "after- 
birth," beyond  a  certain  time  after  the  expulsion  of  the  fostus  from  the 
uterus,  must  be  looked  upon  as  an  accidental  or  pathological  condition 
which  requires  attention.  It  has  been  already  shown  that  the  placenta 
is  usually  shed  or  expelled  soon  after  the  young  creature  is  born,  and 
particularly  with  such  animals  as  the  Mare,  Sow,  and  Bitch,  the 
placenta  of  which  is  diffused  or  zonular  ;  indeed,  with  multiparous 
animals — as  the  two  latter — the  placenta  of  each  foetus  is  extruded 
soon  after  its  birth,  by  the  succeeding  foetus ;  so  that  if  retention  occurs 
at  all,  it  is  only  the  last,  or  the  two  last  placentae  which  remain  in  the 
cornua  of  the  uterus. 

With  Euminant  animals,  however,  retention  is  far  from  rare  ;  though 
even  in  them  there  is  a  difference  in  this  respect,  according  to  species 
— the  accident  being  much  more  frequent  in  the  Cow  than  in  the  Sheep 
or  Goat.  This  frequency  in  Euminant  animals  is  doubtless  due  to  the 
peculiar  formation  of  their  placentae — the  cotyledonal  arrangement  being 
evidently  opposed  to  ready  separation. 

But  if  the  Cow  is  the  animal  of  all  others  in  which  this  accident 
occurs,  it  is  also  the  one  which  appears  to  be  the  least  inconvenienced 
by  it ;  for  it  is  not  uncommon  to  see  Cows  which  four,  six,  eight,  and 
even  ten  or  twelve  days  after  parturition,  have  not  got  rid  of  the 
placenta,  and  yet  are  lively,  the  appetite  is  unimpaired,  and  they  con- 


i:t:TH.\TlUX  ny  THE  FdlTAI.  KXrh'/.n/'h'S.  565 

tinue  to  ruminate  and  give  milk  as  if  there  were  nothiu},'  amiss  ;  though 
in  some  instances  the  animal  may  stamp  with  its  hind-feet,  raise  the 
tail,  and  act  as  if  about  to  defecate  or  micturate,  while  a  small  quantity 
of  fcetid  sanious  fluid  escapes  from  the  vulva. 

Si/7n2)toin^  and  Terminations. 

The  symptoms  are  generally  so  marked  that  the  state  of  affairs  is 
readily  discovered.  Nearly  always  there  is  a  more  or  less  considerable 
mass  of  the  fdtal  envelopes — sometimes  only  the  umbilical  cord — • 
hanging  from  the  vulvar  orifice,  the  labia  of  which  are  often  swollen 
and  injected.  Occasionally  the  mass  is  so  large  as  to  reach  below  the 
hocks,  with  little  bags  of  liquor  amnii  at  the  lower  end  ;  it  has,  if 
recently  expelled,  a  fresh  tint,  not  unlike  that  of  the  intestines  ;  but  if 
exposed  for  some  time,  and  especially  in  summer,  it  is  greyish-coloured, 
somewhat  adhesive,  and  generally  soiled  by  fyeces  or  litter. 

In  other  cases  nothing  is  noticeable,  except  when  the  animal  is  lying 
on  its  abdomen  ;  then  the  pressure  on  the  uterus  pushes  the  cervix  into 
the  vagina,  and  if  any  portion  of  the  membranes  is  through  the  os,  of 
course  it  is  visible.  In  others,  again,  nothing  whatever  is  to  be  seen 
whether  the  creature  is  lying  or  standing,  the  whole  nuxss  being  retained 
in  the  uterus.  After  the  third  day  of  delivery,  the  os  is  usually  closed  ; 
and  unless  a  portion  of  the  membranes  chanced  to  be  in  the  vagina 
before  this  period,  the  entire  placenta  is  imprisoned  in  the  uterus,  and 
a  manual  exploration  will  not  always  discover  it.  Sometimes  only  a 
fragment  of  the  membranes  is  so  retained. 

It  has  been  mentioned  that  in  many  cases  the  animal  does  not  evince 
any  uneasiness  at  first ;  sometimes  when  the  portion  of  placenta  hang 
ing  outside  the  vulva  is  large  and  heavy  and  the  creature  is  standing, 
the  meatus  mnnarius  is  pressed  upon,  and  micturition  is  rendered  diffi- 
cult. There  may  also  be  symptoms  of  abdominal  pain — whisking  the 
tail,  stamping  with  the  feet,  and  nuiking  efforts  as  if  to  defecate  or 
micturate,  with  slight  and  brief  uterine  contractions,  which  may  eventu- 
ally lead  to  the  expulsion  of  the  placenta. 

It  often  happens  that  when  the  os  is  not  completely  closed,  owing  to 
a  portion  of  the  membranes  lying  in  it,  spontaneous  expulsion  takes 
place  after  a  variable  period. 

Deneubourg  asserts  that  it  occurs  at  fixed  intervals,  which  are  almost 
regular  "  tertiary  periods";  tiiat  is,  if  expulsion  does  not  ensue  in  the 
first  twenty-four  hours,  it  should  take  j)lace  on  the  third  day  ;  and  if 
not  then,  it  will  be  either  on  the  sixth,  ninth,  twelfth,  fifteenth,  or  other 
tertiary  interval — but  most  frequently  on  the  ninth  day.  How  far  this 
assertion  may  be  correct,  experience  can  alone  decide ;  what  is  more  to 
the  point  is  the  fact,  that  when  once  this  spontaneous  expulsion  has 
been  elTected  tliere  is  little  to  be  apprehended. 

It  is  not  so  if  retention  be  accompanied  by  decomposition  of  the  mem- 
branes. This  occurs  when  the  air  has  access  to  them  ;  and  all  the 
more  rapidly  does  putrefaction  progress  if  the  temperature  is  high,  and 
they  are  impregnated  with  discharges. 

The  odour  is  most  repulsive,  and  a  sanious  brown-tinted  discharge, 
composed  of  debris  of  the  membranes  and  secretions  from  the  irritated 
mucous  lining  of  the  genital  canal,  fiow  from  the  vulva — soiling  it,  the 
tail,  thighs,  and  hocks,  and  often  excoriating  them.  This  discharge  is 
most  abundant  when  the  animal  extends  itself  to  micturate,  and  it  is 


566  ACCIDENTS  AFTER  FARTURITION. 

then  horribly  foetid.     The  hand,  on  being  passed  into  the  vagina,  is 
covered  with  the  fluid,  and  it  may  encounter  shreds  of  the  placenta. 

In  such  cases  the  health  of  the  animal  often  suffers  ;  there  is  dulness, 
prostration,  diminution  in  the  secretion  of  milk,  decreased  appetite, 
respiration  perhaps  quickened,  temperature  increased,  and  other  indica- 
tions of  illness. 

The  complications  from  placental  retention  are  somewhat  numerous. 
Contact  with  the  decomposing  membranes  may  so  irritate  the  interior 
of  the  uterus  as  to  occasion  metritis,  or  even  metro-peritonitis — a  con- 
dition which  is  always  serious,  and  often  fatal.  There  is  also  risk  of 
septicaemia  ;  and  even  under  the  most  favourable  circumstances  there 
sometimes  remains  a  local  irritation — a  chronic  vaginitis  or  metritis 
that  leads  to  leucorrhoea. 

Some  authorities  have  observed  trismus,  tetanus,  metastatic  arthritis, 
and  chest  affections,  as  seqiidcn  of  placental  retention. 

There  is  no  danger  when  the  retention  has  only  lasted  for  two  or 
three  days,  particularly  if  a  large  portion  of  the  membranes  protrudes 
beyond  the  vulva,  and  it  has  a  fresh  tint.  Attention  is  necessary,  how- 
ever, when  the  placenta  begins  to  putrefy,  and  a  fetid  discharge  com- 
mences from  the  vulva  ;  though  even  so  late  as  fifteen  days  after 
parturition  the  membranes  may  be  expelled  spontaneously,  without  any 
injury  occurring  from  the  prolonged  retention.  But  the  case  is  serious 
when  the  animal  begins  to  show  symptoms  of  general  illness,  and  par- 
ticularly if  no  portion  of  the  placenta  can  be  seen  or  the  os  be  occluded. 
Plastic  adhesion  of  the  placenta  to  the  uterus  is  also  a  grave  complica- 
tion, though  happily  rare. 

In  these  instances,  the  animal  gradually  becomes  listless,  weak,  and 
emaciated,  loses  its  appetite  and  ceases  to  yield  milk,  until  at  length  it 
falls  into  a  state  of  marasmus,  and  perishes  from  septica3mia.  Or  in 
more  rapid  cases,  with  these  general  symptoms  the  lining  membrane  of 
the  vagina  is  of  a  deep-red  colour  and  intensely  hot,  a  fetid  sanguineo- 
purulent  discharge  escapes  from  the  vulva  ;  there  are  tremblings  over 
the  whole  body,  hurried  respiration,  intense  fever,  and  all  the  other 
signs  of  metritis. 

Though  retention  is  not,  in  the  majority  of  cases  in  the  Cow,  a  very 
serious  affair,  yet  it  should  be  attended  to  even  in  this  animal.  With 
other  creatures  it  is  much  more  to  be  dreaded,  as  they  incur  greater 
risks  from  prolonged  retention. 

Saint-Cyr  mentions  the  case  of  a  fine  Mare  which  died  in  less  than 
eight  days  from  metritis,  due  to  the  foetal  membranes  being  retained ; 
though  the  cause  was  not  ascertained  in  time. 

Causes. 

Eetention  occurs  most  frequently  in  cases  of  abortion,  or  when  birth 
takes  place  some  days  before  the  proper  time.  It  has  been  remarked 
that  a  Cow  which  retained  its  placenta  unusually  long  after  the  birth 
of  its  first  Calf,  will  do  so  at  every  succeeding  parturition.  A  pro- 
tracted and  laborious  birth  is  also  said  by  some  authorities  to  favour 
retention,  while  others  declare  that  the  converse  is  true.  The  accident 
is  stated  to  be  more  frequent  with  old  Cows,  and  especially  when  these 
are  employed  in  draught — as  in  France  and  other  countries.  Abnormal 
adhesion  between  the  maternal  and  foetal  placentae  would,  of  course,  be 
a  sure  cause  of  prolonged  retention,  and  we  have  given  instances  of 


RET  EXT  mx  OF  THE  J'WTJL  EXVELOPES.  567 

such  adhesion  ;  indeed,  every  obstetrist  knows  that  at  times  there  is 
much  difficulty  in  disuniting  the  cotyledons  in  the  uterus. 

When  the  cervix  uteri  contracts  rapidly  after  delivery,  and  the  os  is 
consetjuently  iirmly  closed,  the  placenta,  though  non-adherent,  will  be 
retained. 

Rueff  mentions  that  the  accident  is  especially  frequent  in  certain 
years  when  the  herbage  and  forage  is  not  good,  and  particularly  when 
the  latter  is  mouldy  ;  it  has  long  been  known  that  these  conditions 
favour  abortion.  He  also  alludes  to  a  popular  belief  in  Germany,  which 
attributes  this  Zuriickhleihen  der  Nachcychurt,  as  it  is  termed,  to  allow- 
ing the  Calf  to  take  the  teat  before  the  placenta  has  been  expelled ;  the 
irritation  of  the  udder  so  produced  reacts  sympathetically  on  the  uterus, 
which  contracts  at  the  cervix,  and  so  retains  the  membranes. 

According  to  Baumoister,  milking  too  soon,  or  giving  cold  water  to 
drink,  is  supposed  to  act  in  the  same  way. 

Numerous  other  causes  have  been  mentioned  as  influencing  this  reten- 
tion ;  but  they  need  not  be  noticed,  as  there  is  really  no  proof  that  they 
do  operate  in  this  way.  The  accident  occurs  under  all  systems  of 
management,  and  all  kinds  of  conditions  ;  it  is,  therefore,  probable  that 
several  causes  may  produce  it,  and  that  some  of  them  are  still  obscure. 

Treat  rnent. 

The  treatment  of  placental  retention  appears  always  to  have  been  a 
subject  on  which  diverse  views  and  opinions  have  been  held ;  many 
obstetrists  maintaining  that — with  the  Cow  more  particularly- -this 
retention  is  never  dangerous  in  itself,  and  that,  unless  there  arise  com- 
plications, the  removal  of  the  fcttal  membranes  should  in  every  case 
be  left  to  the  efforts  of  Nature  ;  while  others  assert  that  there  is  great 
risk  in  this  retention,  and  that  when  it  has  exceeded  two  or  three 
days  after  the  birth  of  the  fcetus  there  is  need  for  active  interven- 
tion. The  experience  of  the  majority  of  obstetrists  will  negative  both 
of  these  opinions  ;  for  it  is  a  matter  of  almost  daily  observation,  that  in 
many  instances  the  placenta  remains  without  inconvenience  in  the 
uterus  for  several  days — six  or  eight — before  it  is  spontaneously  ex- 
pelled ;  while  in  other  cases  retention  for  the  same  period  is  marked  by 
more  or  less  serious  symptoms.  This  dilTerence  undoubtedly  depends 
upon  circumstances,  the  precise  nature  of  which  cannot  always  be  fully 
ascertained.  Nor  can  positive  rules  be  laid  down  as  to  when  it  is 
time  to  interfere,  or  when  abstention  is  the  prudent  course: — this 
can  only  be  learned  by  individual  experience  and  the  tact  of  the 
practitioner. 

It  may  be  remarked,  however,  that  when  parturition  has  been  normal, 
when  the  Cow  does  not  appear  to  suffer  pain  or  inconvenience,  when 
the  "  straining"  is  unfrequent  and  slight,  the  appetite  good  and  lacta- 
tion established,  and  particularly  when,  during  a  low  or  moderate 
temperature  a  portion  of  the  membranes  protrude  beyond  the  vulva, 
then  there  is  no  great  reason  for  interference  until  a  week,  or  even  more, 
has  elapsed. 

But  if,  on  the  contrary,  the  external  temperature  is  high,  if  the  labour 
has  been  difficult,  the  genital  organs  irritated  or  abraded,  and  if  fever, 
restlessness,  and  suffering  are  noted,  with  strong  and  frequent  strain- 
ing, especially  if  there  are  foul-smelling  discharges  from  the  vagina,  then 
intervention  is  called  for,  no  matter  whether  the  time  which  has  elapsed 
since  parturition  is  long  or  short. 


568  ACCIDENT  a  AFTER  PARTURITION. 

When  the  envelopes  form  a  somewhat  large  mass  hanging  from  the 
vulva,  it  may  be  anticipated  that  early  and  spontaneous  removal  will 
take  place  ;  though  it  sometimes  happens,  as  has  been  pointed  out,  that 
the  weight  of  the  pendulous  portion  causes  inconvenience  in  micturition; 
while  it  fatigues  and  pains  the  animal  by  dragging  on  the  uterus,  and 
induces  expulsive,  but  futile  efforts.  Schaack  has  shown  that  in  nearly 
all  these  cases  it  will  be  found  that  a  loop  of  the  membranes  has  become 
twisted  around  the  pedicle  of  some  large  uterine  cotyledon  ;  and  as  this 
is  the  obstacle  to  separation,  it  is  necessary  to  release  the  loop  as  soon 
as  possible,  in  order  to  prevent  accidents. 

It  has  also  been  remarked  that,  even  when  birth  has  been  easy  and 
favourable,  primiparaj  are  often  irritable  and  impatient,  the  presence 
of  the  secundines  in  the  vagina  and  vulva  increasing  the  restlessness, 
and  occasioning  frequent  and  energetic  uterine  contractions.  In  such 
cases  it  will  generally  be  found  judicious  to  remove  the  membranes  as 
soon  as  possible — on  the  same  day,  or  the  day  succeeding  delivery,  if 
necessary. 

If  after  the  birth  of  the  foetus  nothing  is  seen  at  the  vulva  except  a 
thin  cord,  formed  solely  by  the  umbilical  vessels,  it  is  almost  cer- 
tain that  there  is  strong  adhesion  between  the  maternal  and  foetal 
placentae,  and  that  the  separation  of  the  latter  will  be  protracted — in  all 
likelihood  require  to  be  removed  artificially.  But  even  in  such  a  case 
there  is  no  occasion  for  immediate  interference  ;  on  the  contrary,  it  is 
more  judicious  to  wait,  and  allow  time  for  the  placentae  to  soften  and 
the  adhesions  between  them  to  diminish,  though  the  opportunity  for 
complete  detachment  must  not  be  overlooked. 

When  nothing  whatever  is  discernible  externally,  there  is  reason  to 
surmise  that  the  placenta  is  completely  retained.  But  even  in  this  case 
there  is  no  need  to  resort  at  once  to  its  removal ;  though  it  may  be 
necessary,  in  order  to  prevent  imprisonment  for  some  time,  through  the 
closure  of  the  os  uteri,  to  introduce  the  hand  into  the  uterus,  and  if  it 
is  already  partially  detached,  to  extract  it.  If  it  remains  firmly 
adherent,  however,  it  is  better  to  gather  as  much  as  can  be  seized  into 
a  single  mass,  carry  it  through  the  os  into  the  vagina,  and  tying  it  there 
by  a  long  piece  of  cord,  to  leave  the  latter  hanging  outside  the  vulva. 
This  prevents  the  os  from  closing,  while  the  cord  will  assist  in  effecting 
artificial  removal  at  a  later  period,  should  such  be  required. 

Certain  medicaments,  more  or  less  of  the  nature  of  emmenagogues — 
such  as  rue,  savin,  laurel,  stramonium,  carbonate  of  potass,  etc. — have 
been  for  a  long  time  credited  with  the  power  of  hastening  the  expulsion 
of  the  placenta  ;  and  their  administration  has  been  recommended  before 
resorting  to  manual  force.  Some  of  the  recipes  for  these  potions  are 
very  antiquated,  and  others  are  quite  modern,  and  lauded  by  the  highest 
authorities. 

Zundel,  for  instance,  extols  laurel  berries,  and  gives  the  following 
recipe  : 

Laurel  berries  -----     120  grammes. 

Aniseed    ------       60         „ 

Bicarbonate  of  soda  -         -         -     120         ,, 

These  are  infused  in  4  litres  of  water,  and  given  in  two  doses.  It 
may  be  repeated  the  following  day ;  but,  as  a  rule,  the  membranes  are 
expelled  within  twenty-four  hours  after  the  last  dose  has  been  given. 
Zundel  asserts  that  this  infusion  has  rendered  excellent  service,  sue- 


80 


litlTKXTlnX  itF  THE  FiKT.II.   KM' Kl.orES.  569 

ceeding  in  GO  per  cent,  of  his  cases  of  retention.  Ilering  and  Stock- 
tleth  also  speak  highly  in  its  favour,  and  assert  tliat  it  is  always 
successful,  provided  tliere  is  no  mechanical  obstacle  to  exjnilsion. 
Baunieister  and  Kuefl"  recommend  potass  carbonate  in  the  dose  of 
4o  grammes  daily,  at  three  times,  in  an  infusion  of  chamomile  or 
savin.  Hummer  prescribes  90  gramme  doses  for  three  consecutive  days, 
and  Ilertwig,  Lund,  and  others  also  prescribe  it  with  the  same  object. 
Hering  gives  the  following  formula  : 

Carbonate  of  potass   -         -         -         -     15  grammes. 
Savin  leaves       -         -         -         -         -     30         ,, 

These  are  infused  in  500  grammes  of  water,  filtered,  and  administered 
tepid.     The  dose  to  be  repeated  every  six  hours. 

Garreau  lauds  Caramija's  uterine  tincture,  which  he  states  always 
succeeds  in  producing  expulsion  of  the  membranes,  even  when  they  have 
been  retained  for  two  months  after  parturition. 

The  formula  for  this  tincture  is  given  by  Tabourin  as  follows : 

Powdered  savin        .         .         -         .     050  grammes. 

Treacle 190 

Powdered  cumin      -         -         -         -     125         ,, 

Essence  of  rue     '1   . . 
•       aa 
,,       ,,       savui  I 

Alcohol    ------         2  kilogrannnes. 

Garreau  prescribes  this  tincture  in  doses  of  100  grammes,  given  in 
2  litres  of  savin  infusion. 

Cruzel  has  his  favourite  potion,  composed  of  30  to  40  grammes  of 
green  rue,  or  10  grammes  of  ergot  of  rye  and  20  grammes  of  powdered 
savin,  made  into  a  decoction  in  a  litre  and  a  half  of  water.  Delwart, 
Kainard,  and  Schrader  recommend  ergot  of  r}'e,  and  Ungefrohrn  stra- 
monium seeds  (30  grammes  in  two  litres  of  water),  which  he  believes 
to  be  specific  in  their  action  ;  he  advises  that  linseed  decoction  be  given 
in  the  intervals,  as  it  acts  as  a  diuretic,  and  Rychner  asserts  that  tiiis 
simple  medication  is  particularly  useful  when  the  fu-tal  membranes  are 
so  decomposed  that  they  cannot  be  removed  by  the  hand. 

The  subcutaneous  injection  of  ergotine,  or  ergot  of  rye,  has  also  been 
advised.  l^xtract  of  ergot  of  rye,  1  to  3  grammes,  dissolved  in 
glycerine  and  spirits  of  wine  (15  grammes  of  each),  has  been  used 
for  injection. 

Though  medication  lias  been  so  highly  vaunted  by  some  authorities, 
yet  some  others  have  not  mucli  faith  in  it.  Deneubourg  thinks  its  chief 
advantage  lies  in  inducing  the  owner  of  the  animal  to  exercise  patience 
until  spontaneous  expulsion  is  effected,  the  least  active  measures  being 
the  best.  Other  obstetrists  entertain  the  same  opinion  of  these 
emmenagogues. 

For  a  very  long  time,  an  empirical  mode  of  removing  the  placenta 
when  a  part  of  it  protruded  beyond  the  vulva,  was  to  exercise  slight  and 
continuous  traction  on  it  by  attaching  a  weight  to  the  pendulous  por- 
tion :  in  France  the  farmers  attach  a  sabot  filled  with  gravel  Favre 
of  Geneva,  who  notices  this  rude  method,  admits  that  a  weight  not 
exceeding  two  pounds  may  be  suspended  from  the  membranes,  which 
are  collected  into  a  mass  and  tied  with  a  piece  of  hemp.  This  method 
is,  however,  objectionable  from  several  points  of  view. 

Manual  traction  is  often  employed  when  a  portion  of  the  membranes 


570  ACCIDENTS  AFTER  PARTURITION. 

is  visible.  This  is  seized  either  by  the  hands,  or  by  means  of  a  towel, 
or  wisp  of  hay  or  straw,  and  gently  pulled  at — particularly  when  the 
animal  strains — twisting  it  at  the  same  time,  until  the  whole  mass  is 
removed  from  the  uterine  cavity. 

This  traction  is  not  likely  to  be  productive  of  much  injury  to  the 
Mare,  Sow,  or  Bitch,  as  the  adhesion  of  the  placenta  is  not  great,  and 
is  usually  limited  to  a  few  points  ;  it  is,  therefore,  as  a  rule,  generally 
and  quickly  successful  in  these  animals. 

With  the  Cow,  however,  it  is  not  so,  owing  to  the  numerous  and  often 
strong  attachments  of  the  placenta,  and  its  fragile  texture,  which  renders 
it  easily  torn  if  too  much  force  be  employed;  if  it  does  not  give  way,  and 
the  traction  is  immoderate,  then  there  is  risk  of  irritating  the  uterus, 
tearing  away  the  cotyledons,  or  producing  partial  or  complete  inversion 
of  the  cornua,  or  even  of  the  entire  organ.  Should  the  placenta  give 
way,  this  may  lead  to  greater  difficulty  in  removing  what  is  left  of  it  in 
the  uterus. 

For  these  reasons,  some  practitioners  discountenance  this  mode  of 
abstracting  the  placenta  ;  but  there  can  be  no  doubt  that  if  the  traction 
is  moderate  and  judicious,  the  membranes  not  very  adherent  to  the 
interior  of  the  uterus,  and  a  good  part  of  them  beyond  the  os,  the 
operation  is  quite  justifiable  and  will  be  successful.  When,  however, 
the  resistance  is  marked,  or  the  membranes  begin  to  tear,  it  is  better 
to  desist. 

Deneubourg  recommends  the  following  method,  as  better  than  em- 
ploying the  hands  :  The  protruding  umbilical  cord  is  seized  between 
two  pieces  of  wood,  the  length  and  size  of  an  ordinary  walking-stick, 
and  rolled  round  them  until  they  are  close  to  the  vulva ;  there,  by  a 
slight  and  gentle  circular  movement,  the  portion  engaged  in  the  vagina 
produces  a  kind  of  titillation  which  induces  the  animal  to  stretch  as 
in  micturition — an  act  it  nearly  always  accomplishes,  and  during  this 
period  the  membranes  are  rolled  round  the  pieces  of  wood  as  they  are 
detached,  which  usually  occurs  in  about  six  days,  when  the  whole  is 
removed.  When  resistance  is  experienced,  and  anything  is  found  to 
tear  or  rend,  it  is  evident  that  adhesions  still  exist,  and  the  rolling 
must  cease ;  but  then,  by  a  kind  of  jerking  movement  from  side  to 
side,  there  is  communicated  to  the  uterus  a  series  of  shakes  more  or 
less  energetic,  according  to  the  state  of  the  organ.  Deneubourg  says 
that  there  need  be  no  hesitation  in  employing  a  certain  amount  of 
force  in  practising  these  movements :  "  We  may  act  strongly,  but 
gently."     Great  success  is  said  to  have  attended  this  method. 

But,  after  all,  it  is  doubtful  whether  the  more  scientific  and  surgical, 
if  old  plan — that  of  direct  extraction  by  enucleation  of  the  cotyledons 
— is  not  preferable.  This  method  consists  in  passing  the  hand  into 
the  uterus,  and  detaching  or  enucleating  the  cotyledons,  one  by  one, 
so  as  to  destroy  the  adhesions  between  the  maternal  organ  and  the 
foetal  envelopes,  when  the  latter  can  be  taken  away. 

When  this  extraction  should  take  place  will  depend  upon  circum- 
stances. It  will  generally  be  found  that  it  will  not  be  successful  before 
the  third  day,  as  the  cotyledons  are  too  closely  and  firmly  united  to 
allow  their  disunion  without  injurious  force,  which  may  bring  about 
inversion  of  the  uterus,  or  laceration  of  the  maternal  cotyledons,  and 
consequent  haemorrhage.  About  the  third  day  is  generally  a  favourable 
period,  as  the  cervix  is  still  sufficiently  relaxed  to  pass  the  hand  through 
the  OS  into  the  uterus:    while  disintegration  between  the  foetal  and 


JiETKXTIOX  OF  TIIK  FU-ITAL  EM'KLoI'KS.  571 

maternal  placenttc  has  advanced  sufficiently  to  permit  the  hand  to  com- 
plete the  disunion  without  need  for  violence.  It  sometimes  happens, 
however,  that  extraction  can  be  elTected  so  late  as  the  fifth  or  eighth 
day  after  delivery  ;  but  then  the  membranes  are  extremely  friable,  and 
will  scarcely  withstand  any  degree  of  traction.  Besides,  the  operator 
himself  incurs  great  risk  of  infection,  either  local  or  general,  from  the 
absorption  of  the  putrid  matters  in  the  uterus  by  the  skin  of  the  hand 
and  arm. 

An  assistant  holds  the  tail  of  the  animal  to  one  side,  and  the  hand 
and  arm,  well  oiled,  are  passed  into  the  vagina;  if  a  portion  of  the 
membranes  is  in  tiiis  canal,  then  the  operation  is  not  so  dilVicult,  as  the 
OS  will  probably  be  more  or  less  relaxed,  and  this  portion  lying  towards 
the  palm  of  the  hand — the  back  of  which  is  upwards — serves  as  a 
guide ;  while  the  left  hand  pulls  at  it  gently,  as  occasion  requires. 
When,  however,  nothing  of  the  envelopes  is  to  be  found  outside  the 
OS,  and  that  opening  is  firmly  closed — as  happens  four  or  six  days  after 
birth — then  it  may  be  very  difficult  to  reach  the  interior  of  the  uterus. 
One  finger  must  be  at  first  introduced,  then  two,  three,  and  so  on, 
until  the  hand  in  the  form  of  a  cone,  and  by  a  semi-rotatory  motion, 
can  be  passed  through.  This  operation  is  often  long,  troublesome,  and 
fatiguing,  and  requires  to  be  carefully  managed,  so  as  not  to  bruise, 
irritate,  or  wound  the  organ. 

When  the  hand  reaches  the  interior  of  the  uterus,  it  is  pressed 
forward  between  the  mucous  membrane  of  the  latter  and  the  chorion — 
the  palm  towards  the  latter — separating  them  as  it  advances  until  it 
meets  with  the  cotyledons.  Some  of  these— the  maternal— may  be 
detached  from  the  membranes,  while  others  are  still  imbedded  in  them, 
as  it  were,  through  their  foetal  cotyledons.  These  last  have  to  be 
enucleated ;  and  to  effect  this,  the  cotyledon  is  gently  pressed  at  its 
base  between  the  thumb  and  index  finger,  and,  if  necessary,  the  fingers 
are  moved  over  each  other  as  if  removing  a  button  from  its  buttonhole. 
Other  practitioners  make  pressure  on  the  summit  of  the  cotyledon  by 
the  three  first  fingers,  and  thus  destroy  the  adhesion.  In  this  manner 
the  hand  passes  from  one  cotyledon  to  another,  efTecting  disunion  as 
rapidly,  yet  carefully,  as  possible.  At  times  a  cotyledon  will  be  met 
with  which  adheres  so  very  firmly  that  it  cannot  be  detached  in  the 
way  just  mentioned.  Then  the  nail  of  the  thumb  or  other  finger  must 
be  gently  insinuated  at  the  border,  so  as  to  gradually  raise  it,  and  pass 
the  finger  over  its  entire  surface. 

The  tediousness  of  the  operation  will  be  inferred  when  it  is  known 
that  the  number  of  adherent  cotyledons  may  sometimes  amount  to 
more  than  a  hundred  ;  and  the  fatigue  is  often  so  great  that  the  right 
and  left  hand  have  to  be  employed  alternately — a  circumstance  which 
has  advantages  otherwise. 

When  a  certain  number  of  cotyledons  are  detached,  the  portion  of 
envelopes  so  released  is  carried  into  the  vagina  and  beyond  the  vulva, 
where  the  other  hand,  or  an  assistant,  seizes  and  pulls  gently  on  it. 
As  the  bulk  of  this  increases  by  the  detachment  of  more  cotyledons, 
the  pulling  must  cease,  and  the  mass  will  require  to  be  supported  so 
as  to  prevent  tearing  the  membranes,  or  painful  dragging  on  the  fundus 
of  the  uterus. 

As  the  hand  reaches  the  cornua  the  cotyledons  increase,  and  it 
becomes  difficult  to  reach  them — particularly  the  cornu  in  which  the 
hind-limbs  of  the  Calf  were  lodged,  because  of  the  insufficient  length 


572  ACCWEXTS  AFTER  PAIiTCrJTIOX. 

of  the  arm.  Moderate  traction,  however,  on  the  part  just  detached 
will  bring  the  others  nearer,  and  facilitate  the  task ;  but  the  traction 
must  be  judiciously  managed,  so  as  to  avoid  tearing  the  membranes  or 
the  adherent  cotyledons,  invagination  of  the  cornu,  or  even  inversion 
of  the  uterus.  So  likely  is  this  accident  to  happen,  that  some  practi- 
tioners, instead  of  pulling  at  the  membranes  in  this  way  in  order  to 
disunite  the  most  distant  cotyledons,  are  content  to  await  their  natural 
separation,  merely  tying  near  the  vulva  the  portion  of  the  membranes 
separated,  and  cutting  away  the  parts  beyond — the  separation  generally 
occurring  in  from  two  to  five  days.  To  facilitate  traction,  Gunther 
recommends  that  the  abdomen  of  the  animal  should  be  well  raised  by 
a  plank  placed  under  it,  and  held  by  assistants. 

It  has  sometimes  been  found,  as  already  mentioned,  that  the  greater 
part  of  the  membranes  has  been  expelled,  when  all  at  once  expulsion 
ceased,  notwithstanding  the  volume  and  weight  of  the  pendulous  mass, 
which  caused  so  much  disturbance  to  the  animal  that  it  has  refused  to 
eat,  persisted  in  lying,  and  when  compelled  to  get  up  has  kept  stamping 
its  hind-feet  until  it  could  lie  dow^n  again.  On  introducing  the  hand 
into  the  uterus,  it  is  discovered  that  this  unusual  interruption  to  the 
expulsion  has  been  occasioned  by  one  or  two  large  maternal  cotyledons 
becoming  entangled  in  the  loop  of  a  fold  of  the  membranes.  Sometimes 
the  drag  on  these  cotyledons  has  been  so  great  that  they  have  been 
brought  as  far  as,  or  even  beyond,  the  os.  Eelief  has  been  given  by 
cutting  the  membranes  off  by  scissors,  close  to  the  vulva,  and  then 
releasing  the  cotyledons. 

When  extraction  of  the  membranes  has  been  properly  conducted, 
there  is  no  haemorrhage ;  if  bleeding  ensues,  then  one  or  more  of  the 
maternal  cotyledons  have  been  injured,  or  perhaps  torn  off  altogether 
— an  accident  not  without  danger  sometimes,  and  all  the  more  serious 
if  a  number  of  the  cotyledons  is  involved.  This  injury  may  lead,  in 
addition  to  haemorrhage,  to  uterine  irritation,  metritis,  or  uterine 
phlebitis. 

Still,  such  an  untoward  accident  is  not  always  the  result  of  injury 
to  the  cotyledons,  as  instances  are  recorded  in  which  great  numbers, 
or  even  the  whole  of  the  maternal  placentae,  have  been  torn  away  by 
ignorant  empirics,  and  yet  the  animals  have  survived  ;  at  the  commence- 
ment of  this  work  it  has  been  shown  that  fecundation  and  gestation 
may  even  take  place  after  ablation  of  the  cotyledons.  Nevertheless, 
these  cases  must  be  looked  upon  as  entirely  exceptional,  and  should  not 
be  relied  upon  as  evidence  that  these  bodies  can  be  injured  with 
impunity. 

The  disaggregation  of  the  placentae  has  been,  in  some  instances, 
greatly  facilitated  by  injecting  into  the  vagina,  os,  and  uterus  a  small 
quantity  (1  to  2  drachms)  of  tincture  of  veratrin  (1  to  25),  which 
produces  continuous  expulsive  efforts,  and  in  a  few  hours  slight  traction 
will  remove  the  membranes.  With  the  same  object,  some  practitioners 
have  successfully  injected  a  quantity  of  warm  water  into  the  uterine 
cavity. 

In  order  to  be  assured  that  the  whole  of  the  foetal  envelopes  has 
been  removed  from  the  uterus,  it  is  well  to  make  an  examination  of 
them.  Knowing  their  formation  and  extent,  there  should  be  no  diffi- 
culty in  ascertaining  whether  they  are  all  present. 

After  the  removal  of  the  membranes,  there  remains  in  the  uterus  a 
quantity  of  thick,  grumous,  diversely-coloured,  and  more  or  less  un- 


RETEyrioX  i>r  tIIK  /WT.IL  H.WHI.nl'KS.  [.78 

pleasant-smelling  liquid,  which  is  derived  from  the  fu'tal  fluids,  the 
blood  that  has  escaped  from  the  umbilical  cord,  and  tlie  partly- 
decomposed  envelopes.  As  its  retention  is  likely  to  do  liarm,  par- 
ticularly if  there  is  any  wound  or  abrasion  of  the  mucous  membrane, 
as  nmch  as  possible  of  it  should  be  removed  by  the  half-closed  hand. 
It  is  often  advisable  to  wash  out  the  interior  of  the  organ  with  tepid 
water,  and  to  inject  a  weak  solution  of  cresyl,  carbolic  acid,  chloral, 
or  permanganate  of  potass. 

When  extraction  of  the  envelopes  has  been  effected  in  good  time 
and  with  the  necessary  precautions,  the  Cow  bears  the  operation  very 
well  and  does  not  appear  to  be  much  inconvenienced,  so  that  little 
after-treatment  is  needed.  Gentle  walking,  if  the  weather  is  fme,  in 
order  to  calm  its  restlessness  and  to  allay  the  straining,  if  it  is  still 
present ;  keejjing  it  in  a  well-lighted  and  properly  ventilated  stable, 
with  a  blanket  over  the  body  if  the  temperature  is  low  ;  a  few  enemas, 
if  constipation  tlireatens  ;  and  a  light  laxative  diet,  with  bran,  oatmeal, 
or  linseed  gruel,  are  usually  all  that  is  necessary. 

When  the  envelopes  have  putrefied  in  the  uterus,  through  delay  in 
removing  them,  and  an  abundant  and  fetid  discharge  flows  from  the 
vulva,  the  animal  itself  being  unwell  and  feverish,  then  the  case  is 
serious,  and  requires  instant  attention.  The  uterus  must  be  cleared 
without  delay  from  its  putrescent  contents,  and  in  order  to  accomplish 
this  the  hand  must  be  passed  into  the  organ,  and  everything  removed 
which  it  can  possibly  seize.  Before  doing  so,  however,  the  hand  and 
arm  should  be  well  and  frequently  smeared  with  carbolised  lard,  butter, 
or  oil,  to  prevent  septic  infection  ;  if  there  are  wounds  or  abrasions 
upon  them,  the  greatest  care  should  be  taken  in  this  respect — indeed, 
it  is  questionable  whether  they  should  be  introduced  at  all  if  the  skin 
is  not  intact. 

When  everything  has  been  taken  away  which  the  hand  can  remove, 
then  the  interior  of  the  organ  should  be  thoroughly  cleansed  by  the 
continuous  injection  of  tepid  water  from  a  large  syringe  and  tube,  until 
the  fluid  comes  away  perfectly  clear. 

Very  weak  solutions  of  the  before-mentioned  antiputrescents  should 
also  be  injected,  but  they  need  not  be  allowed  to  remain.  Should  the 
discharge  continue,  this  treatment  may  be  repeated  daily  until  it  ceases  ; 
and  tonics,  stimulants,  and  antiputrescents  (as  sodium  sulphite  or  small 
doses  of  carbolic  acid)  be  administered  internally.  Good  food  and  clean- 
liness are  also  essentials  in  treatment. 

It  must  be  remembered  that  cleansing  and  detergent  injections  are 
absolutely  required  when  the  mucous  membrane  of  the  vagina  or 
uterus  is  inflamed,  abraded,  or  wounded,  and  has  been  in  contact  with 
putrid  membranes  or  fluids.  More  particularly  are  they  necessary 
when  this  occurs  in  the  Mare — an  animal  peculiarly  liable  to  septic 
infection.  Indeed,  so  much  is  this  the  case,  that  it  may  be  laid  down 
as  a  rule  that  manual  extraction  of  the  membranes  is  always  indicated 
in  the  Mare,  when  they  are  not  expelled  immediately  after  birth.  The 
injection  of  warm  water  will  materially  facilitate  the  operation. 

With  this  animal,  however,  retention  of  the  placenta  does  not  in- 
variably lead  to  serious  results,  as  several  cases  are  on  record  in  which 
it  has  continued  for  two  days,  and  even  longer.  Binz  mentions  an 
instance  in  which  the  membranes  were  not  thrown  off  until  the  ninth 
day,  owing  to  adhesion  of  the  uterus  to  a  hernial  sac. 

The  hands  and  arms  of  the  operator  should  be  thoroughly  washed 


574  ACCIUEXTS  AFTER  PARTUFJTIOX. 

as  soon  as  possible  after  the  uterus  has  been  emptied ;  for  this  purpose 
nothing  is  better  than  carbohsed  soap.  On  the  shghtest  sensation  of 
uneasiness  in  the  arm,  advice  should  be  taken  with  regard  to  it,  as  an 
attack  of  Ecthyma  joarturitionis  is  often  a  serious  affair,  and  has 
necessitated  the  amputation  of  fingers,  and  even  the  greater  portion  of 
the  arm. 

So  dangerous  and  unpleasant,  indeed,  is  the  removal  of  a  putrid 
placenta  (the  odour  being  often  most  sickening),  that  disinfection  by 
intra-uterine  injections  of  solution  of  cresyl,  carbolic  acid  (2  per  cent.), 
boric  acid,  corrosive  sublimate  (1  to  2,000),  etc.,  is  regularly  practised 
by  some  veterinary  surgeons.  The  interior  of  the  uterus  is  first  vrashed 
out  with  warm  water  by  means  of  a  powerful  syringe,  or  a  long  india- 
rubber  tube  to  which  a  funnel  is  attached,  and  into  which  the  water 
is  poured.  The  injection  is  continued  until  the  water  that  comes  away 
from  the  vagina  is  colourless  and  odourless ;  then  the  disinfectant  can 
be  thrown  into  the  uterus,  and  the  arm  introduced  to  remove  the 
placenta.  But  the  latter  measure  is  rarely  necessary,  as  the  injections 
generally  suffice  to  detach  it. 

As  the  practitioner  is  also  exposed  to  septic  infection  b}^  inhalation, 
and  as  this  has  occurred  most  frequently  while  fasting,  it  is  advisable 
to  fortify  the  body  against  this  risk  by  taking  some  food  before  pro- 
ceeding with  the  uterine  evacuation  and  cleansing. 


CHAPTEE  11. 
Post  Partum  Haemorrhage. 

H^MOBEHAGE  from  the  uterus  or  "  flooding,"  after  abortion  or  the 
birth  of  the  foetus  at  the  ordinary  term — an  accident  so  frequent  and 
alarming  in  woman — would  appear  to  be  far  from  common  in  the 
domesticated  animals.  This  difference  between  the  female  of  the 
human  species  and  that  of  animals,  is  evidently  due  to  the  dissimilarity 
in  organisation  of  the  uterine  mucous  membrane  in  them,  particularly 
at  the  insertions  of  the  ijlacenta  fctnlis  ;  as  well  as  to  the  absence  of 
those  immense  vascular  lacunas  which  exist  in  the  uterus  of  woman, 
the  walls  of  which  are  so  thin  and  fragile  as  to  be  easily  torn  when  the 
placenta  is  detached,  and  which  renders  insufficient  contraction  of  the 
uterus  after  delivery  such  a  grave  matter.  Another  reason  for  the 
infrequency  of  metrorrhagia  in  the  veterinary  obstetrist's  patients,  is 
the  great  rarity  of  placenta  j^Ta'via  in  them,^  and  which  is  a  somewhat 
common  cause  of  hemorrhage  either  during  or  after  delivery  in  woman. 

Nevertheless,  whether  owing  to  some  anatomical  or  pathological 
peculiarity,  to  atony  of  the  uterine  walls,  rupture  of  vessels  during 
removal  of  the  foetal  placenta,  or  even  during  its  spontaneous  expulsion, 
almost  every  practitioner  of  any  experience  has  met  with  cases  of 
metrorrhagia  of  a  more  or  less  alarming  character.  So  serious,  indeed, 
is  this  haemorrhage,  that  the  mortality  has  been  estimated  as  high  as 
73  per  cent,  of  the  cases  reported. 

At  p.  197,  metrorrhagia  was  alluded  to  as  occurring  during  pregnancy. 

1  Franck  [Handhnch  de  ThieriirztUchen  GehnrtshidJle,&nA  Zeitschriftfiir  Ilticrmedkin) 
has  clearly  demonstrated  the  occurrence  of  placenta  prajvia  in  animals.  At  pp.  87,  88, 
reference  has  been  made  to  it,  and  cases  of  it  are  frequently  mentioned  in  veterinary 
literature. 


POST  I'Airn'M  H.KMOnilllAGK.  575 

In  what  Cox  has  designated  "  pre-placental  presentation,"'  we  may 
have  hiDinorfhage  ensuing.  According  to  this  authority,  such  pre- 
sentations are  rare,  and  if  they  occur  at  the  termination  of  gestation 
maybe  looked  upon  as  unfavourable  ;  though  they  are  most  frequent  in 
cases  of  abortion,  and  are  then  seldom  followed  by  serious  results, 
Metrorrhagia  ensues  \vhen  the  usual  period  of  parturition  has  been 
exceeded,  and  the  "  water-bag"  has  been  presented  and  ruptured,  tlie 
entire  ^/(ictw;/a /«7a//s  coming  away  before  the  f(etus  itself.  '^  in  some 
cases,  a  considerable  portion  of  the  membranes  envelop  the  fore- 
parts of  the  foetus,  and  occasionally  to  such  an  extent  as  to  retard 
delivery  ;  this  may  be  shredded  off  and  removed  without  risk,  but  it 
will  be  found  that  the  posterior  portion  remains  attached.  Tiie  fatality 
attendant  upon  these  cases  is  due  to  neglect  of  examination  and  proper 
aid,  and  this  negligence,  again,  is  owing  to  the  absence  of  'pains.' 
After  the  removal  of  the  fatus,  it  is  found  that  hfemorrhage  has  taken 
place  from  the  open  vessels,  and  the  quantity  of  blood  indicates  that  it 
commenced  immediately  after  separation  of  the  placenta.  I  have  seen 
these  cases  only  in  cattle." 

In  certain  instances  there  can  be  no  doubt  that,  as  in  woman,  insuf- 
ficient contraction  of  the  uterus  is  a  cause  oi  post  part utn  hicniorrhage  ; 
and,  according  to  Schrader,  this  atony  of  the  organ  is  especially 
observed  after  a  rapid  emptying  of  its  cavity,  whetiier  artificially  or 
naturally  produced,  also  after  a  previous  and  very  considerable  disten- 
tion. It  therefore  occurs  in  her  after  very  rapid  delivery,  too  early 
turning  and  extraction,  in  hydramnios,  and  at  the  birth  of  twins.  The 
ha}morrhage  is  sometimes  also  due  to  general  debility,  and  feeble 
development  of  the  uterine  muscles — either  congenital  or  depending 
upon  previous  very  difficult  labours.  Partial  adhesions  of  the  placenta 
to  the  uterine  wall,  which,  however,  are  rarely  caused  by  real  connec- 
tive-tissue bands,  may  also  give  rise  to  profuse  haemorrhage,  as  the 
separated  places  in  the  vicinity  of  the  adlaesious  can  only  imperfectly 
contract. 

Symptoms. 

The  symptoms  of  p)osL  partum  iKemorrhage  are  not  well  marked 
unless  the  bleeding  is  visible,  though  they  are  those  of  profuse  h;emor- 
rhage  in  general.  There  is  the  quick,  weak,  running-down  pulse,  which 
becomes  imperceptible  as  death  approaches,  and  the  tiirobbing,  irregular 
contractions  of  the  heart  ;  the  decoloration  of  the  mucous  membranes, 
rapidly  increasing  prostration  of  the  animal,  with  the  unsteady  stagger- 
ing gait  on  movement,  and  the  difficulty  of  maintaining  the  standing 
position  towards  the  end  ;  the  haggard  fades ;  with  chilliness  of  the 
surface,  cold  clammy  perspiration  breaking  out  over  the  body  ;  and, 
finally,  the  recumbent  position,  convulsions,  and  death. 

Sometimes  there  are  indications  of  abdominal  pain-indicated  by  paw- 
ing and  looking  anxiously  at  the  flanks  ;  but  these  indications  are  only 
likely  to  be  present  when  the  hiemorrhage  is  due  to  traumatic  influences. 
When  the  hicmorrhage  per  vnlvavi  is  discernible — coming  away  in  a 
fluid  condition  or  in  masses  of  clots — then,  of  course,  there  can  be  no 
difficulty  in  diagnosing  the  accident ;  but  when  it  is  entirely  internal, 
the  manifestation  of  the  symptoms  above  indicated  should  give  rise  at 
once  to  a  suspicion  of  the  state  of  affairs,  and  lead  to  a  manual  explora- 
tion of  the  uterus. 

*   VtUrivary  Journal,  March,  1S77,  p.  178. 


576  ACCIDENTS  AFTER  PARTURITION. 

Treatvient. 

The  essential  indication  in  the  treatment,  is  to  suppress  the  haemor- 
rhage as  speedily  as  possible  ;  the  next,  to  sustain  the  vital  powers  of 
the  animal. 

If  the  fcetal  membranes  have  not  been  expelled,  they  must  be  re- 
moved without  delay — yet  as  gently  as  possible ;  for  until  their  removal 
is  effected  the  uterus  will  probably  not  contract.  The  contraction  of 
the  organ  is  very  important,  and  when  the  membranes  are  present  it 
often  happens  that  the  manipulation  required  to  remove  them  brings 
about  this  result.  If  the  membranes  are  not  present,  then  the  hand 
and  arm  must  be  pushed  into  the  uterus  and  gently  moved  about,  in 
order  to  excite  contraction,  if  the  organ  is  flaccid  and  uncontracted.  At 
the  same  time  its  interior  should  be  freed  from  the  blood  and  clots  it 
may  contain  ;  cold-water  douches  must  be  applied  to  the  loins  and 
vulva,  as  well  as  injections  of  the  same  into  the  uterus.  If  deemed 
necessary,  a  towel,  or  sheet  steeped  in  cold  water,  or  a  large  sponge 
impregnated  with  vinegar-and-water,  perchloride  of  iron,  or  any  other 
styptic,  may  be  passed  into  the  vagina,  or  even  into  the  uterine  cavity. 

Should  the  haemorrhage  persist,  revulsives  in  the  form  of  mustard 
cataplasms  or  stimulating  liniments  may  be  applied  to  distant  parts  of 
the  body — as  the  chest,  neck,  or  limbs.  Internally,  tannic  acid,  salts 
of  lead  and  morphia,  perchloride  of  iron,  tincture  of  ergot  of  rye,  or  any 
other  agent  likely  to  act  as  a  haemostatic,  may  be  administered. 

Hypodermic  injections  of  morphia  have  been  recommended,  and 
large  doses  of  oil  of  turpentine — for  the  Cow  from  three  to  five  ounces, 
mixed  with  the  contents  of  half  a  dozen  eggs — have  been  successfully 
employed  by  Macgillivray. 


CHAPTEK  III. 

Inversion  of  the  Uterus. 

Inversion,  procidence,  prolapse  of  the  uterus,  or  vagiiio-uteral  inversion, 
signifies  a  displacement  or  kind  of  hernia  of  the  organ,  which  is  partially 
or  completely  turned  inside  out — the  inverted  fundus  escaping  through 
the  OS  uteri  {partial  inversion),  vagina,  and  vulva,  and  perhaps  descend- 
ing as  low  as  the  hocks  [complete  inversion),  where  it  forms  a  more  or 
less  voluminous  tumour. 

When  the  inversion  is  very  partial,  nothing  whatever  is  seen  exter- 
nally, and  an  exploration  alone  reveals  the  existence  of  the  accident ;  if 
more  developed,  the  uterus  appears  as  a  round  tumour  between  the 
labia  of  the  vulva  when  the  animal  is  lying,  and  especially  if  the  floor  of 
the  stall  slopes  backwards,  which  causes  the  gastro-intestinal  mass  to 
press  upon  the  organ.  Sometimes  the  procidence  is  so  very  slight  that 
there  is  merely  a  bulging  inwards  of  the  fundus  of  the  uterus,  or  of  one 
of  the  cornua. 

In  complete  inversion  there  is  frequently  prolapsus  of  a  portion  of  the 
vagina,  which  appears  in  two  forms  or  degrees,  according  as  there  is 
inversion  of  the  body  of  the  uterus,  or  inversion  of  the  cornua  as  well ; 
sometimes  it  is  only  one  cornu,  which  is  then  deviated  to  the  right  or 
left  of  the  vertical  direction  of  the  body  of  the  organ,  just  as  it  happens 
to  be  one  or  other  of  these  parts.  If  both  cornua  are  completely 
inverted,  they  terminate  inferiorly  in  the  form  of  a  cone  ;  but  if  they  are 


IXrSRSIOX  OF  THE  UTERI'S.  r.77 

only  incompletely  so,  then  they  remain  cylindrical  at  their  lower  end,  at 
the  centre  of  the  cylinder  being  a  depression  or  cuccal  cavity. 

Inversion  of  the  uterus  is,  of  course,  only  possible  when  the  os  uteri 
is  dilated ;  consequently,  it  occurs  either  immediately  before  or  after 
birth. 

Again,  inversion  is  simple  or  complicated.  It  is  simple  when  the 
viscus  is  intact,  uninjured,  and  not  accompanied  by  the  extrusion  or 
displacement  of  any  other  organ.  ^Vhen  it  is  wounded  or  torn,  or  when 
there  is  accompanying  hernia  or  protrusion  of  other  viscera,  then  it  is 
complicated. 

As  we  have  said.  Ruminants  are  most  liable  to  this  accident :  the 
(/Ow  coming  first,  then  the  Sheep  and  Goat ;  the  Mare  is  less  fre- 
quently affected,  and  the  Sow  and  Bitch  perhaps  not  so  often  as  the 
Mare.  Inversion  of  the  uterus  has  been  observed  in  the  Cat  and 
Rabbit. 

With  the  Bitch  and  Sow,  incomplete  inversion  of  the  uterus  is  far 
from  uncommon,  as  is  also  simple  invei'sion  of  the  vagina,  for  which  it 
might  be  mistaken.  In  uniparous  animals  the  whole  of  the  organ  is 
usually  inverted  ;  while  in  multiparous  creatures,  generally  little  more 
than  the  portion  which  contained  the  foetuses  is  involved. 

Tlie  accident  has  been  observed  in  animals  kept  in  houses  and  stables, 
as  well  as  in  those  roaming  about  at  liberty ;  and  it  has  been  known 
from  time  immemorial.  The  Roman  veterinarian,  Yegetius,  alludes  to 
it,  and  recommends  the  employment  of  an  inflated  pig's  bladder  as  a 
good  pessary. 

Syviptoms. 

The  symptoms  of  uterine  inversion  vary  with  its  extent.  With 
uniparous  animals,  inversion  always  commences  at  the  fundus  of  the 
organ,  most  frequently  towards  the  largest  cornu  where  the  greater 
portion  of  the  fa^tus  was  lodged.  Under  the  influence  of  an  irregular, 
and  kind  of  spasmodic  contraction,  this  part  is  drawn  or  pushed  in- 
wards, just  as  the  foot  of  a  stocking  is  inverted  ;  and  this  action  con- 
tinuing, the  fundus  or  cornu  is  more  or  less  rapidly  carried  towards  the 
OS,  through  which  it  passes  into  the  vagina  {incomplete  inversion), 
dragging  after  it  the  body  of  the  organ,  which  also  becomes  inverted  as 
it  proceeds. 

It  is  rare  indeed  that  inversion  does  not  go  beyond  this ;  for  the  con- 
siderable alteration  in  position  and  relations  which  has  already  taken 
place  gives  rise  to  sensations  of  discomfort  and  pain,  and  these  re- 
act on  the  nervous  system,  inducing  contraction  of  the  uterine  and 
abdominal  muscles.  Powerful  and  hurried  expulsive  efforts  ensue,  and 
soon  the  organ  is  pushed  beyond  the  vulva,  where  its  own  weigiit  carries 
it  downwards,  and  renders  the  prolapsus  complete — the  lining  or  mucous 
membrane  having  become  external. 

W^hen  inversion  is  complete,  the  uterus  has  the  form  of  an  enormous 
pear  or  calabash-shaped  tumour  hanging  between  the  posterior  limbs 
— the  wider  and  rounded  portion  being  inferior,  and  sometimes  ex- 
tending as  low  as  the  hocks,  the  narrow  extremity  or  pedicle  being  at 
the  vulva,  in  the  interior  of  which,  and  between  the  labia  and  the 
tumour,  is  a  more  or  less  deep  and  circular  cul-de-sac,  according  as  the 
prolapsus  has  involved  a  certain  extent  of  the  vagina. 

That  the  surface  of  the  tumour  is  composed  of  the  uterine  mucous 
membrane,  is  easily  apparent  from  its  softness  and  colour — which  is 

37 


578  ACCIDENTS  AFTER  PARTUPJTIOX. 

sometimes  a  bright  red,  at  other  times  somewhat  violet  or  brown, 
according  as  it  is  much  injected  with  venous  blood,  irritated  by  the 
external  air,  or  by  the  litter,  faeces,  etc.,  with  which  it  has  come  in 
contact,  and  which  may  be  adhering  to  it.  With  the  Mare  and  Sow, 
the  uterine  placental  villi,  and  the  innumerable  depressions  for  the 
reception  of  those  of  the  foetal  placenta,  can  be  recognised ;  in  the 
Cow,  Sheep,  and  Goat,  there  are  the  deep-red,  isolated,  fungiform 
eminences  or  cotyledons,  and  in  the  Bitch  and  Cat  the  wide  dark- 
brown  zone.  Sometimes  with  the  Cow — more  rarely  with  the  Mare — 
there  are  portions  of  chorion  still  attached  to  the  placental  surface  of 
the  uterus ;  and  nearly  always  there  are  seen  excoriations,  more  or 
less  extensive  ecchymoses,  and  even  gangrenous  patches,  on  the  mem- 
brane— indications  of  the  injury  the  organ  has  sustained,  either  during 
or  after  parturition.  This  mucous  surface  is  not  so  sensitive  as  might 
be  imagined  ;  it  is  more  or  less  hot,  and  bleeds  at  the  slightest  touch, 
though  the  haemorrhage  may  not  be  profuse  ;  at  one  side  or  the  other 
may  be  noticed  a  kind  of  depression — the  opening  to  the  cornu  which 
is  not  yet  inverted. 

The  longer  the  period  which  has  elapsed  since  inversion  occurred, 
so  the  larger  is  the  tumour.  This  increase  is  due  to  the  violent  ex- 
pulsive efforts  of  the  animal,  as  well  as  to  the  increase  in  weight  of  the 
organ,  in  consequence  of  the  congestion  and  infiltration  which  have 
taken  place  in  its  textures ;  constricted — even  strangulated — at  its 
upper  part,  the  circulation  is  maintained  with  great  difficulty,  and  the 
capillaries  become  gorged  with  blood.  The  walls  lose  their  elasticity, 
become  thickened,  dense,  and  darker  tinted,  until,  from  its  increased 
volume  and  altered  aspect,  the  organ  can  scarcely  be  recognised ;  while 
its  reposition  is  rendered  extremely  difficult,  if  not  impossible. 

In  consequence  of  the  excessive  hypersemia,  ulceration  and  gangrene 
usually  supervene  ;  these  are  serious  lesions,  and  may  induce  a  fatal 
termination. 

Such  a  grave  accident  as  this  is,  in  which  there  is  extensive 
displacement,  with  severe  straining  at  the  suspensory  ligaments  of 
the  uterus,  and  sometimes  their  rupture ;  the  irritation  and  perhaps 
abrasions  or  wounds  of  the  mucous  membrane ;  the  tension  on  the 
vagina,  and  the  compression  of  various  parts  or  organs — all  this  might 
be  expected  to  produce  general  disturbance.  And  such  is  the  case. 
From  the  very  commencement,  and  even  before  anything  is  apparent 
at  the  vulva,  the  animal  is  uneasy  and  anxious-looking ;  it  paws  with 
the  fore  or  stamps  with  the  hind  feet ;  switches  the  tail  as  if  driving 
off  insects ;  lies  down  and  gets  up  frequently,  finding  no  ease  in  either 
attitude  ;  and  strains  more  or  less  energeticallj^  at  closer  or  wider 
intervals,  thus  adding  to  the  extruded  mass.  Not  infrequently  the 
Mare  kicks  at  the  prolapsed  uterus,  or  endeavours  to  attack  it  with  its 
teeth. 

At  first  there  is  no  perceptible  fever,  and  the  animal,  in  the  intervals 
of  straining,  attentive  to  what  is  going  on  around,  is  solicitous  about 
its  progeny,  and  may  even  eat.  This  state  is  not  of  long  duration, 
however ;  for  soon  after  inversion  is  complete,  indications  of  fever 
become  manifest — quickened  pulse  and  respiration,  elevated  tempera- 
ture, and  an  expression  of  anxiety  and  pain.  The  straining  is  more 
frequent  and  energetic,  and  soon  exhausts  the  animal ;  and  the  pros- 
tration, together  wnth  the  great  weight  of  the  pendent  uterus,  compels 
it  to  assume  and  maintain  the  recumbent  posture,  in  spite  of  attempts 


JXrEJiSIDX  OF  THE  UTERUS.  579 

to  make  it  get  up.  The  organ  assumes  a  gangrenous  or  intensely 
inflamed  appearance,  and  the  animal  soon  succumbs,  either  from  the 
nervous  prostration  resulting  from  its  sufferings,  or  from  the  condition 
of  the  uterus. 

In  woman,  sudden  inversion  of  the  uterus  always  leads  immediately 
to  great  general  disturbance  —  the  heart's  action  is  deranged,  and 
syncope,  convulsions,  vomiting,  etc.,  may  sometimes  be  caused  by  the 
sudden  change  in  the  position  of  the  uterus.  More  frequently  those 
symptoms  depend  upon  acute  cerebral  aniemia,  to  which  the  sudden 
emptying  of  the  contents  of  the  uterus  already  predisposes,  but  which 
must  be  still  greater  when  not  only  these  contents  but  the  whole  oi-gan 
itself  passes  out  of  the  abdominal  cavity.  The  blood  then  rushes  into 
the  vessels  of  this  cavity,  which  are  suddenly  under  a  greatly  diminished 
pressure,  and  the  cerebral  aniemia  that  ensues  is  due  to  the  scanty 
supply  which  the  upper  half  of  the  trunk  now  receives. 

A  similar  condition  is  sometimes  —  though  rarely  —  observed  in 
animals,  and  particularly  in  the  Mare. 

Complications. 

One  of  the  ordinary  complications  of  this  accident,  is  the  adherence 
of  the  fcetal  placenta  to  the  uterine  surface ;  though  this  is  much  more 
frequent  with  animals  which  have  a  nmltiple  placenta — Cow,  Sheep, 
and  Goat,  than  with  the  Mare,  Ass,  Sow,  Carnivorous  animals,  or  the 
Rabbit. 

The  inversion  of  the  uterus — when  complete — also  brings  about  dis- 
placement of  the  vagina ;  the  deeper  portion  of  this  part  is  found 
folded  on  the  neighbouring  surface  of  the  cervix  ;  the  bladder  and 
inferior  wall  of  the  rectum  are  also  drawn  into  the  middle  of  the 
pelvic  canal,  and  occupy  the  place  the  uterus  has  quitted ;  the  meatus 
urinariiis  is  doubled  on  itself,  and  so  compressed  that  no  urine  can 
pass  through  it ;  while  the  ureters  continuing  to  carry  that  fluid  to 
the  bladder,  this  reservoir  soon  becomes  greatly  distended,  without 
relief  being  possible.  Hence  results  another  source  of  suffering,  and 
another  cause  of  exhausting  efforts  added  to  those  occasioned  by  the 
prolapsed  uterus.  In  certain  cases  there  may  also  exist  prolapsus  of 
the  rectum,  and  displacement,  or  even  inversion,  of  the  bladder. 

The  uterus  may  also  be  wounded  or  torn,  either  from  bad  manage- 
ment during  parturition,  or  from  injudicious  attempts  at  reposition  ; 
or  the  injury  may  be  due  to  Rats,  Cats,  Dogs,  or  Pigs  gnawing  at  the 
bleeding  mass ;  sometimes  it  is  the  creature  itself,  or  a  neighbouring 
animal  which  inflicts  the  damage. 

Contact  with  the  air,  and  particularly  with  foreign  bodies,  induces 
inflammation,  which  frequently  runs  to  on  gangrene,  and  this  to  dissolu- 
tion. Gangrene  readily  occurs  in  the  Sheep.  Sometimes  perforation 
^f  th*^  vagina  or  uterus,  arising  at  times  from  sloughing  of  a  gangrenous 
patch,  has  caused  fatal  peritonitis  ;  in  other  cases  pelvic  abscesses  have 
formed. 

After  reduction  has  been  effected,  metritis  and  metro-peritonitis  may 
appear ;  this  is  not  at  all  unlikely  in  the  Mare.  Lafosse  mentions 
paraplegia  also  as  a  complication ;  this  may  be  a  consequence  of 
gangrene  and  septic  infection. 

An  exceptional  complication  is  hernia  of  the  intestines,  through  a 
rupture  in  the  uterus.  It  may  be  noted  that  in  prolapsus  uteri  in  the 
Mare,  it  has  happened  that  the  colon  has  followed  the  fundus  of  the 


580  ACCIDENTS  AFTER  PAIITUFJTIOX. 

organ,  and  become  invaginated  in  the  inverted  sac.  Funk  also  men- 
tions the  case  of  a  Bitch  in  which  one  of  the  cornua  became  inverted, 
and  prevented  the  expulsion  of  the  remaining  fcetuses  fi'om  the  other 
cornu  ;  this  necessitated  the  performance  of  the  Cgesarian  section. 

Ayrault  has,  on  three  occasions,  encountered  an  unusual  complication 
after  reduction  of  the  prolapsed  organ,  in  the  form  of  severe  lameness, 
with  knuckling  over  of  the  two  hind-fetlock  joints,  but  without  any 
articular  swelling.  This  complication  disappeared  as  the  animals 
recovered  from  the  effects  of  inversion. 

Frofjnosis. 

There  can  scarcely  be  any  doubt  that,  if  no  assistance  is  rendered  to 
an  animal  suffering  from  prolapsus  uteri,  death  must  ensue,  and  more 
or  less  speedily ;  as  gangi'ene  is  inevitable,  while  spontaneous  reduction 
is  impossible. 

In  some  instances  death  occurs  in  less  than  twenty-four  hours,  but 
most  frequently  the  animal  may  live  from  three  to  five  days — very 
rarely  longer.  Sabini,^  an  Italian  veterinarian,  cites  a  case  in  which 
treatment  was  not  adopted  until  the  seventh  day ;  but  this  is  an  alto- 
gether exceptional  instance. 

Inversion  of  the  uterus  is  generally  fatal  when  owners  of  animals 
have  neglected  to  procure  assistance  until  too  late,  or  who  employ 
ignorant  people  to  attempt  reduction.  If  attended  to  sufficiently  early 
by  those  who  are  competent,  the  number  of  recoveries  is  considerable, 
and  perhaps  in  no  other  pathological  condition  is  the  utility  and  power 
of  art,  when  invoked  at  the  proper  time,  better  demonstrated. 

The  prognosis  is  not  equally  favourable,  however,  in  all  the  domesti- 
cated animals ;  and  between  the  Mare  and  Cow,  for  instance,  the 
difference  is  considerable. 

With  regard  to  the  latter  animal,  Deneubourg,  who  has  often  had  to 
treat  this  accident,  never  lost  one  of  his  patients.  In  100  cases, 
Donnarieix  has  only  had  3  deaths.  Moens,  in  27  cases,  has  not  had  a 
fatal  termination.  Guillaume,  cited  by  Gelle,  lost  3  cases  out  of  42  ; 
Loyer  of  Nemours,  9  out  of  27 ;  and  Mazure,  Holland,  1  in  4. 

"With  regard  to  the  Mare,  Donnarieix  had  8  cases,  and  all  perished  ; 
Cruzel  had  3,  and  they  also  succumbed ;  Schaack  only  saved  1 
of  2. 

In  268  cases  of  prolapsus  uteri  in  the  Cow,  collected  by  Saint-CjT, 
there  were  35  deaths — or  a  mortality  of  12  per  cent.  For  the  Mare 
he  only  found  25  cases,  and  of  these  17  were  fatal — a  mortality  of 
68  per  cent. 

A  number  of  authorities  quoted  by  Zundel-  give  the  percentage  of 
recoveries  in  the  Cow  as  97,  and  in  the  Mare  as  50. 

It  would,  therefore,  appear,  and  it  is  no  doubt  true,  that  this  acci- 
dent is  much  more  fatal  in  the  Mare  than  in  the  Cow. 

Inversion  in  the  Sow  is  nearly  always  fatal,  and  often  within  twenty- 
four  hours,  unless  amputation  of  the  uterus  is  resorted  to ;  but  the 
Bitch  will  live,  in  very  rare  cases,  for  two,  three,  or  four  days  with  the 
uterus  prolapsed. 

It  has  often  been  stated  that  inversion  of  the  uterus  leads  to  infe- 
cundity ;  but  though  it  may  do  so  in  some  instances,  yet  this  cannot  be 

1  Journal  des  Vet6r%naires  du  Midi,  1869,  p.  175. 

*  Dictionnaire  de  Med.,  de  Chirurg.  et  d' Hygiene  F^terinaires,  vol.  iii.,  Art.  "Uterus. 


j\rj-:j:sj(L\  of  the  urEiius.  58i 

accepted  as  a  rule.  Numerous  cases  are  on  record,  and  particularly 
for  the  Cow  and  Bitch,  in  which  fecundation  has  taken  place  after  this 
accident. 

Though  inversion  is  likely  to  recur  after  another  birth,  or  even  during 
a  succeeding  pregnancy,  it  is  not  invariably  so  ;  though  to  avert  it  cure 
may  be  necessary. 

Causes. 

Inversion  of  the  uterus  generally  occurs  immediately  after  parturition, 
and  is  most  frequent  in  the  Cow,  whose  uterine  ligaments  are  so  exten 
sive  and  extensible.  It  usually  occurs  within  two  or  three  days,  rarely 
later. 

With  multiparous  animals,  in  which  each  uterine  cornu  forms  a  kind 
of  independent  uterus,  one  of  these  may  alone  be  inverted,  the  foetus 
contained  in  the  other  cornu  being  retained  there  for  some  time — 
though  not  without  danger  to  its  existence,  should  the  period  be  much 
prolonged. 

With  uniparous  animals,  however,  this  does  not  take  place,  as  the 
uterus  cannot  become  inverted  without  the  fcetus  being  expelled. 
Nevertheless,  Aubry*  has  published  a  very  curious  observation  regard- 
ing a  Cow,  aflected  with  prolapse  of  the  vagina  during  pregnancy,  and 
which  had  complete  inversion  of  the  left  cornu  at  the  end  of  that 
period  :  but  the  Calf,  lodged  in  the  right  cornu,  and  which  was  alive 
and  well  developed,  was  retained  there  for  two  entire  days.  It  was 
then  necessary  to  interfere  and  eflfect  delivery,  which  was  followed  by 
total  inversion  of  the  organ.  This  incident,  which  appears  to  be 
unique,  does  not,  however,  preclude  acceptance  of  the  general  rule, 
that  inversion  of  the  uterus  is  absolutely  incompatible  with  the  pro- 
longation of  gestation. 

In  order  that  this  inversion  can  take  place,  it  is  essential  that  the  os 
uteri  be  more  or  less  dilated  ;  consequently,  the  accident  is  only  observed 
in  breeding  animals,  and  either  during  or  soon  after  parturition  or  abor- 
tion. 

In  order  that  it  can  occur,  a  certain  degree  of  relaxation  of  the  sub- 
lumbar  uterine  ligaments  must  be  present ;  there  must  also  be  some 
cause  of  irritation  in  operation  after  the  expulsion  of  the  fcetus,  sufti- 
cient  to  excite  the  contraction  of  the  muscles  of  the  uterus  and  lead  to 
inversion— though  it  is  often  dillicult  to  ascertain  what  this  cause 
may  be. 

In  very  many  instances  pregnancy  has  gone  on  to  its  full  term,  the 
animal  is  strong  and  healthy,  birth  natural  and  easy,  and  tliere  is 
nothing  to  indicate  the  advent  of  such  an  accident- when,  suddenly, 
after  a  few  expulsive  efiforts,  the  uterus  is  ejected  in  an  inverted  state. 

It  has  been  attempted  to  explain  the  occurrence  of  the  accident  in 
such  cases,  by  alluding  to  the  lymphatic  temperament  of  the  animals, 
and  their  consequent  laxity  of  tissue  ;  and  it  is  often  the  case  that 
Cows  which  are  "  soft,"  and  kept  on  food  that  is  better  suited  for  the 
production  of  milk  than  flesh,  are  the  most  frequent  subjects  of  inver- 
sion— this  sometimes  occurring  after  each  birth,  though  parturition  was 
perfectly  normal. 

Inversion  of  the  vagina  during  pregnancy  h-^.s  also  been  mentioned 
as  the  cause  of  inversion  of  the  uterus  ;  and  it  may  be  so  in  some 
instances,  but  it  certainly  is  not  so  in  all.     Indeed,  excellent  authori- 
>  RtcutUdt  Midecint  VeUrinaire,  1859,  p.  731. 


582  ACCIDENTS  AFTER  PARTURITION. 

ties  maintain  that  there  is  no  proof  that  this  accident  is  more  frequent 
in  animals  suffering  from  inversion  of  the  vagina  than  those  which  are 
not.  And  it  is  to  be  remembered,  as  already  stated,  that  the  os  must 
be  more  or  less  dilated  and  dilatable  for  inversion  of  the  uterus  to 
occur — a  condition  which  does  not  always,  nor  yet  frequently,  co-exist 
with  vaginal  inversion.  The  latter,  indeed,  is  far  from  rare  in  non- 
pregnant animals,  and  in  those  which  have  never  been  pregnant ;  and 
it  is  not  at  all  uncommon  in  those  which  are  advanced  in  pregnancy,  and 
yet  do  not  suffer  afterwards  from  this  uterine  displacement. 

Difficult  and  laborious  parturition,  when  much  manipulation  and 
jnergetic  traction  on  the  foetus  have  taken  place,  has  likewise  been 
acknowledged  as  a  cause  of  uterine  inversion ;  and  it  is  certain  that  the 
efforts  to  remove  a  fa3tus  which,  whether  from  malposition,  deviation  of 
parts,  excess  of  volume,  etc.,  cannot  be  expelled  in  a  natural  manner, 
are  somewhat  frequently  followed  by  this  accident.  But  on  the  other 
hand,  how  often  does  it  happen  that  the  most  vigorous — even  painful 
and  violent — traction,  and  long  and  complicated  manoeuvres,  are  not 
succeeded  by  inversion  ;  while,  on  the  contrary,  the  easiest  and  most 
rapid  birth  sometimes  is. 

The  retention  of  the  foetal  placenta  beyond  the  ordinary  period,  must 
also  be  taken  into  account  as  one  of  the  exciting  causes ;  as  it  then  acts 
as  a  foreign  body,  irritates  the  interior  of  the  uterus,  and  so  by  a  reflex 
influence  induces  contraction  of  its  muscular  layer — this  giving  rise  to 
invagination  of  the  extremity  of  one  of  the  cornua,  which  is  supposed 
to  be  the  commencement  of  inversion. 

It  is  also  extremely  probable  that  injudicious  traction  on  the  foetal 
membranes  may,  for  mechanical  and  physiological  reasons,  bring  about 
this  result  in  a  flaccid  and  dilated  uterus,  when  the  cervix  is  also  re- 
laxed. More  especially  is  this  likely  to  happen  if  the  placenta  is 
adlierent  towards  the  fundus  of  the  organ,  or  in  one  of  the  cornua. 

Much  mystery  appears  to  have  attached  to  this  inversion  of  the 
uterus,  and  though  various  causes  have  been  assigned  as  operating  in 
its  production,  yet  as  these  are  not  present  in  every  case,  it  has  been 
admitted  that  a  particular  predisposition  must  have  existed. 

It  is  evident  that  several  causes  may  be  invoked  to  account  for  the 
accident.  A  flaccid,  non-contracted  uterus  after  birth,  with  a  weak 
cervix  and  dilated  os,  and  relaxed  broad  ligaments,  may  be  looked  upon 
as  a  predisposing  condition ;  and  this  is  most  likely  to  be  present  in 
lymphatic  animals,  or  those  suffering  from  atony  brought  about  by 
debility  from  disease,  bad  or  insufficient  food,  exposure  to  weather,  etc. 
When  such  a  condition  is  present,  it  is  easy  to  understand  why  inver- 
sion may  occur  from  abdominal  pressure  on  the  cornua  or  fundus  of  the 
organ,  or  from  external  mechanical  force  ;  and  we  can  also  comprehend 
why  an  antiperistaltic  movement  of  one  of  the  cornua,  or  a  portion 
of  it — just  as  happens  in  intussusception  of  the  intestines — may  take 
place  sometimes  immediately  after  birth,  and  before  the  cervix  has  had 
time  to  contract.  Any  trifling  irritation  may  lead  to  this  wrong  move- 
ment, and  once  commenced  it  is  far  more  likely  to  continue  than  to 
cease — as  in  the  case  of  the  intestines,  when  one  portion  becomes  in- 
vaginated  within  another. 

We  believe  this  will  be  found  to  be  the  correct  opinion. 


IXrEJiSIOX  OF  THE  UTERUS.  583 


Treatvient. 


Whatever  may  be  the  cause  of  inversion  of  the  uterus,  the  obstetrist 
must  lose  no  time  in  remedying  the  accident ;  as  when  interference  is 
not  prompt,  a  fatal  termination,  or,  at  the  very  least,  serious  conse- 
quences, will  rapidly  follow. 

In  treating  it,  several  important  indications  ai'e  to  be  observed,  but 
they  may  be  classed  as :  (1)  the  immediate  or  preliminary  measures 
which  the  local  symptoms  demand,  {'2)  the  reduction  or  reposition  of  tlie 
uterus,  (3)  the  retention  of  the  organ,  (i)  the  after  treatment ;  should  re- 
position be  impossible  or  contra-indicated,  then  recourse  must  be  had 
to  (5)  amputation  of  the  uterus. 

Pkeliminauy  Measures. — The  preliminary  measures  consist  in  com- 
bating the  local  and  general  symptoms. 

The  animal  is  sometimes  standing,  sometimes  lying  down.  If  the 
latter,  it  must  be  got  up ;  as  the  standing  attitude  is  by  far  the  best  for 
reducing  the  inversion,  there  being  more  space  in  the  abdomen  when 
its  walls  are  not  compressed  by  the  ground,  and  the  obstetrist  can 
operate  more  easily  and  quickly,  while  the  downward  inclination  of  the 
lower  surface  of  the  pelvis  and  abdomen  is  favourable  for  reduction  and 
retention.  If  the  animal  is  not  very  feverish,  but  only  debilitated,  and 
there  is  otherwise  no  great  urgency  in  the  case,  a  strong  diffusible 
stinmlant  may  be  administered,  with  the  view  to  enabling  it  to  get  up. 
It  may  also  be  induced  to  rise  by  bringing  a  dog  before  it ;  or  it  may 
be  aided  by  a  sack  or  sheet  passed  under  the  chest. 

If  it  cannot  be  made  to  get  up,  or  is  unable  to  stand  when  raised, 
reposition  must  be  effected  while  it  is  lying — fatiguing,  and  often  trouble- 
some as  the  operation  then  is.  This  fatigue  and  ditViculty  may  be 
somewhat  diminished  in  raising  the  hind-quarters  of  the  animal  as  nmch 
as  possible,  by  nieans  of  bundles  of  straw  placed  under  them, — all  the 
litter  being  removed  from  beneath  the  abdomen,  so  as  to  relieve  its 
contained  viscera  from  pressure  as  much  as  possible.  Cosse,  Tyvaert, 
Ilaubner,  Anderson,  and  others  advise  placing  the  animal  on  its  back, 
with  the  croup  so  raised  ;  while  Viborg,  Fiissler,  Bettinger,  Obermayer, 
Ilering,  Merkt,  Adam,  and  several  other  obstetrists  recommend  raising 
or  suspending  it  by  the  hind-limbs,  over  a  beam — a  procedure  which, 
they  assert,  is  most  advantageous  when  reposition  is  possible  or  advis- 
able. But,  as  has  just  been  said,  the  recumbent  position  with  the 
larger  animals  is  always  to  be  avoided  when  possible,  and  every  means 
should  be  tried  to  make  them  stand.  With  the  smaller  animals — as 
the  Sheep,  Goat,  Sow,  Bitch,  or  Cat — it  is  convenient  to  place  them  on 
a  bench  or  table,  and  lying  either  on  the  side  or  back,  with  the  hind- 
quarters well  raised. 

If  the  accident  is  recent— an  hour  or  two,  or  even  a  little  longer— the 
uterus  may  be  returned  at  once ;  but  should  a  longer  inters'al  have 
elapsed,  it  is  well  to  ascertain  the  condition  of  the  rectum  and  bladder, 
and  to  empty  them  if  necessary  ;  though  it  must  be  confessed  that  it  is 
often  a  most  difficult  task  to  accomplish  evacuation  of  the  bladder.  It 
may  be  done,  however,  by  causing  assistants  to  raise  the  uterus,  then 
seeking  for  the  meatus  urinarius  on  its  lower  surface,  near  the  vulva, 
and  introducing  one  or  two  fingers  into  that  canal,  or  a  catheter  through 
it  into  the  bladder. 

Should  the  foetal  membranes  still  be  adherent  to  the  uterine  surface 


584  ACCIDENTS  AFTER  PARTURITION. 

— wholly  or  partially — they  must  be  carefully  removed  without  injuring 
the  cotyledons,  enucleation  being  effected  in  the  manner  already 
described.  If  properly  performed,  this  removal  should  not  cause  any 
haemorrhage ;  and  if  any  pulpy  gangrenous  cotyledons  are  found,  it  is 
better  to  remove  them  at  once  with  scissors  than  leave  them  to  be 
eliminated  in  the  ordinary  way  ;  though  if  they  show  any  vitality  at  all 
they  need  not  be  interfered  with.  Torn  or  gangrenous  portions  of 
mucous  membrane  are  also  to  be  excised  in  the  same  manner. 

This  done,  the  uterus  should  be  cleansed  from  matters  adhering  to  its 
surface- — such  as  litter,  mud,  dirt,  filth  or  blood;  this  may  be  effected 
by  means  of  a  fine  soft  sponge  or  cloth,  the  fluid  employed  being  either 
cold  or  tepid  water,  milk  and  water,  some  astringent  or  soothing  lotion, 
if  there  is  much  tumefaction  or  irritation,  or  a  stimulating  fluid— as  the 
dilute  tincture  of  opium — if  the  organ  is  much  bruised  and  congested. 
Some  practitioners  immerse  the  entire  uterus  in  a  bucket  containing 
either  of  these  fluids ;  and  some  particularly  prefer  cold  water,  allowing 
the  organ  to  remain  in  it  for  as  long  as  five  or  ten  minutes.  By  this 
means  it  is  freed  from  extraneous  matters  and  cleansed  ;  while  the  con- 
gestion is  allayed  and  the  mass  considerably  reduced  in  size.^  Meyer, 
Pfirter,  and  others  state  that  this  immersion  in  cold  water  has  an 
astonishing  effect,  and  greatly  facilitates  reposition.  Schnee  even  recom- 
mends the  application  of  ice,  which,  he  asserts,  not  only  diminishes  the 
volume  of  the  protruded  organ,  but  allays  its  irritability  and  contractions. 
When  attempting  to  reduce  the  cornu  or  uterus,  he  holds  a  piece  of  ice 
in  the  hand  he  applies  to  the  part. 

If  from  long  inversion  and  consequent  congestion,  infiltration  or 
inflammation,  the  volume  of  the  uterus  is  so  increased  that  it  appears 
impossible  to  return  it,  scarifications  may  be  made  on  its  surface  ;  these 
often  lead  to  a  notable  decrease  in  its  size,  and  reduction  may  then  be 
effected.  If  it  is  determined  to  scarify  the  organ,  the  greatest  circum- 
spection should  be  observed  in  making  the  incisions  ;  they  must  be  quite 
superficial,  and  only  a  few  at  a  time.  Should  the  haemorrhage  prove 
excessive — which  it  sometimes  does  when  the  scarifications  are  deep 
and  numerous — then  styptics  must  be  applied. 

When  the  organ  is  so  increased  in  size  that  it  cannot  be  returned,  it 
is  well  to  ascertain  whether  this  is  not  due  chiefly  to  the  intestines 
having  entered  the  pelvic  cavity  and  filled  the  space  in  the  inverted 
uterus.  If  this  be  the  case,  they  must  be  removed  from  it  before  reduc- 
tion is  attempted. 

Coculet's-  method  of  reducing  the  size  of  the  congested  uterus  has 
been  successfully  employed  on  many  occasions.  A  dry  and  clean 
piece  of  linen,  about  a  yard  in  length,  and  twenty-eight  to  thirty 
inches  wide,  is  passed  beneath  the  inverted  uterus,  and  close  up  to  the 
vulva ;  its  lower  border  is  then  lifted  over  the  organ,  one  of  the  ends 
folded  over  it,  and  the  other  end  over  this,  so  as  to  envelop  the  entire 
uterus  —  the  four  corners  of  the  wrapper  being  uppermost.  Tepid 
water  is  now  kept  incessantly  applied  to  this  cloth,  which  is  gradually 

^  A  little  care  on  the  part  of  owners  of  animals  would  often  prove  of  great  advantage 
in  averting  serious  consequences  in  such  an  accident  as  inversion  of  the  uterus,  befoie 
the  arrival  of  the  veterinary  surgeon.  This  care  should  be  mainly  directed  to  keeping 
the  animal  in  a  standing  attitude,  and  preventing  the  uterus  from  being  soiled,  bruised 
or  torn,  as  well  as  swollen.  The  organ  may  readily  and  easily  be  preserved  from  injury 
by  receiving  it  on  a  sheet  or  large  cloth,  or.  better  still,  a  basket  or  tray,  and  keeping 
it  well  raised  until  professional  assistance  arrives, 

2  Journal  des  Veterinaires  du  Midi,  1862. 


INVERSION  OF  THE  UTERUS.  585 

tightened  every  minute,  by  placing  the  open  hand  beneath  the  mass, 
and  with  the  other  hand  pulling  at  the  upper  end  of  the  wrapper.  This 
equable,  gentle,  and  sustained  pressure  over  the  entire  organ  in  fifteen 
to  twenty  minutes  brings  about  a  marked  diminution  in  its  size,  and 
renders  its  reduction  easier. 

Esmarch's  india-rubber  bandage  has  been  suggested  to  overcome  the 
uterine  congestion  in  these  irreducible  cases,  but  there  is  no  record  of 
its  having  been  tried. 

If  the  uterus  is  torn,  it  may  be  necessary  to  close  the  wound  by  the 
continuous  suture — but  this  must  not  be  drawn  too  tight,  mere  apposi- 
tion of  the  edges  being  all  that  is  necessary.  If  the  wound  is  not  exten- 
sive, it  need  not  be  closed  ;  indeed,  there  are  many  cases  on  record  in 
which  wounds  of  the  uterus  have  not  been  sutured — the  organ  having 
been  merely  returned  to  the  abdominal  cavity,  and  yet  recovery  has 
taken  place. 

Careful  washing  witli  a  weak  solution  of  boric  acid  is  perhaps  the 
best  course  to  adopt  before  reposition  is  attempted  in  any  case. 

If  hernia  of  the  intestine  or  any  other  viscus  is  present,  then,  of 
course,  this  must  be  reduced  before  the  uterus. 

Keduction  ou  Reposition. — "When  inversion  of  the  uterus  is  incom- 
plete— a  very  rare  occurrence — and  the  organ  has  not  passed  beyond 
the  vagina,  reduction  is  comparatively  easy.  It  is  sulhcient,  with  the 
larger  animals,  to  introduce  the  closed  list  into  the  vagina,  and  to  push 
the  uterus  as  far  into  the  abdomen  as  may  be  deemed  necessary.  When 
the  animal  strains,  the  operator  must  not  push,  but  maintaining  what 
he  has  accomplished  as  well  as  he  can,  recommence  as  soon  as  the 
expulsive  effort  has  ceased.  Whether  inversion  is  complete  or  incom- 
plete, and  if  the  animal  is  standing  or  lying,  it  is  always  well  to  have 
the  hind-parts  higher  than  the  fore. 

When  it  is  complete,  then  four  assistants  are  generally  necessai'y. 
One  of  these  stands  at  the  animal's  head,  and  holds  it  firmly — if  a  Cow 
he  may  seize  it  by  a  horn  with  one  hand  and  nasal  septum  by  the 
other ;  if  it  is  a  Mare,  a  twitch  on  the  nose  or  ear  may  be  required,  and 
it  may  even  be  necessary  to  have  a  side-line  on  one  of  the  hind-limbs 
Another  assistant  holds  tlie  tail  over  the  croup  with  one  hand,  and  with 
the  other  he  presses  or  pinches  the  loins  in  order  to  diminish  the  strain- 
ing ;  while  a  man  stands  at  each  side  of  the  croup  to  aid  in  raising  and 
returning  the  uterus.  It  is  well  to  attract  the  animal's  attention  as 
much  as  possible,  as  it  then  offers  less  opposition  to  the  manipulations, 
and  does  not  strain  so  violently.  I'incliing  the  nose  and  loins  will  be 
found  ver}'  efTective  in  this  respect,  and  if  a  Cow,  a  Dog  may  be  intro- 
duced in  front  of  it.  Should  the  animal  be  much  exiiaustcd  or  un- 
steady, two  additional  assistants  may  be  required  to  stand  at  each 
side. 

The  utems  must  be  placed  on  a  cloth  or  sheet  in  two  or  three  folds 
and  well  moistened,  the  ends  being  held  by  the  two  assistants  at  the 
croup,  so  that  the  organ  may  be  lifted  as  high  as  the  vulva.  By  doing 
so,  there  is  neither  traction  nor  compression  on  the  mass,  and  as  the 
circulation  in  it  is  thereby  much  facilitated,  the  tumefaction  subsides  to 
a  corresponding  degree.  It  also  allows  the  operator  more  freedom,  as 
he  could  not  sustain  the  weight  of  the  prolapsed  organ — which  is  some- 
times as  much  as  100  to  140  pounds — and  at  the  same  time  attempt  its 
reposition.     Indeed,  some  practitioners  recommend  that  the  two  comers 


586  ACCIDENTS  AFTER  PARTURITION. 

of  each  end  of  the  cloth  on  which  the  uterus  is  placed,  should  be  tied 
round  the  neck  of  the  assistants,  so  that  their  hands  may  also  be  free 
to  aid  the  operator  in  his  manoeuvres  :  though  the  device  must,  one 
would  imagine,  have  more  disadvantages  than  conveniences. 

When  the  animal  strains  very  severely  and  continuously — as  some- 
times happens  during  reposition — it  is  useful  to  constrain  the  chest 
as  much  as  possible  by  a  girth,  so  as  to  prevent  its  expansion.  It 
may  even  be  necessary  to  give  a  strong  anodyne  draught  of  chloral  or 
opium,  or  a  dose  of  alcohol  sufficient  to  produce  semi-narcosis.  Indeed, 
with  the  Mare,  in  serious  cases  it  is  most  advantageous  to  administer 
chloroform  or  ether,  in  order  to  produce  general  anaesthesia  before 
attempting  to  handle  the  uterus. 

For  effecting  reposition,  two  methods  are  recommended,  and  these  we 
will  now  notice — merely  observing  that,  whichever  be  adopted,  the 
operator  always  places  himself  directly  behind  the  animal,  with  the 
inverted  organ  immediately  before  him. 

First  Method.— \i  the  inverted  tumour  formed  by  the  uterus  is  not 
very  voluminous,  and  if  by  the  application  of  cold  water  to  it — should 
it  be  tumefied — it  is  reduced  in  size,  then  reposition  may  be  effected  by 
pressure  on  the  fundus  of  the  organ.  This  pressure  is  to  be  made  by 
the  closed  fist  against  the  central  part  of  the  tumour  ;  and  in  some 
instances,  if  it  is  well  directed,  and  the  inversion  not  serious,  the  organ 
may  be  returned  to  the  pelvic  cavity  by  one  push,  while  another  will 
carry  it  into  the  abdomen. 

Eainard  and  other  practitioners  approve  of  this  method,  and  describe 
it  somewhat  in  detail.  The  operator  is  to  seek  for  the  largest  cornu — 
that  which  contained  the  foetus — seize  it  by  the  fundus,  and  reduce  this 
by  pushing  it  inwards,  as  we  would  the  finger  of  a  glove  which  has 
been  turned  outside  in — continuing  the  reduction  by  successive  portions 
until  the  pedicle  of  the  tumour  is  reached,  when  more  serious  resistance 
is  encountered  from  the  os  uteri.  This  being  overcome,  the  body  of  the 
uterus  is  next  replaced,  either  by  the  fist  pressing  against  the  widest 
part,  or  by  using  a  pessary.  The  pressure  is  to  be  directed  straight 
forward,  through  the  vulva  and  pelvic  canal,  upwards  and  inwards. 

Great  care  is  necessary  in  exerting  the  pressure,  which  should  not 
be  applied  while  the  animal  is  straining.  During  expulsive  efforts  the 
operator  must  be  content  to  wait,  merely  keeping  the  parts  where  he 
has  carried  them,  until  the  straining  has  ceased.  The  pressure  must  be 
steady  and  well  directed,  so  as  not  to  bruise  or  lacerate  the  uterus. 
"When  a  portion  is  got  within  the  vulva,  it  is  held  there  by  one  hand, 
while  the  other  manipulates  the  next  part  to  be  returned.  Eeduction 
must  be  effected  progressively,  so  that  the  organ  may  be  completely 
replaced  ;  if  it  is  not,  then  re-inversion  is  certain  to  occur. 

Some  practitioners  employ  the  pad  or  cup-shaped  pessary,  to  aid  them 
in  this  operation  ;  the  round  end  is  applied  to  the  fundus  of  the  uterus, 
and  pressure  is  made  at  the  other  end  of  the  instrument  by  the  chest 
or  abdomen  of  the  operator,  whose  hands  are  thus  at  liberty  to  direct 
the  viscus  into  the  vulva  and  vagina. 

Second  MetJiod. — If  the  uterine  tumour  is  voluminous,  and  hangs 
heavily  as  low  as  the  hocks,  then  the  first  method  is  dangerous,  if  not 
impracticable,  and  must  not  be  attempted.  The  best  method  now  un- 
doubtedly is  to  return,  first,  tJie  jJarts  of  the  organ  nearest  the  vulva,  and 
not  act  directly  on  tbe  fundus  of  the  uterus  until  the  greater  portion 
has  been  replaced  in  the  pelvis. 


IM'EJiSIOX  OF  THE  CTEIU'S.  587 

In  ortler  to  accomplish  this,  the  assistants  on  each  side  of  the  croup 
raise  the  uterus  in  the  manner  ah-eady  described,  so  as  to  bring  it  near 
the  vulva,  and  opposite  the  axis  of  the  pelvis.  Then  the  operator  gently 
presses  with  open  hands  at  each  side  on  the  parts  close  to  the  vulvar 
opening,  in  order  to  force  them  gradually  into  it.  By  acting  in  this  way 
with  care  and  patience,  and  preventing,  as  well  as  he  can,  the  expulsion 
of  those  portions  he  has  already  reduced,  the  tumour  by  degrees  becomes 
diminished,  and  may  even  be  entirely  returned.  But  it  is  not  necessai-y 
to  continue  the  method  after  two-thirds  or  three-fourths  of  the  total 
mass  has  been  carried  into  the  pelvic  cavity  ;  for  it  is  then  more  ex- 
peditious, and  quite  as  safe,  to  apply  the  closed  fist  to  the  extremity  of 
the  tumour,  and  push  it  directly  into  the  vagina  and  abdomen.  In 
some  instances  it  will  be  found  that,  towards  the  termination  of  reduc- 
tion, the  organ  itself  returns  to  its  normal  position,  and  often  quite 
suddenly,  as  if  it  had  been  thrown  forward  ))y  a  spring. 

Sometimes  a  combination  of  the  first  and  second  methods  is  most 
useful — an  assistant  pressing  on  the  extremity  of  the  tumour,  while  the 
operator  manipulates  near  the  vulva. 

When  the  uterus  has  been  returned  to  the  abdominal  cavity,  the 
operator  has  then  to  ascertain  if  it  is  properly  disposed.  It  sometimes 
happens  that  the  extremity  of  one  or  other  of  the  cornua  remains 
invaginated  in  itself  to  a  certain  extent,  and  thus  renders  reduction 
incomplete  ;  this  will  undoubtedly  induce  renewed  straining,  and  in 
all  probability  bring  about  re-inversion.  It  is,  therefore,  essential 
that  the  hand  of  the  operator  should  carefully  examine  every  part  of 
the  interior  of  the  uterus  and  the  genital  canal,  and  particularly  around 
the  cervix. 

This  is  more  especially  necessary  when,  after  reposition  has  been 
efifected,  straining  continues — a  sure  indication  that  the  parts  are  not 
in  their  normal  position.  The  hand  must  be  again  introduced,  and  if 
any  abnormal  folds  of  the  mucous  membrane — any  commencing  invag- 
ination— is  encountered,  they  must  be  gently  smoothed  down  or  adjusted 
— not  forgetting,  should  the  cornua  be  involved,  the  very  dissimilar  dis- 
position of  these  in  the  Mare  and  Cow. 

When  reposition  has  been  finally  accomplished,  the  straining  ceases, 
and  the  animal  soon  appears  to  be  quite  easy :  that  is,  if  reduction  is 
made  early — on  the  same  day,  for  instance — and  provided  there  is  no 
injury  to  the  organ.  It  is  generally  advisable  to  keep  the  hand  in  the 
uterus  for  a  short  time  until  the  latter  begins  to  contract  freely ;  if  this 
is  not  done,  the  flaccid  organ  may  again  become  inverted. 

With  the  smaller  animals,  reposition  is  rendered  diflicult  because  of 
the  pelvis  not  admitting  the  hand  ;  and  with  some  of  them,  and  par- 
ticularly the  Sow,  reduction  of  the  prolapsed  cornu  or  cornua  is  often  a 
serious  matter.  The  cornua  must  bo  reduced  in  the  manner  already 
indicated,  the  finger,  or  even  a  tallow  candle,  being  employed  to  adjust 
them,  then  the  body  of  the  organ  should  follow  ;  a  small  pessary  witli 
a  handle,  or  retroverter,  may  be  used  to  complete  the  operation.  Frick,* 
a  Swiss  veterinarian,  has  adopted  a  plan  which  has  succeeded  in  his 
hands,  and  also  with  other  obstetrists  who  have  tried  it.  The  inverted 
organ  being  reduced,  the  animal  is  raised  by  the  hind-limbs,  and  a 
quantity  of  mucilaginous  fluid  is  injected  into  the  vagina  and  uterus, 
until  they  are  tilled.  This  fluid  acts  in  a  mechanical  manner,  forcing 
the  uterus  to  distend  and  assume  its  ordinary  form.  It  has  been 
'  Schicfizer  Archii:,  vol.  xii.,  p.  '249. 


588  ACCIDENTS  AFTER  PAUTUrJTIOX. 

suggested  that  this  distention  plan  should  also  be  adopted  for  the  larger 
animals. 

It  should  be  observed  that  reduction  has  been  effected  in  large  and 
small  animals  by  elevating  the  hind-quarters  until  they  are  almost 
vertical,  the  weight  of  the  uterus,  with  careful  manipulation  on  the  part 
of  the  operator,  carrying  it  down  to  its  normal  situation. 

Eetention  of  the  Utekus. — Eeduction  of  the  inverted  uterus  having 
been  accomplished,  and  everything  done  to  remove  the  slightest  traces 
of  invagination,  the  animal — unless  serious  injury  has  been  inflicted  on 
the  organ — immediately  begins  to  look  easier  and  happier,  and  the  inex- 
perienced would  suppose  that  there  was  no  further  occasion  for  inter- 
ference. The  experienced  obstetrist,  however,  is  well  aware  that  certain 
precautions  must  be  adopted  against  a  possible  recurrence  of  the  accident. 
True,  this  recurrence  is  to  a  certain  extent  provided  for  by  raising  the 
croup  of  the  animal  as  high  as  may  be  convenient,  either  by  means  of 
litter  or  boards,  and  keeping  the  forehand  low.  But  this  is  not  always  a 
preventive,  and  veterinary  obstetrists  have  therefore  devised  other  means 
for  retaining  the  uterus  in  its  place  until  all  risk  of  another  inversion 
has  passed  away.  These  devices  consist  of  pessaries,  sutures,  and 
handaaes. 


Fig.  210. 
Pad  Pessary. 

Pessaries. — These  are  instruments  of  various  forms,  which  are  intro- 
duced into  the  genital  organs,  and  kept  there  for  a  certain  time  in  order 
to  prevent  displacement  of  the  uterus  after  its  reduction.  There  are 
several  described  and  used  by  veterinary  obstetrists. 

The  2^(1  i)essary  (Fig.  210)  is  a  round  piece  of  wood,  from  twenty  to 
twenty-five  inches  in  length,  with  a  hole  at  one  end,  through  which 
passes  a  loop  of  strong  cord  six  to  eight  inches  long ;  at  the  other  end 
is  a  round  pad,  three  or  four  inches  in  diameter,  composed  of  tow  or 
rags,  covered  by  a  piece  of  soft  cloth  or  oiled  silk,  and  firmly  tied  to  the 
stalk  by  a  piece  of  twine  fixed  in  a  small  circular  groove  therein. 

In  using  this  pessary,  the  pad  is  steeped  in  oil  or  melted  lard  ;  it  is 
then  carefully  introduced  into  the  vagina,  placed  against  the  cervix 
uteri,  and  cords  from  each  side  of  the  loop  at  the  other  end,  attached 
to  a  surcingle  round  the  chest,  keep  it  firmly  in  its  place.  The  pad  por- 
tion of  the  pessary  may  be  of  wood,  though  the  elastic  material  is  to  be 
preferred.  A  transverse  piece  of  wood,  with  an  eyelet  at  each  end,  and 
made  to  move  up  and  down  the  handle  by  means  of  a  screw,  is  sometimes 
substituted  for  the  loop  of  cord. 

This  pessary  may  be  most  usefully  employed  as  a  repositor,  in  effect- 
ing reduction  of  the  inverted  uterus. 

The  ring  jjessary  (Fig.  211)  is  equally  simple,  and  is  preferred  by 
some  practitioners  to  the  pad  one.  It  is  composed  of  a  wooden,  or 
better,  an  iron  ring,  about  two  and  a  half  inches  in  diameter,  pierced  by 
an  elongated  or  mortised  hole  at  opposite  sides,  and  of  a  strong  wooden 


IXrEliSlOX  OF  THE  i'TEJtrs. 


r.89 


stem  about  twenty  inches  long,  cleft  in  two  as  far  as  the  middle,  where 
it  is  tied  by  a  piece  of  twine  or  wire.  Tiie  ends  of  the  two  branches 
(A  A)  are  tiriuly  tenoned  in  the  mortises  of  the  ring  ;  and  tiie  other 
end  of  the  stalk  (B)  is  flat,  and  passes  through  the  central  opening  of  a 
transverse  piece  (T  T),  which  is  about  eight  inches  long,  and  has  at  each 
end  an  aperture  (O  O),  in  whicli  are  fastened  the  cords  or  straps  destined 
to  tix  the  apparatus. 

When  rciiuired  for  use,  the  ring  is  wrapped  in  a  narrow  piece  of  fine 
linen,  which  is  rolled  round  it  in  a  uniform  manner,  so  that  it  may  not 
irritate  the  neck  of  the  uterus,  with  which  it  has  to  come  in  contact. 


Fig.  211. 
Ring  Pessaut. 


Fig.  212. 
Cip-anhBam.  rK.s.sAnv. 


This  part  is  well  oiled,  and  being  passed  through  tlie  vagina,  is  so  placed 
against  the  uterus  that  the  cemx  will  be  in  tlie  middle  of  the  ring,  which 
should  make  pressure  on  the  cul  de  sac  of  the  vagina.  It  is  secured  by 
means  of  cords  or  straps  at  the  end  of  the  transverse  portion,  in  a  similar 
manner  to  the  other  pessary. 

The  Cup-and-ball  pcssari/  (Fig.  212),  invented  or  first  described  by 
Chabert,  is  not  unlike  the  last.  It  is  composed  of  around  iron  or  steel 
ring  (A  A),  about  the  same  in  diameter  as  the  other  ;  from  this  arise 
three  stalks  (B  B  B)  ;  these  unite  about  six  or  seven  inches  from  the 
ring  into  a  single  stalk  (T  T),  which  is  screwed  from  a  little  beyond  this 


590  ACCIDENTS  AFTER  PARTURITION. 

union  to  the  end.  On  this  screwed  portion  moves  a  transverse  piece 
(C  C),  by  its  middle  opening  or  female  screw  (E)  ;  this  piece  has  open- 
ings (G  G)  at  its  extremities  which  receive  straps  or  cords. 

To  use  it,  the  ring  and  the  three  branches  are  dipped  in  melted  wax, 
then  cooled,  and  again  and  again  dipped  and  cooled,  until  the  instru- 
ment has  acquired  a  sufficient  volume,  and  the  middle  of  the  ring  is 
reduced  to  about  one  and  a  half  inches.  This  prevents  its  injuring  the 
genital  organs,  when  it  is  applied  exactly  in  the  same  manner  as  the 
preceding  pessary — the  cervix  uteri  being  in  the  centre  of  the  ring. 

A  rondelle  i^essary  has  been  devised  by  Leblanc,  and  Eainard  has 
invented  a  pessary  (similar  to  Fig.  210)  for  small  animals. 

A  bottle  pessary  has  frequently  done  good  service,  when  nothing  more 
suitable  w^as  at  hand.  An  ordinary  glass  bottle,  with  a  deep  concave 
and  smooth  bottom,  has  a  long  piece  of  wood  fixed  in  the  neck,  and 
can  thus  be  made  to  act  like  the  other  pessaries  ;  but  its  weight  is 
objectionable,  and  there  is  also  the  danger  of  its  breaking. 

A  very  ancient  pessary — employed  even  by  the  Greeks  of  an  early 
period — and  one  which  has  been  most  usefully  resorted  to  by  Tolney, 
Laubender,  Willburg,  and  others,  is  the  bladder  of  the  Pig  or  Ox. 
When  required  for  use,  the  bladder  is  steeped  in  warm  water,  then  a 
long  wooden  tube,  or  a  piece  of  india-rubber  tubing,  is  fastened  to  the 
neck  of  it ;  the  bladder  is  introduced  into  the  uterus  and  inflated,  when 
the  tube  is  closed.  Eainard  recommends  that  it  be  only  placed  in  the 
vagina  ;  but  the  majority  of  obstetrists  prefer  it  in  the  uterus.  It  has 
been  allowed  to  remain  there  as  long  as  ten  to  fourteen  days. 

For  valuable  animals,  it  has  been  suggested  that  Gariel's  air  pessary 
might  be  employed.  This  acts  on  the  same  principle  as  the  bladder ; 
in  fact,  it  is  an  india-rubber  bladder  inflated  by  means  of  a  long  tube 
with  a  stop-cock.  This  tube  may  be  in  connection  wnth  another  bag 
and  stop- cock,  the  former  being  already  filled  with  air,  which  can  be 
transferred  to  the  other  bag  when  it  is  placed  in  the  vagina  or  uterus. 

The  smaller  animals  rarely  require  pessaries  of  this  description  ; 
though  there  is  no  reason  why,  if  necessary,  modifications  of  the  three 
first,  on  a  proportionately  small  scale,  might  not  be  employed.  The 
ring  might  be  made  of  india-rubber,  or  cork.  For  the  Bitch  more 
particularly,  the  cuvette  pessary  has  been  recommended  and  used. 
This  is  an  imitation  of  that  employed  for  woman,  and  is  merely  an 
oval,  circular,  or  oblong  piece,  made  of  gum,  india-rubber,  gutta-percha, 
or  ivory,  one  to  two  inches  in  diameter,  and  having  a  hole  in  the 
middle.  When  required  to  be  introduced,  this  pessary  is  well  oiled  ; 
the  narrow  end  is  passed  edgeways  into  the  vulva,  and  the  piece  is 
pushed  beyond  the  bulb  of  the  vagina.  Then,  by  means  of  the  index- 
finger,  it  is  placed  vertically,  the  hole  in  the  middle  allowing  the  finger 
to  fix  it  in  the  centre  of  the  vulva,  its  two  ends  being  retained  by  the 
branches  of  the  ilium,  or  at  least  in  front  of  the  ischium  and  the  bulb. 

A  spring  or  elastic  pessary,  such  as  is  now  frequently  employed  for 
woman,  and  which  can  be  more  easily  introduced  into  the  vagina,  might 
be  useful  with  the  smaller  domesticated  animals. 

Salt,  of  Birmii:igham,  has  introduced  into  human  gynaecology  a  new 
flexible  annular  pessary,  which  might  be  advantageously  employed  by 
the  veterinarian  for  small  animals.  It  consists  of  a  watch-spring  coiled 
spirally,  with  the  extremities  left  free,  and  encased  in  caoutchouc ;  it 
collapses  for  introduction,  and  when  in  situ  it  expands  to  the  circular 


/M'J-JnSIOX  OF  TUB  UTERUS.  r.91 

form,  or  such  other  shape  as  may  best  accommodate  its  contact  with 
surrounding  parts. 

The  value  of  pessaries  in  inversion  of  the  uterus  in  animals  has 
been  a  good  deal  discussed.  We  are  not  aware  that  they  have  been 
much,  if  at  all,  employed  in  this  country  ;  and  in  Germany  they  do  not 
appear  to  have  obtained  much  favour  ;  while  in  France,  though  they 
have  often  been  resorted  to,  yet  tlieir  use  has  been  only  limited,  as  their 
practical  utility  has  been  questioned  by  many  excellent  obstetrists. 

It  has  been  pointed  out  that  if  they  can  be  supported  without  incon- 
venience by  some  phlegmatic  unimpressionable  animals,  more  frequently 
they  irritate  the  organs  in  the  pelvis,  cause  straining  and  uneasiness, 
and  produce  those  relapses  which  their  application  was  intended  to 
avert.  Therefore  it  is  that,  nowadays,  they  are  not  made  available  to 
anything  like  the  extent  they  were  a  few  years  ago. 

Saint-Cyr  admits  that  if,  in  some  exceptional  case,  it  is  necessary  to 
employ  a  pessary,  the  Piifs  bladder  deserves  the  preference  for  the 
larger  animals.  It  is  found  nearly  everywhere,  requires  no  other  pre- 
paration than  merely  softening  its  texture  by  pouring  some  tepid  water 
into  it,  whilst  its  outer  surface  can  be  well  oiled.  It  is  easily  placed 
where  desired,  even  in  the  uterus  ;  its  soft,  flexible  walls  cannot  bruise 
or  excoriate  ;  and,  by  inflation,  it  can  be  distended  to  the  size  necessary 
for  each  particular  case. 

Sutures. — The  suture  is  generally  preferred  to  the  pessary,  as  being 
simpler,  more  easily  applied,  and  having  fewer  inconveniences  than 
the  latter.  Being  inserted  outside  the  genital  organs,  they  do  not 
irritate  those  which  are  most  concerned  in  inversion,  neither  do  they 
provoke  expulsive  etTorts  on  the  part  of  the  animal. 

The  sutures  may  be  of  hemp,  silk,  or  metal ;  and  they  may  be  passed 
dii-ectly  through  the  lips  of  the  vulva,  or  include  the  skin  towards  the 
point  of  the  hip,  on  each  side.  The  first  may  be  named  the  labial 
suture,  the  second,  the  Jiip  suture. 

The  labial  suture  may  be  "  interrupted,"  or  "  quilled,"  and  is  made 
according  to  the  principles  of  surgery.  A  saddler's  large  needle,  or  a 
sacking-needle  with  a  handle  at  one  end  and  an  eye  near  the  point,  is 
the  most  useful.  Through  the  eye  is  passed  a  piece  of  whipcord,  two 
or  three  strands  of  woll-waxed  thread,  or  a  piece  of  cotton  or  silk  tape, 
or  moderately  thick  carbolised  catgut.  The  needle  is  passed  through 
one  lip  of  the  vulva— say  the  right — from  the  outside,  and  near  tlic 
up})er  commissure  ;  it  is  then  passed  through  the  left  lip,  from  within 
to  without,  towards  the  inferior  commissure.  It  is  then  cut  from  the 
suture,  sutVicient  of  the  latter  being  left  for  both  ends  to  tie  in  the 
middle  of  the  vulva.  A  second  suture  is  placed  in  the  contrary  direction 
— upper  part  of  lt»ft  to  lower  part  of  right  lip-  so  that  the  two  sutures 
cross  each  other  obliquely,  in  an  X  fashion.  The  ends  are  now  tied 
towards  the  centre  of  the  vagina ;  and,  if  thought  necessarj',  a  third 
suture,  directly  transverse,  may  be  placed  between  these. 

It  is  more  convenient  and  painless  to  pass  the  needle  first  through 
the  tissues,  then  the  suture  through  the  eye  of  the  needle,  withdrawing 
the  latter,  which  carries  the  suture  with  it. 

This  labial  suture  is  painful,  as  it  is  placed  in  textures  already  swollen 
and  sore,  and  it  does  not  always  retain  a  sufficiently  solid  hold  to  pre- 
vent the  uterus  tearing  it  out  when  the  straining  is  very  severe  and 
violent.     The  hip  suture  has  therefore  often  been  resorted  to  in  these 


592  ACCILEXTS  AFTER  PAETUBITIOX. 

cases,  and  with  advantage.  The  needle — either  the  above  or  a  small 
seton  needle — is  passed  through  a  fold  of  skin  lifted  up  at  the  point  of 
the  hip  or  ischium,  on  a  level  with  the  upper  commissure  of  the  vulva, 
and  carried  across  to  the  other  hip.  The  next  suture  is  a  trifle  lower, 
and  the  others  below  this  :  there  being,  in  all,  about  four  to  six  sutures, 
the  ends  of  each  being  tied  in  the  middle,  or  fastened  to  bits  of  round 
wood  at  each  side.  In  this  way  the  vulva  lies  behind  a  number  cf 
strong  cords  —  their  strength  and  durability  being  in  proportion  to 
the  width  of  skin  they  are  made  to  enclose.  The  sutures  maybe  drawn 
more  or  less  tightly,  and  they  may  either  be  transversely  parallel  or 
cross  each  other  obliquely. 

When  the  animal  is  not  pregnant,  the  vulva  is  not  nearly  on  a  level 
with  the  ischial  tuberosities.  After  parturition,  however,  it  is  swollen 
and  prominent,  and  projects  beyond  these  parts.  It  will  therefore  press 
against  the  hip  sutures,  and  may  even  become  excoriated  or  cut  by 
them  ;  so  that,  to  avoid  injury  and  diffuse  the  pressure,  it  is  well  to 
place  a  thick  pledget  of  tow  or  other  soft  material  on  each  side  of  the 
vulva,  on  which  the  sutures  may  chiefly  rest. 

Though  good  service  has  been  obtained  from  these  sutures  in  a 
number  of  instances,  yet  many  practitioners  prefer  the  metallic  suture. 
This  may  be  of  lead,  or  iron  wire  softened.  The  needle  is  like  that 
used  for  the  other  sutures  ;  a  pair  of  wire-pliers  is  necessary,  and  two 
sizes  of  wire  are  recommended.  The  thickest  size  is  cut  into  pieces  of 
a  convenient  length,  and  an  eyelet  turned  at  one  end,  w^hile  the  other 
is  made  into  a  hook.  The  left  lip  of  the  vulva  is  seized  by  the  left 
hand,  and  the  needle  pushed  through  it  from  the  outside,  a  little 
obliquely  upwards,  so  as  to  bring  it  out  above  the  superior  commissure  ; 
the  wire  is  passed  into  the  eye  at  the  point,  and  the  needle  being 
smartly  withdrawn,  the  wire  is  pulled  through.  The  needle  is  intro- 
duced into  the  right  lip  in  the  same  manner,  but  downwards,  and  the 
wire  pulled  through  it.  The  hooked  end  is  now  passed  into  the  one 
with  the  eyelet,  drawn  sufficiently  through,  cut  off,  and  the  end  bent 
also  into  an  eyelet,  the  suture  constituting  an  ellipse  at  this  part,  which 
is  opposite  the  vulvar  opening.  Beneath  this  suture  one  or  two  more 
are  placed,  and  all  are  joined  together  by  the  thinner  wire,  which, 
doubled,  is  longer  than  the  space  occupied  by  the  sutures ;  each  piece 
is  passed  into  each  eyelet  of  the  upper  suture,  and  firmly  crossed  and 
twisted  as  far  as  the  two  points  of  the  suture  ;  the  same  is  done  with 
the  second  and  the  third  suture — the  whole  being  joined  into  a  solid 
piece,  which,  according  to  report,  does  not  interfere  with  the  physiolo- 
gical functions  of  the  animal. 

The  same  objection  applies  to  wire  sutures  through  the  vulva  as  to 
vegetable  sutures  ;  bub  there  can  be  no  doubt  that  they  are  less  painful 
and  more  effective  when  passed  through  the  skin  at  the  point  of  the 
hip.  Two  wires  across  are  generally  sufficient ;  the  ends  are  bent  round 
by  pliers  after  they  are  inserted,  and  through  these  eyelets  on  each  side 
a  vertical  wire  is  passed  (Fig.  213).  This  keeps  the  horizontal  wires 
together  and  in  place. 

Metallic  sutures  in  the  form  of  pins,  screwed  at  one  end  to  fix  into 
plates  after  being  passed  through  the  labia  of  the  vulva,  and  other  con- 
trivances of  this  description,  have  been  described ;  but  in  principle 
they  are  all  the  same,  and  there  is  no  manifest  advantage  in  their 
employment. 

In  fact,  it  may  be  said  of  all  the  labial  or  other  sutures,  that  they  in 


J.VrBIiSKLV  OF  THE  irEiius. 


:i93 


no  respect  prevent  the  inversion  of  the  organ  internally,  but  merely 
hinder  its  escaping  beyond  the  vulva  ;  and  as  their  utility  depends  not 
only  upon  the  material  of  which  they  are  composed,  Imt  also  upon  the 


I 


4 


Fig.  213. 
Zcnoel's  Labial  Sdturks. 

integrity  or  power  of  resistance  of  the  textures  through  which  they 
pass,  it  often  happens  that  they  either  give  way,  or  they  "  tear  out  " 
prematurely,  leaving  sometimes  troublesome  wounds  or  cicatrices. 


Fig.  214. 
The  Loop  of  Dklwabt's  Turss. 


It  must  not  be  forgotten,  too,  that  even  under  the  most  favoui-able 
■circumstances,  these  sutures,  both  during  their  insertion  and  their 
maintenance,  are  a  source  of  uneasiness  and  pain  to  the  animal. 

38 


594 


ACCIDEXTS  AFTEB  PARTUPJTIOX. 


Bandages  or  Trusses. — To  dispense  with  the  inconveniences  of  the 
pessary  and  suture,  the  bandage  or  truss  has  been  proposed  and  exten- 
sively employed  ;  and  in  the  great  majority  of  cases  of  uterine  inversion, 
it  should  be  adopted  in  preference  to  the  other  methods  of  retention. 

The  truss  or  bandage  may  be  composed  of  cords,  surcingles,  leather, 
canvas,  etc.,  which  are  so  arranged  and  disposed  as  to  make  pressure 
upon  the  sides  of  the  vulva,  and,  by  keeping  it  closed,  prevent  the  ex- 
trusion of  the  uterus  without  interfering  with  defecation  or  micturition. 

There  are  several  kinds  of  truss  in  use,  and  these  vary  somewhat  in 
their  details,  though  in  principle  they  are  the  same.  Some  of  them  are 
fixed  around  the  shoulders  and  neck,  others  round  the  chest  only,  and 
others,  again,  round  both  regions — most  frequently  to  a  collar  or  surcingle. 
Allusion  will  be  made  to  those  which  are  recognised  as  most  valuable. 


Fig.  215. 
Delwart's  Truss  applied. 


Two  of  the  most  useful  and  readily-made  trusses  are  composed  of 
light  rope  or  thick  cord — something  like  a  clothes-line.  One  of  these 
is  termed  "  Delwart's  Truss,"  and  is  formed  by  cords  united  by  a  loop 
in  their  middle,  in  such  a  manner  that  an  oval  space  (a,  Fig.  214) 
sufficient  to  admit  the  vulva,  and  compress  it  laterally,  is  formed — the 
inferior  commissure  being  left  free,  to  allow  the  escape  of  urine,  and 
uterine  discharges,  should  there  be  any.  The  two  portions  of  one  of 
the  cords  {b  b)  passing  over  the  back,  are  secured  to  a  collar  or  band 
round  the  neck  or  chest ;  while  those  of  the  other  cord  (c  c)  pass  between 
the  thighs,  and  are  tied  to  the  lower  part  of  the  collar  or  surcingle,  in 
the  manner  depicted  in  Fig.  215.  The  loop  may  be  wrapped  in  tow  or 
cloth,  to  prevent  chafing  to  the  parts  under  the  tail. 

Another  rope  truss,  described  by  Eenault,^  is  perhaps  more  simple, 
yet  quite  as,  if  not  more,  effective  than  the  preceding.  This  is  com- 
^  Maison  Rustique  du  XIX.  Siecle,  vol.  ii.,  p.  286. 


ixi'Kh's/ttx  oh'  THE  iTHnrs.  :>\^'> 

posed  of  a  leather  strap  wliich  buckles  round  the  neck,  and  a  rope  from 
twenty-four  to  tiiirty  feet  long — the  thickness  of  the  little  linger,  or  a 
triHe  less,  according  to  the  size  of  the  animal.  The  neck-strap  is  not 
indispensable,  though  it  is  useful  in  giving  more  firmness  to  the  truss  ; 
it  may  be  replaced  by  a  thicker  rope,  or  in  the  case  of  the  Mare  by  an 
ordinary  draught  collar. 

In  order  to  aj>ply  the  bandage,  the  neck-strap  or  collar  is  first  to  be 
put  on  ;  the  cord  is  then  to  be  doubled  in  eijual  parts  and  put  across  the 
back,  behind  the  withers,  so  that  each  portion  may  fall  behind  the 
shoulders,  to  be  passed  under  the  chest.  In  front  of  the  chest,  the  two 
portions  are  crossed,  the  left  passing  to  the  right  and  the  right  to  the 
left.  Each  side  is  carried  through  the  collar,  and  back  over  the  front 
of  the  shoulder,  at  the  top  of  wliich  both  are  tied  in  a  simple  knot,  so 


-i\  Z-^*?^^^ 


Fig.  216. 
Rknaults  Truss. 


as  to  be  easily  untied  when  required.  At  ten  or  twelve  inches  from 
this,  a  firmer  knot  is  tied,  then  several  otliers  beyond  it  towards  the 
loins — according  to  the  length  of  the  animal — and  at  nearly  equal 
distances  as  far  as  the  root  of  the  tail,  where  a  sinqjle  knot  is  tied.  The 
branches  of  the  cord  then  separate  on  each  side  of  the  vulva,  and  unite 
again  by  a  simple  knot  below  the  inferior  commissure;  again  separating, 
each  cord  is  carried  between  the  hind-legs,  brought  up  by  the  flank 
towards  the  loins  on  each  side,  and  tied  over  the  back  to  one  of  the 
loops  there,  as  shown  in  Fig.  216.  This  truss  can  be  made  as  easy  or 
tight  as  may  be  necessary ;  its  simplicity  is  its  great  recommendation.' 

'  Hcir^burgh  (  Veterinnrimu  vol.  xiv.,  p.  490)  descrilxjs  ft  similar  tru.ns,  which  he  appliwl 
t<>  a  Mare  that  had  inverted  the  utenw  three  days  after  foaling.  Giving  the  animal 
some  extract  of  hyoscvanius  and  gnm  (pii,  dissolved  in  a  pint  of  warm  water,  to  allay  the 
straining,  aa  soon  as  thi.n  dose  began  to  operate  he  reduced  the  organ.  This  waa  done  by 
securing  the  animal,  sponging  over  the  uterus  with  a  little  vinegar  and  wat«-r,  and 
"taking  hold  of  a  clean  t<iwel  in  the  left  hand,  doubled,  and  the  comers  of  the  towel 


596  ACCIDEXTS  AFTER  PAETURITION. 

A  very  efficient  and  suitable  truss  is  that  made  of  a  piece  of  stout 
leather,  with  a  round  opening  in  it  above,  corresponding  to  the  anus, 
and  an  oblong  opening  beneath  this,  through  which  the  vulva  passes. 
The  leather  is  so  shaped  as  to  embrace  and  lie  close  to  the  root  of  the 
tail  and  between  the  buttocks,  extending  for  some  distance  below  the 
vulva,  as  in  Fig.  217.  It  is  maintained  in  position  by  four  strong 
leather  straps — two  above  and  two  below — which  pass  on  each  side  to 
a  surcingle  around  the  chest,  which  may  again  be  attached  to  a  collar 
or  breast-strap,  should  the  straining  be  violent. 

Another  kind  of  truss  is  formed  by  an  ordinary  crupper  attached  to  a 
surcingle,  and,  if  need  be,  this  to  a  breast-strap  or  collar.  From  the 
part  of  the  crupper  under  the  tail  proceed,  two,  three,  or  four  narrow 
leather  straps,  which,  passing  over  the  vulva,  are  attached  to  the  loop 


Fig.  217. 
Leather  Truss. 

of  a  doubled  rope  in  the  perinaeum,  each  portion  of  the  rope  being 
passed  between  the  hind-legs  and  tied  to  the  lower  part  of  the  sur- 
cingle.     Or  a  cord  may  be  attached  to  the  crupper  at  each  side  of 

falling  back  on  the  arm — made  bare  for  the  purpose.  I  then  applied  the  doubled  fist  to 
the  fundus  of  the  uterus,  with  the  assistance  of  the  right  hand  in  bearing  it  up  by  a 
moderate  degree  of  force,  and  returned  it  to  its  place,  slowly  withdrawing  the  hand,  and 
leaving  the  towel  for  a  few  minutes.  I  next  proceeded  to  remove  the  towel,  by  intro- 
ducing the  hand,  greased  for  the  purpose,  into  the  vagina,  taking  it  by  the  corners, 
turning  it  several  times  round,  and  at  the  same  time  bringintr  it  out  slowly.  After 
which  I  introduced  the  arm  to  the  full  length,  in  order  to  ascertain  whether  it  was  in 
its  proper  position,  using  a  little  force  on  the  further  end,  in  order  to  stretch  it.  I  then 
withdrew  the  arm,  and  proceeded  to  apply  the  uecessarj'  bandages.  First,  a  strong  girth 
or  surcingle  was  buckled  tightly  round  the  abdomen,  to  prevent  the  muscles  acting  with 
such  force  as  again  to  expel  the  uterus.  This  is  essentially  necessary.  I  then  took  a 
small  rope,  or  narrow  web  (the  one  used  on  this  occasion  was  a  cavesson  for  breaking 
horses  in  the  menarje),  forming  an  eye  (loop)  in  the  middle,  to  be  passed  over  the  neck, 
as  if  for  casting.  I  then  passed  the  ends  between  the  fore-legs  and  along  the  belly — one 
on  each  side  of  the  udder,  up  between  the  hind-legs — tying  a  single  knot  exactly  at  the 
inferior  part  of  the  vulva.  Another  was  placed  superior  to  the  anus,  carrying  the  ends 
up  on  each  side  the  tail,  fixing  them  securely  and  tightly  to  the  loop  round  the  neck,  and 
on  each  side  of  the  withers."'  This  truss  was  a  perfect  success,  and  could  be  dispensed 
with  in  three  days.     Horsburgh  condemns  sutures  passed  through  the  labia  pudendi. 


jxi'i-jjisioy  <>F  THE  rrKurs.  r.07 

the  vulva,  and  carried  forward  between  the  hind-legs  and  underneath 
the  belly  in  the  same  manner,  two  or  three  transverse  narrow  straps 
passing  between  the  two,  immediately  over  the  vulvar  opening. 

When  there  is  much  swelling,  a  soft  cloth  doubled  several  times,  or  a 
sponge  steeped  in  cold  water,  may  be  placed  over  the  vulva  beneath  the 
strapri,  though  in  such  a  way  as  not  to  interfere  with  micturition  or  de- 
fecation. 

Various  other  trusses  for  the  Mare  or  Cow  have  been  proposed  by 
veteriiKiry  obstetrists,  but  in  principle  they  are  all  the  same.  We 
need  only  notice  one  of  these,  which  has  been  proposed  by  Lund,  a 
Danish  veterinary  surgeon,  and  which  has  been  greatly  lauded  by 
Dieterichs  and  others  for  its  cheapness,  simplicity,  and  elliciency.  The 
chief  part  of  it  is  a  narrow  piece  of  iron,  nine  millimetres  thick  (about 
one  third  to  three-eighths  of  an  inch),  welded  at  its  extremities,  and 
turned  into  a  triangular  shape  that  enables  it  to  include  the  vulva,  while 
the  loops  at  its  three  corners  allow  it  to  receive  cords  (Fig.  218).     The 


Fig.  218. 
LcNn's  TRDS.S  Iron. 

base  of  the  triangle,  which  fits  under  the  tail,  is  about  two  to  two  and 
a  half  inches  wide,  and  the  sides  from  five  to  seven  inches  long.  The 
loopholes  at  the  angles  may  be  replaced  by  small  hooks  to  receive  the 
cords. 

This  metal  plate — which  may  be  of  round  iron  and  convex  on  one 
side,  concave  on  the  other — fits  over  the  vulva  and  the  base  of  the  tail, 
the  apex  being  below  the  lower  commissure,  while  the  convex  side  is 
towards  the  animal.  Cords  pass  through  the  loops  or  around  the 
hooks,  one  above,  another  below — as  in  Fig.  219— and  are  fastened  to  a 
surcingle  or  collar,  or  both,  like  the  preceding  trusses.  Any  black- 
smith can  make  the  plate  in  a  few  minutes  ;  and  from  what  has  been 
said  in  praise  of  this  cheap  and  simple  method  of  retaining  the  uterus, 
there  can  be  no  doubt  that  it  will  be  found  most  useful. 

All  these  trusses  are  intended  for  the  larger  animals,  and  cannot  well 
be  appUed  to  the  smaller  creatures,  with  the  exception  perhaps  of 


598 


ACCIDENTS  AFTER  PARTVPdTION. 


Lund's  plate,  which,  much  diminished  in  size  and  made  of  a  piece  of 
strong  iron  wire,  might  be  serviceable  for  the  Ewe,  Sow,  Goat,  or  large 
Bitch.  For  small  animals  Eainard  recommends  a  bandage  made  by 
folding  a  piece  of  strong  cloth  in  a  triangular  manner.  The  base  of 
this  triangle  lies  over  the  loins,  is  carried  down  the  flanks  to  beneath 
the  abdomen,  where  the  corners  are  tied;  the  apex  of  the  triangle  is 
passed  over  the  croup  and  vulva — a  hole  being  made  for  the  tail  to 
pass  through  and  another  for  the  anus — brought  between  the  hind-legs, 
and  either  by  means  of  tapes  attached  to  it,  or,  if  sufficiently  long,  by 
splitting  up  the  end  to  a  short  distance  so  as  to  make  two  strips  of  it, 
fastening  the  piece  to  the  ends  already  tied  beneath  the  belly. 

It  must  be  acknowledged  that  these  trusses,  no  matter  how  skilfully 
they  may  be  contrived  or  however  well  they  may  be  adjusted,  will  not 


Fig.  219. 
LuNu's  Truss  applied. 


hinder  vaginal  inversion  of  the  uterus  ;  all  they  can  do  is  to  prevent 
the  organ  from  being  suddenly  protruded  beyond  the  vulva  again,  and 
so  exposed  to  the  air  and  the  irritating  effects  of  extraneous  matters 
before  it  can  be  returned  once  more.  This  alone,  however,  is  an  im- 
portant object  achieved,  and  is  a  great  step  towards  permanent  reten- 
tion. Besides,  by  maintaining  the  labia  of  the  vulva  in  close  apposition, 
the  truss,  if  well  applied,  prevents  the  admission  of  air  into  the  genital 
canal,  and  thus  does  away  with  one  source  of  irritation.  And  as  the 
apparatus  does  not  cause  any  pain  or  inconvenience  to  the  animal,  it 
is  to  be  preferred  to  any  other  means  for  retaining  the  uterus. 

With  regard  to  the  best  kind  of  bandage,  this  is  of  secondary  im- 
portance to  its  proper  application.  Simplicity  and  efficiency  are  the 
desiderata,  and  these  will  be  found,  we  believe,  in  the  trusses  we  have 
described,  and  particularly  in  those  of  Eenault  and  Lund. 

If  reposition  of  the  uterus  is  properly  effected  and  the  truss  well 


/.V/'A'A'.s/o.V  OF  THE  ITERI'S.  599 

applied,    there    is   little    reason    to   apprehend   a    recurrence    of    the 
accident. 

Aktku  Tkeatment.  —  When  the  uterus  has  been  returned  to  its 
natural  situation,  an  antiseptic  injection  or  "  swabbing  "  of  the  interior 
should  be  carried  out,  and  precautions  against  a  recurrence  of  tlie 
inversion  adopted  ;  then  little  more  remains  to  be  done  except  to 
observe  some  simple  directions,  which  are  to  be  followed  for  a  few  days 
after  reposition. 

If  the  weather  is  favourable,  and  little  or  no  fever  present,  the  animal 
— covered  with  a  rug — should  be  walked  about  for  a  few  minutes ;  as 
this  takes  away  its  attention  from  the  accident,  regulates  tiie  general 
circulation,  and  allays  the  expulsive  efforts. 

The  animal  should  stand  with  the  hind  parts  well  raised,  and  it 
ought  not  to  be  allowed  to  lie  down  for  a  day  or  so. 

Great  attention  should  be  paid  to  the  diet,  particularly  with  Rumi- 
nants, from  their  tendency  to  tympanitis  and  constipation.  Indeed, 
tympanitis  may  be  sometimes  considered  a  cause  of  inversion  in  the 
Cow  and  Ewe  ;  and  the  rumen  is  at  times  so  distended  with  gases,  and 
so  proves  such  an  obstacle  to  reduction,  that  it  has  to  l)e  punctured  in 
the  usual  way  before  reposition  can  be  effected.  For  the  same  reason, 
this  inflation  of  the  digestive  organs  has  to  be  guarded  against  in  the 
after  treatment.  For  the  first  day,  only  oatmeal  gruel  with  barley- 
water — both  tepid — should  be  allowed  in  small  but  frequent  quantities. 
For  some  days,  easily-digested  sloppy  food  may  be  given,  and  if  the 
appetite  is  tickle  it  should  be  tempted  by  choice  portions  of  diet; 
though  the  quantity  nmst  not  be  large  at  any  time  until  all  danger  is 
past. 

If  there  is  apprehension  of  inflammatory  complications,  such  as 
metritis  or  peritonitis,  emollient  poultices  or  a  strong  rubefacient  may 
be  applied  to  the  abdomen.  It  is  advisable  in  all  cases  in  which  the 
mucous  membrane  has  been  injured  or  exposed  to  the  air  for  some 
time,  to  inject  some  antiseptic  fluid — such  as  boric  acid  solution — into 
the  uterine  cavity  for  two  or  three  days. 

Should  tliere  be  a  tendency  to  constipation,  soap-and-water  enemas 
may  be  administered. 

Micturition  is  rarely  deranged  ;  but  if  no  urine  is  passed  within 
twenty-four  hours  after  reposition,  an  examination  should  be  made, 
and  the  bladder  emptied  in  the  usual  manner.  The  different  disposition 
of  the  urethral  valve  in  the  Mare  and  Cow  will,  of  course,  be  borne  in 
mind  in  passing  the  catheter. 

Nearly  always  these  simple  measures  suthce  to  restore  the  animal  to 
its  usual  condition  in  three  or  four  days,  in  uncomplicated  cases.  In 
exceptional  instances,  however,  metritis,  metro-peritonitis,  or  leucor- 
rhcca  will  follow  the  accident.  The  animal  may  go  off  its  milk  and  fall 
into  low  condition,  without  exhibiting  any  acute  symptoms  ;  or  indica- 
tions of  puerperal  fever  may  supervene.  Sometimes  the  animal  remains 
sterile  for  a  variable  period.  With  the  Ewe,  chronic  inversion  of  the 
uterus  often  leads  to  loss  of  the  wool. 

In  complicated  cases  there  may  be  wounds,  lacerations,  rupture  of 
the  uterus,  cornua,  or  vagina,  lesions  of  neighbouring  organs  or  textures, 
etc. ;  these  will  be  referred  to  hereafter. 

A  curious  complication  of  uterine  inversion  has  been  mentioned  by 
Ayrault,'  who  witnessed  it  in   three  cases.     This  was  great  lameness 
•  RecutU  de  Midecxnt  VcUrinaire,  1S57,  p.  72.3. 


600  ACCIDENTS  AFTER  PARTURITION. 

in  the  limbs,  without  swelling  of  the  joints,  but  with  marked  knuckling 
over  of  the  hind-pasterns.  It  disappeared  spontaneously  as  the  patients 
recovered  from  the  other  effects  of  the  inversion. 

Abiputation  of  the  Uterus — Meteotomy. — Though  it  should  be 
recognised  as  a  rule  that,  provided  there  is  no  serious  complication 
and  the  obstetrist  is  called  in  good  time,  with  patience  and  skill 
reposition  of  the  inverted  uterus  is  possible,  yet  cases  will  occur  in 
which  the  operator  is  baffled  in  his  attempts  at  reduction,  or  when,  at 
the  first  glance  or  after  an  examination,  he  has  to  recognise  this  as 
impossible  or  useless.  "  Since  I  have  been  in  practice,"  says  Schaack, 
"  I  have  been  often  called  upon  to  remedy  this  kind  of  displacement, 
and  from  what  I  have  seen  I  am  led  to  believe  that  the  impossibility 
of  reduction  is  not  so  much  due  to  the  difficulties  in  the  cases  them- 
selves, as  to  the  hurtful  manoeuvres  which  have  been  performed. 
Nevertheless,  it  must  be  acknowledged  that  the  development  of  the 
hernia  and  the  rigidity  of  the  tissues  are  sometimes  so  great  that  it 
requires  a  certain  amount  of  confidence  in  one's  self  not  to  be  dis- 
concerted nor  afraid.  ...  To  be  successful  it  is  necessary  to  insist — 
to  insist  in  spite  of  everything — on  applying  one's  self  to  seize  each 
alternative  point  of  relaxation  ;  to  engage,  bit  by  bit,  the  displaced  organ 
in  the  vulva,  in  commencing  with  that  which  is  nearest  this  opening, 
then  successively  all  the  remainder." 

This  advice  is  judicious  and  sound ;  but,  as  has  been  said,  in  certain 
cases  the  extruded  organ  is  so  injured,  either  by  the  unskilful  attempts 
of  ignorant  men  to  return  it,  or  from  other  causes,  that  it  would  be 
certain  death  to  the  animal  to  replace  it  in  the  abdomen.  We  refer 
now  to  extensive  lacerations  and  bruises,  or  when  the  organ  has 
become  softened  and  gangrenous ;  and  lacerations  and  ruptures  are 
always  more  serious,  it  must  be  remembered,  in  the  lower  than  the 
upper  wall  of  the  uterus. 

In  other  cases,  when  reduction  has  not  been  complete,  and  one  horn 
remains  more  or  less  invaginated,  or  the  body  of  the  organ  is  not  well 
adjusted,  inversion  will  again  and  again  occur  in  spite  of  all  attempts 
at  retention ;  and  this  only  too  frequently  leads  to  such  grave  injury 
that  there  is  no  hope  of  the  organ  regaining  its  normal  condition,  even 
should  reposition  be  at  last  successful.  Indeed,  its  walls  are  so 
softened  and  friable  that  they  cannot  withstand  the  least  pressure, 
but  tear  whenever  an  attempt  is  made  to  carry  the  uterus  into  the 
vulva. 

With  certain  animals,  too  ■ —  as  Swine  —  reposition  is  extremely 
difficult,  particularly  when  one  or  both  cornua  are  inverted ;  as  the 
smallness  of  the  organ,  as  well  as  the  narrowness  of  the  pelvis,  is  a 
great  obstacle  to  manipulation. 

In  such  exceptional  circumstances  complete  extirpation  of  the  uterus 
{Metrotomji)  has  been  recommended  and  practised. 

It  is  now  many  years  since  the  operation  was  introduced  into 
veterinary  surgery,  as  Binz  states  that  it  was  performed  by  Jenne,  a 
German  veterinarian  in  Forchheim,  in  1802. 

Though  the  operation  is  apparently  a  most  formidable  and  painful 
one,  and  only  to  be  ventured  upon  as  a  last  resource,  yet,  on  the  whole, 
it  is  tolerably  successful.  Of  thirty  cases  collected  by  Saint-Cyr,  no 
fewer  than  twenty-three  recovered  from  the  operation.  Franck  refers 
to  thirty  cases,  eighteen  of  which  recovered,  and  four  (two  Cows  and 
two  Goats)  were  killed,  though  not,  it  would  appear,  on  account  of 


ixvEiismx  of  THE  rr Kill's.  goi 

the  operation.  Of  these  thirty  cases  only  one  was  a  Mare  ;  17  were 
Cows  ;  3  Goats  ;  4  Sows  ;  1  ]"^we  ;  2  Bitches  ;  and  '1  Cats.  He  remarks 
that,  of  the  unfortunate  cases,  there  were  prohably  some  which  died 
from  other  causes  than  the  amputation  ;  while  others  evidently  perished 
from  septic  infection.  Recoveries  have  taken  place  after  the  Caesarian 
section  and  excision  of  the  uterus  practised  on  the  same  animal,  at 
the  same  time. 

The  operation  might  be  more  successful  did  it  not  happen  that  it  is 
late  before  it  is  resorted  to,  and  very  often  the  animal  is  already  greatly 
exhausted. 

It  is  curious  to  note  that  it  has  been  recorded  by  several  observers, 
that  some  Cows  which  recovered  have  shown  signs  of  a'Strum — doubt- 
less because  the  ovaries  were  left  intact ;  while  other  Cows  have  yielded 
milk  after  the  operation.  Lecoq  knew  of  a  Cow  from  which  the  uterus 
had  been  removed,  and  which  gave  an  abundance  of  milk  for  two  years 
afterwards. 

Openitioii. — Various  modes  of  operating  have  been  practised  and 
recommended.  With  the  larger  animals,  the  hind-limbs  should  be 
secured — especially  with  the  Mare — or  they  may  be  thrown  down,  or 
fixed  in  a  travis  if  there  is  one  convenient. 

Chloroform,  chloral,  or  morphia  should  be  administered  to  the  animals 
about  to  be  operated  upon.  It  is  also  a  good  plan  to  tie  the  uterus  up 
in  a  large  cloth,  so  that  it  may  be  easier  moved  about  by  the  operator 
or  his  assistants,  and  render  the  operation  cleaner  and  less  repulsive- 
looking. 

The  oldest,  and  perhaps  most  popular,  method  is  the  liijatior  in  ma.s.s. 
A  piece  of  strong  whipcord,  well  waxed  and  made  into  a  running  loop, 
is  passed  over  the  tumour  as  near  to  the  vulva  as  possible,  but  without 
including  the  meatus  urinarius.  When  evenly  placed  around  the 
pedicle,  it  is  gradually  but  firmly  tightened  by  pulling  at  each  end,  so 
as  to  completely  intercept  the  circulation  in  the  organ.  This  done,  the 
cord  is  tied  in  a  knot. 

Though  this  method  has  been  mucli  employed,  and  with  a  fair  amount 
of  success,  yet  it  has  been  condennied  by  some  good  authorities,  on  the 
plea  that  it  is  dangerous  to  tie  such  a  voluminous  mass  ;  as  all  tlie  parts 
cannot  be  sufViciently  and  equally  compressed  to  become  mortified  at 
the  same  time.  Those  parts  which  have  not  been  firmly  constricted 
still  retain  a  certain  amount  of  circulation,  become  inflamed,  and  occa- 
sion violent  pain. 

Rainard  therefore  recommends  the  douhle  lifjatitrc.  A  long  sacking  or 
saddler's  large  needle,  is  armed  with  a  somewhat  long  double  piece  of 
whipcord.  This  is  passed  through  the  middle  of  the  pedicle  of  the 
tumour,  from  below  to  above,  and  the  needle  cut  away  from  the  cord. 
The  pedicle  is  thus  perforated  by  two  pieces  of  cord  ;  one  of  these  is 
very  (irmly  tied  round  the  right  half  of  the  pedicle,  the  other  round  the 
left,  so  as  to  include  the  whole  in  two  separate  ligatures. 

Claverie'  reports  a  serious  hannorrhage  from  the  employment  of  this 
double  ligature  after  removal  of  the  uterus,  which  necessitated  the 
application  of  a  ligature  in  mass  above  the  others,  as  well  as  the  appli- 
cation of  the  actual  cautery  to  the  cut  surface.  It  is  possible  that  the 
needle  wounded  some  large  vessel,  which,  of  course,  would  not  be  in- 
cluded in  either  of  the  Ugatures. 

'  Journal  dfs  V'^iUrinaires  du  Midi,  1860,  p.  r-35. 


602  ArcIDEXTS  AFTER  PARTI'RITIOX. 

The  uterus  of  the  Cow  has  been  successfully  deprived  of  its  circula- 
tion by  means  of  clams  about  an  inch  thick  and  ten  inches  long.  They 
were  applied  close  to  the  vulva,  and  the  two  ends  fastened  together  by 
twine. 

Saint-Cyr  alludes  to  a  successful  case  of  amputation  of  the  uterus  in 
a  woman,  by  means  of  caustic  clavis,  or  rather  a  clamp ;  the  operator 
being  M.  Valette  of  Lyons  ;  and  he  believes  that  the  same  procedure 
might  be  advantageously  adopted  by  veterinary  surgeons.  He  recom- 
mends the  long  curved  clams  used  for  hernia,  and  suggests  that  the 
groove  be  filled  either  with  chloride  of  zinc,  or  with  tallow  powdered 
over  with  corrosive  sublimate. 

By  whatever  procedure  the  pedicle  of  the  tumour  is  rigidly  com- 
pressed, the  uterus  has  afterwards  to  be  excised.  Some  veterinarians 
are  of  opinion  that  it  is  better  to  wait  until  it  is  completely  mortified, 
or  even  until  it  sloughs  away  spontaneously;  and  they  allege,  in  justifi- 
cation of  this  opinion,  the  danger  of  htemorrhage  when  dealing  with 
such  a  large  and  vascular  organ  as  the  uterus  is  at  parturition.  Others, 
dreading  the  dangers  resulting  from  the  retention  of  such  an  enormous 
mass  suspended  behind  the  animal,  counsel  its  immediate  amputation. 
The  incessant  traction  it  exercises  on  the  vagina,  the  obnoxious  odour 
it  gives  off,  the  contact  with  the  absorbing  surface  of  the  septic  products 
resulting  from  its  mortification,  expose  the  animal,  they  declare,  to 
serious  accidents,  which  can  only  be  averted  by  at  once  cutting  away 
the  uterus. 

These  dangers  are  certainly  most  serious  ;  and  as  the  risk  of  hemor- 
rhage may  be  obviated  by  sufficiently  constricting  the  base  or  pedicle  of 
the  mass,  it  is  advisable  to  amputate  it  at  once,  and  at  a  short  distance 
— from  an  inch  to  three  inches — behind  the  constriction. 

Trasbot^  brings  under  notice  the  use  of  the  ecrascnr  in  amputating 
the  uterus.  The  case  to  which  he  refers  was  not  successful ;  but  it  is 
probable  that  this  result  was  due  to  the  imperfect  or  improper  manner 
in  which  the  instrument  was  used. 

With  the  ecraseur,  the  tissues  should  be  slowly  and  gently  cut  through. 
The  entire  pedicle  may  be  included,  or  the  chain  may  be  passed  through 
the  middle  of  it  by  means  of  a  needle,  like  the  double  ligature.  But 
there  is  grave  risk  in  this  mode  of  amputation,  as  the  abdominal  cavity 
is  opened  when  the  pedicle  is  divided  by  the  chain,  and  through  the 
opening  the  intestines  may  escape,  or  blood  and  the  products  of  in- 
flammation and  putrefaction  may  enter  the  peritoneal  cavity,  and  give 
rise  to  a  grave  condition. 

The  elastic  ligature  (Dittel's)  has  been  suggested  as  worth  a  trial,  and 
if  properly  applied  the  result  might  be  favourable.  Indeed,  it  has  been 
successfully  employed  in  amputating  the  uterus  of  a  Cow,  a  Sheep,  and 
a  Bitch.  The  operation  is  simply  applying  a  long  piece  of  india-rubber 
tubing  around  the  pedicle,  and  tying  it  firmly  there.  The  tissues  are 
cut  through  by  the  continuous  pressure,  which  causes  obliteration  of  the 
vessels  and  cessation  of  nutrition. 

It  has  also  been  suggested  that  Esmarch's  method  of  amputation  by 
clastic  compression  of  the  part  to  be  excised,  might  be  most  successfully 
employed  in  ablation  of  the  uterus  in  animals.  Considering  the  volume 
of  the  uterine  tumour  and  its  great  vascularity,  there  must  be  an  immense 

^  Bulletin  de  la  Socie'te  Centrale  de  Medecine  Vtttrinaire,  1870. 


iNVERsmx  OF  Till-:  iTi-:i:us.  eos 

advantage  in  sending  back  into  the  circulation  of  the  animal  the  larger 
part,  or  even  the  whole  of  the  blood  contained  in  the  or^'an,  before 
separating  this  from  the  body,  and,  in  addition,  perfonning  a  bloodless 
operation.  Coculet's  method  of  reducing  the  volume  of  tlie  inverted 
uterus  by  compression,  has  been  already  alluded  to,  and  is  the  same 
in  principle.  Ksmarch's  method  essentially  consists  in  winding  around 
the  part  to  be  amputated — commencing  at  the  distal  extremity — an 
elastic  band,  so  as  to  press  the  blood  from  this  part  into  the  body  ;  and 
above  the  band  to  tie  firmly  a  piece  of  india-rubber  tubing,  so  as  to 
prevent  a  reflux  of  blood  by  the  arteries.  The  elastic  band  is  then  re- 
moved and  the  part — pale  and  bloodless — is  excised. 

W'iien  the  uterus  has  been  cut  away,  the  portion  of  vagina  or  cei-vix 
remaining  should  be  returned  as  far  as  possible  into  the  genital  canal, 
and  if  there  is  any  hirmorrhage  injections  of  cold  water  will  probably 
check  it.  Cicatrisation  generally  occurs  within  fourteen  days.  If 
ablation  of  the  uterus  is  not  effected  immediately  after  constriction  of 
the  pedicle,  but  allowed  to  take  place  spontaneously,  mortification  and 
sloughing  are  completed  in  from  six  to  ten  days. 

In  some  cases  the  animals  do  not  appear  to  be  much  disturbed  after 
the  operation,  in  others  they  are  very  uneasy.  Ledru^  describes  an 
instance  in  which  the  Cow  operated  upon  was  for  an  hour  as  if  mad. 
It  lay  down,  got  up,  rolled  about,  kicked  and  stamped,  and  climbed 
into  the  manger.  The  eyes  appeared  to  be  starting  from  their  orbits ; 
it  Hexed  its  hind-limbs  like  a  horse  attacked  with  paraplegia,  and  it 
was  impossible  to  get  near  it.  These  symptoms  appear  to  have  been 
caused  by  the  intense  pain  ;  though  they  gradually  subsided  and  the 
animal  ultimately  recovered. 

In  many  instances  no  unusual  symptoms  have  been  observed,  and  the 
mother  has  anxiously  occupied  itself  witli  its  progeny.  Tiiis  has  been 
noticed  with  the  Sow. 

After  the  operation  the  cows  appear  to  have  fatted  well ;  and  when 
killed,  in  those  which  were  examined  large  masses  of  fat  have  been 
found  in  the  place  of  the  uterus,  and  filling  the  pelvis. 

It  may  be  remarked  that  in  one  case  recorded — in  the  Cow — a  portion 
of  intestine  had  become  prolapsed  witji  the  uterus,  the  interior  of  the 
sack  of  which  it  occupied  ;  another  similar  occurrence  was  noticed  in  a 
Bitch.  Franck  insists  on  this  complication  being  always  looked  for  in 
the  Mare,  and  he  recommends  that  this  animal  be  either  narcotised 
by  morphia  or  chloroform,  so  as  to  get  rid  of  the  violent  straining  to 
which  it  yields  itself. 

An  exploratory  incision  may  then  be  made  in  the  l)ody  of  the  uterus, 
and  if  any  intestine  is  found  in  its  interior,  this  must  be  returned  to 
the  abdomen  before  amputation  is  ventured  upon. 


CHAPTHli    IV. 
Inversion  of  the  Vagina    Inversio  Vaginae. 

IsiBRStos,  procidencc,  prolapsus,  or  fall  of  the  vagina,  is  a  hernia  of  this 
part  through  the  vulvar  opening,  analogous  to  that  of  the  uterus,  and 
with  which  it  may  be  complicated  when   inversion  of   the  latter    is 

'  JtectuU  de  Midtclne  Vairinairt,  1866,  p.  115. 


604  ACCIDENTS  AFTER  PARTURITION. 

extreme ;  though  in  such  a  case  it  does  not  add  to  the  symptomatology 
or  gravity  of  the  accident. 

It  may  occur  in  other  than  pregnant  or  parturient  animals,  though 
rarely ;  the  cases  recorded  of  Mares  had  no  assignable  cause  for  the 
accident,  though  those  occurring  in  the  Bitch  were  observed  immedi- 
ately after  copulation,  and  ascribed  to  anatomical  and  physiological 
peculiarities.  It  may  also  take  place  during  pregnancy,  particularly 
towards  its  termination,  when  the  gravid  uterus  pushes  it  outwards. 
Most  frequently,  however,  it  is  witnessed  after  parturition,  particularly 
when  delivery  has  been  difficult  and  protracted,  owing  to  a  disproportion 
between  the  size  of  the  foetus  and  the  passage  through  which  it  passes, 
and  especially  when  force  has  been  necessary  to  extract  it,  and  the  ex- 
pulsive efforts  have  been  severe. 

It  often  occurs  when  the  "  waters  "  have  escaped  for  some  time,  and 
the  young  creature,  lodged  in  the  genital  canal,  is  extracted  without 
the  precaution  of  lubrication.  The  progress  of  the  foetus  through  the 
di'y,  tenacious  passage  causes  the  mucous  membrane  of  the  vagina  to 
gather  in  ridges  and  folds  ;  the  connective  tissue  beneath  is  torn,  and 
this  leads  to  inversion,  which  may  occur  immediately,  along  with  the 
exit  of  the  foetus,  oi  when  the  animal  afterwards  strains — sometimes  so 
long  as  four,  six,  or  eight  days  subsequent  to  parturition. 

Fatigue,  such  as  that  induced  by  travelling,  or  severe  exertion  imme- 
diately or  soon  after  calving,  or  keeping  the  animal  in  a  stall  the  floor 
of  which  slopes  too  much  backwards,  are  also  likely  to  produce,  or  at 
least  predispose  to,  the  accident.  It  may  also  take  place  after  abortion 
and  retention  of  the  placenta. 

When  inversion  of  the  vagina  occurs  without  that  of  the  uterus,  the 
latter  is  propelled  backwards  by  the  contractions  of  the  abdominal 
muscles,  pushing  before  it  the  walls  of  that  canal  until  it  has  extruded 
them  beyond  the  vulva,  and  itself  occupies  the  cavity  of  the  pelvis. 
During  this  extrusion,  the  connective  tissue  which  attaches  the  vaginal 
mucous  membrane  to  the  adjacent  organs  and  the  pelvis  is  more  or  less 
lacerated ;  and  it  is  this  laceration  which  constitutes  the  serious  character 
of  the  accident,  and  differentiates  it  from  simple  prolapse  due  to  relaxa- 
tion of  the  connective  tissue,  w^hich  is  of  no  great  moment.  The  latter 
condition  is  not  very  rare  towards  the  end  of  pregnancy,  and  under  cer- 
tain circumstances  may  lead  to  complete  inversion.  Eainard  mentions 
having  seen  a  Goat  which  had  inversion  of  the  vagina  fifteen  days 
before  parturition,  and  to  such  an  extent  that  the  mouth  and  nostrils 
of  the  foetus  protruded  through  the  half-open  os  uteri,  so  that  it  could 
breathe  and  lick  the  hand. 

This  simple  inversion  of  the  vagina  during  pregnancy,  however,  dis- 
appears spontaneously  after  parturition,  as  it  is  simply  due  to  the 
backward  pressure  of  the  gravid  uterus  ;  but  that  occurring  after  birth 
has  no  tendency  to  spontaneous  reduction  any  more  than  complete 
inversion  of  the  uterus.  Very  exceptional  cases  have  been  reported,  in 
which  the  simple  form  was  succeeded  by  the  more  serious  one  ;  but 
Saint-Cyr  insists  upon  these  being  so  rare  that  they  only  serve,  when 
compared  with  the  latter,  to  prove  the  rule. 

x\s  has  been  said,  this  serious  inversion  of  the  vagina  occurs  far  more 
frequently  after  abortion  and  parturition,  though  not  so  often  as  inver- 
sion of  the  uterus. 


JM'KJ^SP'.y  I  IF  THE  I'AHiyj.  606 

Siimptoins. 

Of  course,  the  chief  symptom  of  this  accident  is  the  presence  of  a 
tumour  protruding  from  between  the  labia  of  tlie  vulva,  and  which  may 
hang  for  some  distance  below  that  opening.  In  tills  respect  it  resembles 
inversion  of  the  uterus,  though  the  dilTerence  is  otherwise  very  marked. 
In  the  majority  of  cases  the  tumour  is  most  voluminous  when  the 
animal  is  lying,  and  can  then  be  best  examined.  It  is  circular  in  out- 
line, varies  in  size  from  that  of  an  apple  to  the  dimensions  of  a  large 
melon,  and  is  not  unlike  a  sausage  in  shape;  the  surface  is  smooth, 
more  or  less  of  a  deep  red  colour  streaked  with  darker  patches,  and 
covered  by  a  thick  white  nmcus  or  a  fibrinous  exudate  ;  in  other  cases 
it  is  inrtamed,  excoriated  by  the  tail  or  litter,  and  covered  with  foreign 
matters.  There  are  no  traces  of  cotyledons  or  placental  follicles. 
On  the  under  surface  of  the  tumour  is  obsenx'd  a  longitudinal  depres- 
sion or  furrow,  which  leads  to  the  urethra.  At  its  end  is  a  round 
opening,  into  which  the  finger  can  be  passed  as  far  as  the  os  uteri, 
which  will  be  found  either  completely  closed  or  partially  open.  At  the 
vulva  the  tumour  is  narrow,  and  exhibits  longitudinal  folds  or  ridges, 
due  to  the  constriction  caused  by  the  vulva.  Passing  tlie  tinger  between 
the  tumour  and  the  vulva,  there  is  found  a  depression,  or  ctil-de-sac, 
formed  by  its  direct  continuity  with  the  vulvar  nmcous  membrane.  In 
certain  cases  the  cervix  uteri  can  be  seen  in  the  middle  of  the  tumour. 
Not  infrequently  the  tumour  is  invisible  when  the  animal  is  standing ; 
though  it  may  show  itself  when  it  lies  down,  micturates,  defecates,  or 
strains.  When,  however,  the  inversion  is  extensive,  or  the  case  is 
chronic,  the  tumour  often  remains  external  to  the  vulva. 

There  is  generally  more  or  less  ditViculty  in  micturating,  arising  from 
the  pressure  on  the  urethra  ;  and  instances  are  recorded  in  which 
extreme  distention  of  the  bladder  from  retention  of  urine  had  occa- 
sioned serious  symptoms,  and  led  to  paralysis,  and  even  rupture,  of 
that  viscus.  There  may  also  be  more  or  less  straining — indeed,  this 
symptom  is  nearly  always  present ;  febrile  symptoms  may  likewise  be 
noted  in  some  cases. 

When  the  mucous  membrane  has  been  long  exposed  to  the  air,  it 
becomes  thickened  and  indurated,  from  the  constant  irritation  giving 
rise  to  effusion  and  exudation  :  it  assumes  a  grayish  tint,  and  is  covered 
with  a  hardened  epithelium,  which  gives  it  a  leathery  appearance. 

The  local  symptoms  we  have  indicated  siiould  sulhciently  distinguish 
between  this  accident  and  the  presence  of  tumours  in  the  genital  canal. 
In  the  Bitch,  inversion  of  the  vagina  has  been  sometimes  mistaken  for 
a  condylomatous  tumour  ;  and  cases  are  recorded  in  which  tumours  of 
this  kind,  protruding  beyond  the  vulva,  through  insuHicient  examination 
have  been  mistaken  for  inversion.  Inversion  of  tlie  bladder  has  also 
been  confounded  with  that  of  the  vagina.  The  pyriform  cysts  that 
sometimes  form  in  that  canal,  and  contain  a  clear  citron-coloured  fluid, 
have  likewise  been  occasionally  considered  as  inversion  of  the  vagina. 

To  avoid  errors  which  might  have  a  serious  result,  a  careful  examina- 
tion must  be  made,  and  nothing  should  be  attempted  in  the  way  of 
operation  until  the  state  of  afifaira  is  exactly  determined. 

Prognosis. 

Inversion  of  the  vagina  is  not  nearly  so  serious  an  accident  as  inver- 
sion of  the  uterus  ;  and  Cows,  Mares,  and  Bitches  may  often  suffer  from 


606  ACCIDENTS  AFTER  PARTURITIOX. 

this  condition  for  months  without  showing  much  apparent  inconvenience. 
This  is  the  kind  of  inversion  that  is  liable  to  recur  ;  reposition  may  be 
readily  effected,  but  no  sooner  is  it  accomplished  than  inversion  again 
takes  place  through  the  animal  straining. 

In  other  instances,  however,  the  accident  is  much  more  serious.  The 
mucous  membrane  of  the  vagina,  exposed  to  contact  with  the  urine, 
fffices,  and  litter,  in  addition  to  friction  from  the  tail  and  other  objects, 
as  well  as  the  attacks  of  flies,  etc.,  becomes  irritated,  excoriated,  abraded, 
and  indurated,  while  it  is  greatly  thickened  from  exudation ;  a  more  or 
less  foetid  muco-purulent  secretion  covers  its  surface ;  cicatrisation  of 
the  torn  submucous  connective  tissue  ensues ;  new  adhesions  are 
formed  which  fix  the  part  in  its  abnormal  situation,  and  offer  what  is 
sometimes  an  insurmountable  obstacle,  if  not  to  reduction,  at  least  to 
retention,  after  that  has  been  effected.  If  assistance  is  not  afforded,  the 
animal  gradually  loses  condition  and  becomes  emaciated ;  hectic  fever 
sets  in,  and  it  falls  into  a  state  of  marasmus.  At  other  times  the 
extruded  part  becomes  acutely  inflamed,  intense  fever  supervenes,  and 
the  creature  succumbs  to  the  effects  of  vaginitis — either  simple  or  com- 
plicated with  metritis — and  almost  as  rapidly  as  from  inversion  of  the 
uterus. 

Treatment. 

The  more  speedily  treatment  is  resorted  to  after  inversion  has 
occurred,  the  more  easily  is  reduction  effected  and  likely  to  prove  per- 
manent, while  the  risks  from  injury  are  greatly  diminished. 

The  treatment  is  somewhat  similar  to  that  recommended  for  inversion  of 
the  uterus,  the  preliminary  steps  being  the  same  in  both  accidents,  and 
reduction  is  accomplished  according  to  the  same  rules.  The  part  of  the 
vaginal  membrane  nearest  the  vulva  is  to  be  carefully  and  gradually 
returned,  should  the  tumour  be  large  ;  if  comparatively  small,  then  it 
may  be  reduced  en  masse,  by  applying  the  closed  fist  to  the  centre  of  the 
most  dependent  part,  and  pushing  it  into  the  canal.  When  reduction 
has  been  effected,  it  is  particularly  necessary  to  observe  that  every  part 
has  assumed  its  normal  shape  and  position  ;  as  it  often  happens  that 
the  mucous  membrane,  particularly  towards  the  bottom  of  the  canal, 
forms  a  thick  fold,  which  must  be  effaced  if  it  is  desired  to  obviate 
renewed  straining  and  a  recurrence  of  the  inversion.  All  the  folds  and 
inequalities  from  one  end  of  the  canal  to  the  other,  as  far  as  the  cervix, 
should  be  smoothed  carefully  down  by  the  hand  or  a  soft  damp  cloth. 
If,  after  reduction,  the  straining  continues,  it  may  be  inferred  that  the 
mucous  membrane  is  irritated  by  the  existence  of  wrinkles  or  folds  on 
its  surface.  The  hand  must  then  be  introduced  again  into  the  vagina, 
and  the  ridges  effaced  either  by  passing  the  hand  over  them,  so  as  to 
carry  the  membrane  onwards,  or  by  gentle  pressure  entirely  obliterating 
them. 

If  the  membrane  is  irritated  and  inflamed,  astringents — such  as 
acetate  of  lead — and  anodynes — such  as  opium — may  be  applied  to  it ; 
and  as  a  matter  of  precaution,  a  truss  maybe  used  for  a  few  hours. 

When  the  foetal  membranes  are  still  in  the  uterus,  some  obstetrists 
recommend  that  they  should  be  removed  before  reduction  of  the  inver- 
sion is  attempted ;  but  others  are  of  opinion  that  reduction  should  be 
accomplished  first,  and  removal  of  the  membranes  afterwards,  unless 
the  latter  are  so  lightly  attached  that  they  can  be  pulled  away  without 
introducing  the  hand  into  the  uterus.     In  any  case  the  membranes 


iM'h'JiSKKV  of  Tilt:  r.iinxA.  tior 

must  be  removed,  as  their  presence  is  certain  to  cause  expulsive  efforts 
which  will  inevitably  lead  to  protrusion  of  the  vagina  again. 

For  retention  of  the  reduced  part,  sutures  are  often  preferred  :  they 
are  passed  through  the  labia  of  the  vulva.  Harms  and  Schleg'  employ 
ritKjclns  with  this  object.  Schleg's  ring  is  a  thin  flat  band  of  steel, 
pointed  at  one  end,  and  with  a  round  hole  and  slot  a  little  above  the 
point  ;  at  the  other  end  is  a  kind  of  button  raised  on  the  surface.  The 
point  is  passed  through  the  labia,  and  the  band  bent  round  so  as  to 
meet  and  button  at  the  ends.  This  ring  has  been  worn,  according  to 
Schleg.  from  a  few  days  to  more  than  live  months.  Other  sutures  have 
been  described  ;  but  they  are  all  on  the  same  principle  as  Zundel's 
already  mentioned  (I'Mg.  213). 

In  some  cases  one  of  the  trusses  alluded  to  for  inversion  of  the  uterus 
may  be  found  useful,  especially  if  the  accident  is  recent.  Pessaries 
should  not  be  employed. 

When  the  submucous  connective  tissue  of  the  vagina  has  been  nmcli 
lacerated,  and  abnormal  adhesions  have  taken  place,  then  a  recurrence 
of  the  inversion  is  to  be  apprehended.  This  recurrence  is,  of  course, 
most  likely  to  take  place  in  chronic  inversion,  and  all  the  skill  and 
patience  of  the  veterinary  surgeon  will  be  required  in  dealing  with  such 
a  case.  At  times  the  accident  has  proved  so  troublesome,  and  retention 
has  so  batiled  every  attempt  after  reduction  was  effected,  that  amputa- 
tion of  the  protruded  portion  has  been  practised,  and  with  success. 

Rainard  appears  to  have  been  the  first  to  venture  on  this  bold  measure, 
and  he  practised  the  operation  several  times  on  Bitches.  He  ligatured 
the  entire  inverted  mass  close  to  the  vulva,  in  one  case  ;  but  as  this 
gave  rise  to  intense  fever,  and,  when  cured,  the  animal  suffered  from 
incontinence  of  lU'ine,  he  adopted  another  procedure.  Instead  of 
including  the  whole  of  the  tumour  in  one  ligature,  he  divided  the  pedicle 
into  three  portions,  which  he  tied  separately,  so  that  each  ligature  only 
enclosed  one-third  of  the  mass.  After  tightening  the  ligatures,  the 
Bitch  was  allowed  to  run  at  large,  the  only  attention  it  received  being 
the  injection  of  emollient  Huids  into  the  vagina,  and  a  smaller  allowance 
of  food.  The  pain  was  much  less  in  intensity  and  duration  than  in  the 
first  case,  and  the  tumour  came  away  in  five  or  six  days,  when  recovery 
took  place.  Kainard.  however,  advises  immediate  excision  of  the 
portion  of  the  mass  beyond  the  ligatures,  when  these  have  been  drawn 
tight. 

Daprey  operated  on  a  two-year-old  Filly  in  a  somewhat  different 
manner.  Inversion  of  the  vagina  had  been  present  for  fifteen  days,  and 
the  tumour  was  as  large  as  a  man's  head  ;  it  was  cold,  of  a  dark-brown 
colour,  and  the  animal  was  greatly  agitated  and  fevcrisli.  As  gangrene 
was  apprehended,  it  was  decided  to  remove  the  whole  mass.  This  was 
done  by  practising  a  kind  of  saddler's  stitch  around  it,  by  means  of  two 
needles  armed  with  a  waxed  thread  ;  and  when  sewn  round,  the  two 
ends  of  the  ligature  were  drawn  so  tight  as  to  raise  the  enclosed  sides 
of  the  tumour  into  plaits  like  the  mouth  of  a  tied  sack  ;  they  were  then 
firmly  joined.  The  Filly  was  kept  standing  with  the  hinder  part  of  the 
body  raised,  and  the  tumour  was  dressed  with  chlorinated  water  and 
vinegar.  Between  the  seventh  and  eighth  days  the  mass  came  awav  ; 
the  discharge  diminished  in  quantity  and  fcetidness,  and  on  the  tenth 
day  the  animal  was  nearly  well. 

Bernard,  of  the  Toulouse  Veterinary  School,  operated  upon  a  female 
'  Magaziii/iir  Thierheiihunde  unci  Viehzucht,  1869,  p.  13. 


608  ACCWEXTS  AFTER  PAETUFJTIOX. 

Ass,  which  had  the  vagina  inverted  for  more  than  a  month,  and  every 
means  of  retention  had  failed.  Amputation  was  practised,  by  a  circular 
incision  around  the  base  of  the  tumour.  At  the  first  cut  of  the  bistoury, 
it  was  observed  that  the  mucous  membrane  was  very  much  thickened, 
and  easily  detached  from  the  other  parts  ;  so  that,  instead  of  making  a 
total  amputation,  it  was  considered  better  to  make  it  only  partial,  by 
dissecting  away  all  that  tissue  to  the  extent  of  four  or  five  inches.  This 
was  done,  and  the  hemorrhage  was  inconsiderable  ;  but  it  persisted  so 
long  afterwards  that  the  animal  was  seized  with  symptoms  of  syncope. 
However,  these  symptoms  passed  away,  and  the  creature  began  to  eat. 
A  rope  truss  was  applied,  and  for  eight  days  there  was  a  discharge  of 
pus.  At  the  end  of  that  time,  when  the  truss  was  removed,  recovery 
was  found  to  be  complete.  On  exploring  the  vagina  some  time  after- 
wards, a  thick  but  dilatable  ring,  about  the  middle  of  the  vagina,  was 
found,  through  which  first  one  finger,  then  two  and  three,  could  be 
passed.     Beyond  this  ring  the  canal  was  normal  in  width. 

There  can  be  no  doubt,  then,  that  the  inverted  vagina  may  be  ampu- 
tated without  much  risk,  when  reduction  is  impossible  or  incomplete  ; 
but  whether  an  animal  which  has  undergone  this  operation  can  be 
utilised  for  breeding  purposes  afterwards,  we  have  no  evidence  to  prove. 
It  is  possible  that  the  cicatricial  tissue  uniting  the  wound  may  be  suffi- 
ciently yielding  to  allow  of  gradual  dilatation  by  manual  or  mechanical 
means,  and  thus  not  offer  much  impediment  to  impregnation  or  parturi- 
tion. 


CHAPTEE    V. 
Inversion  of  the  Bladder— Prolapsus  Vesicae. 

At  p.  351,  allusion  was  made  to  inversion  of  the  bladder  as  occurring 
before  parturition,  and  the  symptoms  and  treatment  of  this  accident 
were  described.  The  remarks  there  made  are  applicable  to  the  accident 
when  it  follows  delivery.  It  is  of  somewhat  rare  occurrence,  and  is 
perhaps  more  frequently  met  with  in  the  Mare  than  in  the  Cow. 

We  have  particularly  insisted  upon  the  necessity  for  a  careful  exami- 
nation of  all  vulvar  tumours  before  adopting  any  surgical  measures  ; 
and  this  precaution  is  above  all  things  necessary  in  this  accident,  as 
incision  of  the  bladder  is  certain  to  lead  to  a  fatal  termination. 

Reduction  should  be  attempted  according  to  the  directions  given  at 
p.  352,  and  care  must  be  taken  not  to  lacerate  the  organ,  as  this  also 
will  prove  fatal.  Elmue^  relates  an  occurrence  of  this  description. 
Reduction  has  been  accomplished  successfully  in  the  Mare  two  months 
after  parturition,  when  the  accident  happened. - 

In  desperate  cases,  when  reduction  cannot  be  effected,  or  when  the 
organ  is  so  much  injured  that  reposition  is  almost  certain  to  be  followed 
by  death,  amputation  may  be  ventured  upon  with  some  prospect  of 
success. 

With  regard  to  the  operation,  Cartwright  remarks  :  "It  is  be  observed 
that  the  ureters  enter  the  substance  of  the  neck  of  the  bladder  obliquely 
towards  its  sides,  but  their  orifices  are  to  be  seen  when  the  bladder  is 
inverted,  the  Cow  or  Mare  standing,  at  the  upper  surface  of  the  viscus, 
about  half  an  inch  apart.     To  detect  them,  we  must  draw  the  bladder 

1  Canstatt's  Jahresberichf,  1859. 
-'  Archives  Veterinaire,  1877,  p.  801. 


INVEKSION  OF  THE  JiLADDER.  600 

sufHciently  down,  so  that  wo  may  be  able  to  inspect  the  parts.  Where 
they  enter,  the  inner  membrane  (now  the  ureter)  will  have  a  soft  and 
jelly-like  protuberant  appearance,  in  the  middle  of  which  will  he  detected 
two  very  small  openings  of  a  nipple-like  shape.  To  be  certain  that  we 
have  hit  upon  them,  we  may  introduce  a  probe,  and  pass  it  down 
towards  the  suspended  fundus.  Havinj];  discovered  the  orifice  of  the 
ureters,  and  passed  a  ligature  around  the  neck  of  the  bladder  below 
them,  we  have  nothing  more  to  do  than  occasionally  tighten  it,  so  as  to 
effect  complete  strangulation  and  sloughing  of  the  body  of  the  bladder ; 
though,  as  soon  as  we  find  it  dead,  we  may,  to  save  time,  cut  it  away 
with  a  scalpel.  We  should  also,  after  having  applied  the  ligature, 
puncture  the  distended  fundus ;  since  its  great  weight  may  cause 
dragging  and  inflammation  about  its  cervix,  or  may  force  the  ligature 
over  the  mouth  of  the  uterus,  which  would  occasion  the  death  of  the 
animal.  After  the  separation  has  taken  place,  the  remaining  portion 
will  contract  within  the  vagina,  and  the  cavity  will  be  closed  by  the 
vulva.  The  urine  will  generally  ever  after  run  down  the  thighs,  excori- 
ating them  ;  though  in  other  cases  the  fluid  will  accumulate  within  the 
vulva,  and  be  from  time  to  time  ejected  in  large  quantities." 

When  excision  is  not  resorted  to,  spontaneous  amputation  may  take 
place. 

When  the  inversion  or  prolapsus  is  complicated  by  rupture  of  the 
floor  of  the  vagina,  then  the  accident  is  of  the  most  serious  character, 
though  not  invariably  fatal  in  its  results. 


CHAPTER  VI. 
Traumatic  Lesions  of  the  Genital  and.  Neighbouring  Organs. 

1'jITHER  during  or  after  parturition,  the  genital  and  neighbouring  organs 
are  exposed  to  injuries  of  a  more  or  less  serious  character,  according  to 
their  situation  and  extent.  These  we  will  now  consider  in  the  following 
order:  1.  Laceration  and  rupture  of  the  uterus;  2.  Laceration  and 
rupture  of  tlic  vagina;  3.  Thrombus  of  the  vulva  and  vagina;  4.  Relaxa- 
tion of  the  j)clvic  symphysis ;  5.  Jiupturc  of  the  bladder;  6.  liupturc  of  the 
intestines;  7.  Rupture  of  tlic  diaphragm;  8.  Rupture  of  the  abdominal 
viusclcs;  9.  Rupture  of  the  sacra-sciatic  ligament:  10.  Rupture  of  the 
lieart. 

I. — L.VCKKATIGN    .\ND    RlI'TUUE    OF    THE    UtkRUS. 

Laceration  and  rupture  of  the  soft  parturient  passages  are  very  far 
from  being  unusual  during  parturition  in  the  domestic  animals,  par- 
ticularly in  the  Mare  and  Cow,  and  of  these  the  uterus  and  vagina  are 
most  frequently  involved. 

Solutions  of  continuity  of  the  uterus  are  often  met  with  by  the  vete- 
rinary obstetrist,  and  they  are  either  incomplete — when  the  organ  is 
only  partially  torn  or  lacerated,  or  complete — when  it  is  torn  through 
and  the  uterus  opens  into  the  abdominal  cavity.  These  tears  may 
occur  either  during  pregnancy,  during  parturition,  or  at  a  variable 
period  after  the  fa?tus  has  been  removed  from  the  uterus — when  it 
is  generally  a  complication  of  inversion  of  this  organ.     Ante  partum 

39 


.610  ACCIDENTS  AFTER  PARTURITION. 

rupture  has  been  already  fully  alluded  to  at  p.  194,  and  we  have  now  to 
study  its  occurrence  during  and  after  birth. 

Bujjture  during  Birth. — Eupture  of  the  uterus  may  occur  spon- 
taneously in  a  complete  or  incomplete  form  during  parturition  ;  and 
though  the  accident  is  perhaps  not  so  frequent  in  animals  as  in  woman, 
yet  there  are  many  cases  on  record  in  which  it  has  undoubtedly  occurred 
in  them,  and  it  has  been  affirmed  by  highly  competent  authorities  that 
it  has  been  observed  in  Cows  which  had  not  received  any  assistance 
during  parturition. 

It  can  easily  be  understood  why,  if  there  is  any  material  obstacle  to 
the  passage  of  the  foetus — such  as  induration  or  torsion  of  the  cervix, 
or  malposition  or  deformity  of  the  young  creature — the  violent  con- 
tractions of  the  powerful  muscular  layer  of  the  organ  should  overcome 
the  resistance  of  some  portion  of  its  own  fibres,  and  thus  lead  to  a  more 
or  less  extensive  laceration,  which  may  involve  the  other  tunics  and 
produce  complete  perforation.  Non-perforating  or  incomplete  lacera- 
tions occur,  in  the  majority  of  instances,  towards  the  cervix,  and  are 
usually  longitudinal.  Complete  rupture  may  take  place  at  any  part  of 
the  organ. 

This  accident  is  more  likely  to  occur  spontaneously  when  there 
happens  to  be  an  alteration  in  the  texture,  wholly  or  partially,  of  the 
uterine  wall ;  though  this  predisposing  cause  does  not  appear  to  be  so 
often  present  in  animals  as  in  the  human  female,  in  which  sudden  per- 
forating ruptures  never  take  place  when  the  organ  is  healthy.  Never- 
theless, there  can  be  no  reason  to  doubt  that  in  animals  alterations  in 
the  tissue  of  this  organ  may  and  do  occur  ;  and,  as  in  woman,  this  may 
assume  the  form  of  anomalous  development ;  interruption  of  the  normal 
tissue  by  interstitial  fibroids  or  cicatrices  ;  separation  of  the  muscular 
fibres  by  submucous  fibroids,  or  by  projecting  thin  parts  of  the  foetus  ; 
inflammatory  softening  of  some  portions  of  the  parenchyma  during 
pregnancy  ;  or  thinning  of  the  wall  at  some  part  by  pressui-e.  This 
pressure  may  arise  from  contact  with  the  brim  of  the  pelvis,  or  exostoses 
in  or  upon  the  bony  canal. 

The  exciting  cause,  however,  proceeds  from  considerable  impediment 
to  the  progress  of  labour,  and  the  accident  is  due  to  the  energetic  con- 
tractions of  the  uterine  walls  and  abdominal  muscles,  as  well  as  to  the 
pressure,  direct  or  indirect,  of  the  diaphragm  by  the  fully  dilated  chest. 

In  such  cases  the  rent  may  be  so  great  that  the  foetus  passes  entirely 
through  it  into  the  abdominal  cavity,  enveloped  or  not  in  its  membranes ; 
or  only  a  portion  of  it  escapes  through  the  tear,  and  it  ma}'  be  extracted 
therefrom  with  more  or  less  difficulty  per  vias  nahirales ;  in  some 
recorded  cases  birth  has  taken  place  by  natural  efforts,  the  existence  of 
rupture  only  becoming  evident  when  the  uterus  was  accidentally  extruded 
after  birth. 

More  frequently,  however,  the  accident  arises  from  artificial  mechanical 
causes,  brought  into  operation  in  the  course  of  manoeuvres  for  effecting 
the  extraction  of  the  foetus.  The  various  instruments  employed  may 
either  tear  or  incise  the  uterus ;  or  the  organ  may  be  lacerated  during 
traction  on  the  foetus  when  the  "  waters  "  have  escaped,  and  its  walls 
closely  envelop  the  young  creature  ;  or  during  retropulsion  or  version. 
The  thinness  of  the  uterine  wall  at  this  period  renders  such  an  accident 
as  laceration  one  of  easy  occurrence  ;  and,  however  large  the  tear  may 
be  during  life,  after  death  it  usually  appears  much  smaller,  because  of 
the  contraction  of  the  muscular  tissue. 


TRAUMATIC  LESIONS  OF  THE  (I  EXIT  A  L  ORGANS,  ETC.  611 

In  all  these  cases,  when  the  organ  romanis  in  situ,  the  diagnosis  is 
ditticult,  and  generally  it  is  only  on  post  mortcin.  examination  that  the 
lesion  is  discovered.  The  moment  of  its  occurrence  may  ho  inferred 
when  a  crotchet  suddenly  loses  its  hold,  or  the  feet  of  the  fa-tus  pene- 
trate the  uterine  walls. 

Certain  clinical  symptoms  are  often  ohservcd  during  life,  which,  if  they 
were  constant,  niiglit  lead  to  a  suspicion  of  the  existence  of  rupture. 
Thus,  the  expulsive  efforts  are  very  energetic  and  regular  up  to  a 
certain  period,  when  all  at  once  they  cease  ;  the  animal  hegins  to 
manifest  symptoms  of  abdominal  pain — lying  down  and  getting  up, 
stamping  and  pawing,  looking  towards  its  flanks,  moving  about  uneasily, 
moaning,  bellowing,  neighing,  or  even  screaming,  when  the  rupture 
occurs.  It  has  been  stated  that  the  Cow  opens  its  mouth  and  protrudes 
the  tongue,  extends  the  head,  and  utters  a  moan  or  grunt  at  each  ex- 
piration, but  does  not  strain — these  symptoms  being  indicative  of 
uterine  rupture. 

Non-perforating  lacerations  do  not,  as  a  rule,  give  rise  to  very  marked 
symptoms  immediately;  though  subsequently  they  may  produce  metritis 
or  metro-peritonitis,  or  induce  septic  infection.  Their  presence  is  not 
easily  diagnosed  during  Ufe. 

In  some  few  instances,  the  existence  of  complete  rupture  has  been 
ascertained  by  manual  exploration  of  the  uterus  ;  in  others  it  has  been 
discovered  de  visit  in  inversion  of  the  organ.  The  pulse  soon  becomes 
feeble  if  there  is  much  luemorrhage,  and  exhaustion  quickly  supervenes. 
If  death  does  not  occur  promptly,  acute  fever  ensues,  with  symptoms  of 
peritonitis  or  septic  infection. 

The  complications  attending  this  accident  are  always  serious,  and 
render  the  prognosis  unfavourable  in  nearly  every  case.  When,  how- 
ever, the  laceration  occurs  at  the  upper  part  or  sides  of  the  uterus,  the 
accident  is  not  so  grave  as  when  the  lloor  of  tlie  organ  is  involved  ;  if 
the  OS  remains  closed,  so  as  to  prevent  the  admission  of  air,  the  prog- 
nosis is  still  more  favourable,  though  this  can  rarely  be  the  case. 

The  chief  complications  are  lnemorrJioijc,  hernia  of  the  intcsti)ics,  and 
peritonitis. 

Death  from  direct  luemorrhage  is  less  frequent  than  might  be  antici- 
pated, knowing  the  great  vascularity  of  the  uterus  at  parturition.  This 
infrequency  is  explained  by  the  fact  that  bleeding  from  such  a  lacera- 
tion is  less  profuse  than  from  an  incised  wound  of  tlie  same  dimensions. 
Nearly  always,  too,  the  foetus  is  partially  or  entirely  expelled  from  the 
uterus  into  the  abdominal  cavity,  or  is  born  immediately  after  the 
accident,  and  the  organ  then  may  firmly  contract. 

Nevertheless,  in  some  instances,  the  luemorrhage  is  so  great  that  a 
fatal  termination  soon  takes  place,  witli  all  the  symptoms  ah'eady 
described  at  p.  oTo. 

Hernia  of  the  intestines  occurs  when  the  rent  is  somewhat  large,  and 
the  uterus,  flaccid  and  uncontracted,  allows  them  to  enter  its  cavity — ■ 
they  being  pushed  therein  by  the  action  of  the  abdominal  muscles.  In 
some  instances  the  intestinal  mass  received  into  the  uterus  has  been  so 
large  that  they  have  passed  through  the  vagina  and  vulva,  reached  the 
ground,  and  the  animal  has  trodden  upon  them  —  thus  hastening 
death  ;  while  in  others,  the  hernia  has  been  reduced  and  the  creature 
survived. 

Peritonitis  may  be  primary  or  secondary.  \Vhen  primary,  it  is  due 
to  the  escape  of  blood,  the  fcetal  fluids  or  envelopes,  or  the  foetus  itself. 


612  ACCIDENTS  AFTER  PARTURITION. 

When  secondary  or  consecutive,  it  may  result  either  from  the  extension 
of  the  inflammation  to  the  peritoneum,  or  the  discharge  of  the  lochia, 
pus,  etc.,  from  the  uterus.  The  escape  of  fluids  is,  of  course,  more 
likely  to  take  place  when  the  rupture  is  inferior  than  when  lateral  or 
superior.  Death  is  nearly  always  the  result  of  peritonitis  or  metro- 
peritonitis. 

Treatment. 

The  treatment  of  rupture  of  the  uterus  during  parturition  is  generally 
very  unsatisfactory.  Very  little  can  be  done  to  check  the  haemorrhage, 
if  it  is  great,  and  consecutive  peritonitis  is  always  a  most  serious 
complication. 

If  the  foetus  remains  within  the  peritoneal  sac,  a  favourable  termina- 
tion can  scarcely  be  hoped  for  ;  though  in  some  rare  instances,  if  air 
does  not  obtain  access  to  the  cavity  of  the  uterus  or  abdomen,  it  is 
possible  that  the  case  may  terminate  in  one  of  the  various  ways  of  extra- 
uterine pregnancy.  If  the  foetus  is  extracted,  the  rent  may  heal  up  ; 
though  this  is  very  unlikely  if  the  edges  are  much  contused,  and  the 
animal  will,  in  all  probability,  perish  from  consecutive  purulent 
peritonitis. 

If  the  foetus  is  still  wholly  or  partially  in  the  uterus,  it  and  its  enve- 
lopes must  be  extracted  without  delay,  and  as  gently  as  possible ;  as 
haemorrhage  w^ill  probably  only  cease  with  the  contraction  of  the  organ. 
If  the  uterus  does  not  contract,  but  remains  flaccid  after  removal  of  the 
placenta,  then  it  may  be  stimulated  to  do  so  by  introducing  the  hand 
into  the  interior  for  some  time,  after  removing  the  coagula.  If  this 
fails,  and  the  rupture  is  not  in  the  floor  of  the  uterus,  small  pieces  of 
ice,  cold  water,  or  astringents  may  be  introduced,  and  ergot  of  rye 
administered ;  a  jet  of  cold  water  should  be  allowed  to  play  upon  the 
loins,  wherever  the  rupture  may  be.  If  there  is  hernia  of  the  intestines, 
these,  of  course,  must  be  promptly  returned  into  the  abdominal  cavity 
before  anything  is  done  to  the  uterus. 

Some  authorities  advise  that  the  uterus  should  be  gently  inverted, 
brought  outside  the  vulva,  in  order  that  the  rent  may  be  closed  by 
suture,  and  then  returned.  But  this  course  is  not  to  be  recommended, 
as  it  is  very  dangerous,  and  the  wound  will  unite  without  sutures  if 
the  organ  contracts  and  no  complications  follow. 

The  cavity  of  the  uterus  should  be  swabbed  with  a  weak  solution  of 
carbolic  acid  (1  to  100 — 250)  or  cresyl,  and  to  prevent  septic  infection  by 
admission  of  air,  a  pledget  of  carbolised  lint  or  tow  should  be  placed 
in  the  os  or  vagina,  and  changed  now  and  again. 

Straining  must  be  subdued  by  doses  of  opium  or  chloral,  or  the 
subcutaneous  injection  of  morphia,  and  the  diet  should  be  carefully 
attended  to.  If  there  is  constipation,  mild  laxatives  and  enemas  may 
be  administered,  Consecutive  fever  and  peritonitis  must  be  treated 
by  cold  afl'usions,  and  large  doses  of  anodynes — such  as  opium,  as  well 
as  counter-irritants.  Metritis  must  be  treated  in  the  same  manner, 
by  the  gentle  injection  of  cold  water ;  or  the  introduction  of  small 
pieces  of  ice  into  the  genital  canal  will  be  beneficial.  Should  symptoms 
of  septic  infection  appear,  stimulants,  with  small  doses  of  carbolic  acid 
and  sulphite  of  soda,  must  be  given. 

When  the  foetus  has  passed  through  the  rent  into  the  abdominal 

cavit}',  delivery  i^e?-  vias  naturales  is  then  impossible,  and  the  Ctesarian 

'section  must  be  resorted  to ;  unless  it  be  decided  to  allow  the  animal 


THAl'MATIC  LESIDXS  OF  THE  (IKXITAL  OliUAXS,  ETC  6i:{ 

to  take  its  chance,  and  get  rid  of  the  foetus  as  in  extra-uterine  footation, 
shoulil  it  survive  the  accident. 

Rupture  of  the  Uterus  after  Parturition. 

Rupture  of  the  uterus  after  parturition  generally  complicates  inver- 
sion of  the  organ,  and  is  due  to  mechanical  injury  either  on  the  part 
of  amateurs,  or  even  of  the  veterinary  surgeon,  when  endeavouring  to 
replace  it ;  sometimes  it  is  produced  by  the  animal  itself,  or  by  other 
animals  when  the  prolapsed  organ  gets  in  their  way.  In  some  instances 
it  has  been  caused  by  the  jagged  bones  of  the  fujtus  in  embryotomy, 
and  in  others  by  pessaries  introduced  into  the  genital  canal  to  retain 
the  inverted  organ. 

In  such  instances  the  diagnosis  is  easy ;  for  if  the  uterus  is  still 
inverted  the  rent  is  visible,  and  its  dimensions,  situation,  and  gravity 
can  be  taken  into  account. 

It  is  somewhat  remarkable  that  laceration  or  rupture  of  the  extruded 
organ  is  much  less  serious  than  the  same  amount  of  injury  to  the 
uterus  in  situ,  and  it  would  appear  that  in  inversion  there  is  the 
greatest  tolerance  of  the  most  serious  lesions.  Why  this  should  be 
has  not  been  explained;  but  the  fact  is  nevertheless  patent,  that  in 
very  many  instances,  when  reposition  of  the  uterus  has  been  effected, 
the  rupture  has  readily  cicatrised,  and  union  has  been  so  complete  and 
substantial  that  the  animals  have  afterwards  been  successfully  bred 
from. 

Some  autiiorities  have  closed  the  rent  by  suture  ;  but  very  many 
have  not,  and  the  termination  has  been  as  favourable  in  the  one  series 
of  cases  as  the  other.  Unless  the  rupture  is  in  the  lower  wall  of  the 
uterus,  sutures  are  at  least  supertluous. 

Beyond  the  measures  for  reduction  of  the  inversion,  and  the  necessary 
antiseptic  after-treatment,  little  more  has  to  be  observed.  \Vhen  the 
rupture  is  serious  in  inversion,  and  grave  results  are  to  be  apprehended 
should  the  uterus  be  returned,  then  it  may  be  advisable  to  amputate 
the  organ.     This  may  be  accomplished  in  the  manner  already  indicated. 

II. — Laceration  and  Rupture  of  the  Vagina. 

Lacerations  and  rupture  of  the  vagina  are  not  at  all  infrequent  in  the 
larger  domesticated  animals,  and  they  are  generally  as  serious  as  those 
of  the  uterus.  They  may  occur  during  copulation,  as  well  as  in  parturi- 
tion ;  but  they  are  more  common  in  the  latter.  TriHing  laceration  of 
the  vagina  and  vulva  is  often  observed  in  primiparu-,  or  those  animals 
in  which  the  soft  parturient  passages  are  narrow  or  rigid^ 

The  injury  may  be  either  sj)0)itniieons  or  accidental.  The  accidental 
injuries  are  those  produced  artificially  during  assisted  labour,  and  are 
due  either  to  the  instruments  employed — hooks,  forceps,  knives,  etc., 
the  hand  or  the  nails  of  the  fingers  of  the  obstetrist,  the  sharp  exposed 
bones  of  the  foetus  when  embryotomy  has  been  practised,  or  from  some 
salient  part  of  the  young  creature  during  the  uterine  contractions.  In 
the  latter  case,  the  feet  generally  cause  the  laceration  or  rupture. 
Deformity  of  the  pelvis,  or  roughened  nodules  of  bone  in  the  vicinity  of 
the  genital  canal,  may  also  lead  to  serious  lesions  of  the  vagina. 

When  the  lesion  occurs  in  what  we  may  call  a  "spontaneous  manner," 
it  happens  either  that  the  vagina  is  lacerated  along  with  the  uterus, 


614  ACCIDENTS  AFTER  PARTURITION. 

during  natural  labour  and  from  continuity  of  texture  ;  or  when  the  os  is 
amply  dilated,  but  the  vagina  is  overstretched  by  the  foetus. 

In  some  instances  such  an  accident  as  rupture  of  the  vagina  may  be 
secondary — as  when  the  textures  which  form  its  walls  are  much  bruised 
and  contused  during  the  passage  of  the  foetus.  Then  gangrene  may 
supervene,  and  the  mortified  tissue  be  thrown  off  in  a  gradual  manner, 
until  complete  perforation  has  taken  place. 

The  lesions  arising  from  these  different  causes  are  extremely  varied 
— from  removal  of  the  epithelium  or  simple  abrasion,  to  laceration  of 
the  mucous  membrane,  or  even  complete  perforation  of  the  vagina ; 
they  may  be  situated  either  towai'ds  the  vulva  or  cervix  uteri,  on  the 
sides,  floor,  or  roof  of  the  canal ;  or  they  may  only  concern  the  vagina, 
or  involve  at  the  same  time  the  neighbouring  organs  and  textures. 
Consequently,  the  gravity  and  the  symptoms  of  such  lesions  vary  con- 
siderably, according  to  their  simplicity  or  complexity.  Nevertheless, 
as  will  be  noted  hereafter,  a  trifling  abrasion  may  bring  about  very 
serious  consequences  ;  while  an  apparently  formidable  injury  may  be 
followed  by  no  unfavourable  indications. 

With  regard  to  rupture  of  the  vagina,  and  particularly  that  which 
may  be  designated  "  spontaneous,"  it  may  be  remarked  that  when  the 
lesion  occurs  towards  the  cervix  uteri,  it  is  nearly  alw^ays  transversal, 
and,  as  has  been  before  stated,  the  vagina  may  be  completely  separated 
from  the  uterus.  In  other  instances,  the  form  and  direction  of  the 
rupture  will  differ  considerably.  Longitudinal  rents  often  extend  into 
the  cervix  uteri  and  body  of  the  uterus. 

Of  all  the  domestic  animals,  the  Mare  appears  to  suffer  most  frequently 
from  lesions  of  the  vagina  produced  during  parturition.  The  reasons 
for  this  liability  have  already  been  alluded  to  ;  they  may  be  chiefly 
referred  to  the  length  of  the  limbs  of  the  foetus,  and  the  energetic  and  rapid 
contractions  of  the  uterus,  as  well  as  the  greater  susceptibility  of  this 
animal  to  morbid  influences — such  as  septicaemia.  Nevertheless,  in  all 
animals  these  injuries  are  notoriously  serious,  and  if  tlie  laceration 
occurs  when  the  tissues  of  this  part  are  bruised,  chafed,  and  irritated 
by  manipulations  during  a  laborious  delivery,  they  are  all  the  more 
grave.  Eainard  justly  remarks  that  Bitches  and  Cats  in  which  such  a 
condition  of  the  tissues  exists,  all  succumb  if  there  is  the  most  trifling 
rupture  of  the  vagina,  even  if  there  be  no  hernia. 

If  the  laceration  is  extensive  towards  the  bottom  of  the  vagina,  the 
abdominal  cavity  will  be  opened,  and  the  foetus,  if  it  has  not  been 
expelled,  may  have  partly  passed  through  the  rupture  ;  in  consequence 
of  the  walls  of  the  passage  being  much  less  contractile  than  those  of  the 
uterus,  the  accidental  opening  is  more  pervious  in  tlae  vagina  than  the 
uterus,  and  thus  all  the  more  readily  allows  the  intestines  or  bladder  to 
pass  through. 

Laceration  or  rupture  of  the  vagina  is  more  easily  diagnosed  than 
when  this  accident  occurs  in  the  uterus,  as  it  is  much  more  accessible 
to  the  eye  and  hand  ;  though  in  some  cases  it  is  difficult  to  ai'rive  at  an 
exact  knowledge  of  the  situation  or  extent  of  the  injury. 

With  regard  to  j^^'ognosis,  this  will  much  depend  upon  circumstances 
and  the  complications  met  with.  Sometimes  a  naere  abrasion  of  the 
mucous  membrane  which  produces  a  raw  surface,  or  a  laceration  extend- 
ing to  the  submucous  connective  tissue,  may  lead  to  septic  infection. 
This  is  particularly  to  be  apprehended  should  the  fcetus  or  membranes 
have  undergone  decomposition,  or  any  putrid  matter — as  the  lochia — 


THAi'MATIC  LESIONS  OF  THK  HEXITAL  (>/i(;.L\S,  ETC.  t)15 

been  allowed  to  remain  in  the  genital  canal,  especially  during  hot 
weather.  Wounds  or  lacerations  of  the  tloor  of  the  vagina  are  generally 
more  serious  than  those  on  the  roof  or  sides,  for  the  reasons  mentioned 
with  regard  to  rupture  of  the  uterus.  And  even  wounds,  or  rupture  of 
the  sides  or  roof  of  the  caiuil,  are  much  more  serious  than  the  incisions 
made  through  its  walls  in  ovariotomy,  owing  to  the  presence  during 
parturition  and  the  puerperal  state  of  fluids  which  may  quickly  become, 
or  are  already,  putrescent. 

Hiemonhiujc  is  generally  not  so  much  to  be  dreaded  as  in  lacerations 
of  the  uterus  ;  though  occasionally  it  may  be  so  serious  as  to  endanger 
the  life  of  the  animal. 

Hernia  of  the  intestine  occurs  when  perforation  of  the  vaginal  wall 
near  the  cervix  is  complete,  and  the  peritoneal  cavity  is  opened.  This 
is  a  serious  complication,  as  is  also  licniia  of  tlic  bladder,  which  may 
happen  when  the  rent  is  adjacent  to  that  viscus  ;  though  sometimes  it 
is  deemed  a  fortunate  circumstance  that  cystocele  is  present,  as  the 
bladder  effectually  closes  the  rupture  in  the  vagina,  and  thus  prevents 
the  escape  of  the  lochial  and  other  fluids  into  the  abdominal  cavity. 

Vaginal  fistula,  due  to  perforation,  has  been  described.  The  single 
opening  is  on  the  floor  or  at  the  side  of  the  vagina  ;  an  exploration  by 
the  linger  proves  that  the  canal  runs  in  an  oblique  direction,  and  does 
not  communicate  with  the  bladder  or  rectum.  It  contains  a  quantity 
of  thick  yellow  pus  which  flows  intermittently  from  the  vulva,  and  might 
lead  to  tlie  supposition  that  the  case  was  one  of  vaginal  catarrh. 
Cagny,  who  gives  this  description,  says  it  is  readily  cured  by  tearing  the 
superficial  wall  of  the  fistula  with  the  finger,  so  as  to  convert  it  into  a 
simple  wound  which  needs  no  further  attention.  It  might  be  well, 
however,  to  apply  an  antiseptic  dressing  until  cicatrization  was  well 
advanced. 

Peritonitis  and  pelvic  cellulitis  are  also  very  serious  complications  of 
laceration,  and  are  a  consequence  either  of  the  extension  of  vaginal 
inflammation  to  the  neighbouring  tissues,  or  the  escape  of  septic  matters 
or  inflammatory  products  into  the  pelvic  connective  tissue  or  the  peri- 
toneal cavity. 

It  will  be  observed  that,  if  extensive  laceration  of  the  vagina  does 
not  produce  rapid  death,  there  are  other  grave  dangers  to  be  appre- 
hended from  either  present  or  subsequent  complications.  The  inflamma- 
tion of  the  vagina  and  submucous  tissues,  with  suppuration  and  partial 
gangrene,  may  lead  to  the  formation  of  fistulic,  or  even  of  wide-spread 
destruction  of  the  soft  parts  in  the  i)('lvic  cavity,  which  sooner  or  later 
induces  a  fatal  termination.  Should  this  not  occur,  and  some  of  the 
neighbouring  organs  have  been  injured  at  the  same  time  as  the  vagina, 
then  there  may  be  such  important  damage  intlicted  as  to  render  the 
animal  nearly  valueless.  Some  of  these  injuries  will  be  alluded  to 
presently. 

The  si/mpt&ins  of  injury  to  the  vagina  and  neighbouring  organs  will, 
of  course,  vary  with  their  nature  and  extent. 

Much  constitutional  disturbance  is  generally  only  manifested  when 
the  lesions  are  serious,  or  when  septic  infection  has  taken  place.  Small 
rents  may  not  give  rise  to  any  perceptible  derangement,  except  perhaps 
a  little  fever  and  tumefaction  ;  hut  if  they  extend  deeply  into  the  con- 
nective tissue,  then  acute  fever,  infiltration,  and  other  grave  symptoms 
may  supervene. 


616  ACCIDENTS  AFTER  PAIiTUBITION. 

"With  regard  to  treatment,  this  also  must  depend  upon  circumstances. 

When  rupture  of  the  vagina  is  recognised  during  parturition,  delivery 
should  be  effected  as  speedily  as  possible,  and  with  every  care,  in  order 
to  prevent  the  laceration  extending  and  the  foetus  passing  into  it.  If, 
unfortunately,  some  part  of  the  latter  has  lodged  in  the  rent,  it  must  be 
removed  therefrom  with  the  utmost  precaution,  so  as  not  to  injure  other 
viscera.  The  foetal  membranes  should  also  be  extracted  as  soon  as 
possible.  If  there  is  haemorrhage  from  the  vagina,  this  may  be  sup- 
pressed by  ice  or  injections  of  cold  water  if  the  rent  is  superior  or 
lateral ;  if  it  is  inferior,  then  a  sponge  or  a  cloth  soaked  in  cold  water, 
in  which  is  a  small  proportion  of  iron  perchloride,  should  be  placed  in 
the  canal.  Should  there  be  hernia  of  the  bladder  or  intestines,  these 
must  be  replaced  at  once. 

In  all  cases  of  wounds,  abrasions,  or  rupture  of  the  vagina,  every  pre- 
caution should  be  observed  with  a  view  to  the  prevention  of  septic 
infection.  With  this  object  the  greatest  cleanliness  must  be  observed, 
all  decomposing  matters,  or  those  likely  to  decompose,  should,  if 
possible,  be  scrupulously  removed,  and  injections  or  "  swabbings  "  of 
weak  solutions  of  carbolic  acid  or  other  antiseptics,  practised.  If  there 
is  much  danger  of  haemorrhage,  a  suitable  tampon  of  lint  or  fine  tow, 
saturated  in  one  of  these  fluids,  may  be  allowed  to  remain  in  the  vagina 
for  some  time. 

Complications  of  Buptured  Vagina. 

We  have  mentioned  some  serious  complications  of  ruptured  vagina, 
in  which  adjacent  organs  and  tissues  were  involved.  These  are  chiefly 
the  rectum,  bladder,  and  perinaeum,  one  or  more  of  which  may  be  per- 
forated and  torn,  along  with  the  vagina.  These  ruptures  vary  in 
extent  and  gravity,  and  while  some  are  necessarily  fatal,  others  are  not 
so  ;  but  they  may  lead  to  serious  deformity  and  inconvenience,  such  as 
accompany  chronic  fistulge  in  important  regions.  They  are  recto-vaginal 
fistula,  rupticrc  of  the  jjerz^c^zn?;,  vesico-vaginal  fistula,  and  occlusion  of 
the  vagina. 

Eecto- Vaginal  Fistula. — Injuries  to  the  rectum  are  generally  pro- 
duced through  the  wall  of  the  vagina,  during  the  passage  of  the  foetus. 
When  the  salient  parts  of  the  latter,  and  more  especially  the  feet,  are 
misdirected  and  pressed  up  towards  the  sacrum  of  the  mother,  and  if 
the  rectum  chances  to  be  distended  with  fteces,  not  only  will  the  vagina, 
but  this  viscus  also  may  be  perforated,  and  some  portion  of  the  foetus 
soon  appears  at  the  anus.  If  this  accident  is  discovered  in  time,  it  may 
be  possible  to  push  back  the  parts  thus  misplaced  into  their  natural 
channel,  and  complete  delivery  by  the  vagina  ;  but  notwithstanding 
this  happy  termination,  the  communication  between  the  vagina  and 
rectum  very  often  remains  permanent,  and  a  recto-vaginal  fistula  is 
established. 

The  treatment  of  these  cases  is  not  always  satisfactory,  so  far  as  a 
perfect  cure  is  concerned.  Sutures  have  sometimes  been  employed  to 
close  the  wound  in  the  rectum,  when  accessible.  But  this  surgical 
operation  can  rarely  be  resorted  to,  and  all  that  may  be  done  is  to  keep 
the  lacerated  parts  clean,  by  frequent  injections  j;er  vaginam  and  rectum, 
prevent  constipation,  and  treat  the  injury  on  ordinary  principles — not 
forgetting  the  free  employment  of  antiseptics. 

If  sutures  are  employed  to  close  the  fistula,  they  may  be  supported  by 
a  pessary  or  tampon  placed  in  the  vagina,  beneath  the  fistula. 


TlLil'MATIC  LKSIDXS  nF  TllK  HKSITAL  i >/;'.-. I \S,   KTC.  617 

When  the  hnibs  or  other  parts  of  the  fcetus  protrude  through  the 
anus,  it  is  nearly  always  advisable  to  amputate  them,  in  order  to  move 
the  body  more  easily  in  the  vaj^'ina,  and  with  less  risk  of  further  injury  to 
the  parent.  Once  in  the  {genital  canal,  then  the  firtus  can  be  extracted 
in  the  ordinary  manner.     Opiates  should  be  largely  administered. 

Ri  TTfUK  OK  THE  Pkkin.ki  M. — Laceratiou  of  the  vagina  is  not  at  all 
infrequently  complicated  with  more  or  less  extensive  rupture  of  the 
perin;eum,  and  occasionally  rupture  of  the  vagina,  rectum,  and  perineum 
may  be  met  with  in  the  same  animal.  Sometimes  it  is  only  the /o/nc/«'/<e 
and  superior  commissure  of  the  vulva  which  are  involved;  in  others  the 
entire  extent  of  the  perina^um  is  lacerated,  and  the  lesion  only  ends  at 
the  anal  sphincter  ;  while  in  others,  again,  the  sphincter  and  part  of  the 
rectum  are  included. 

If,  in  malpositions  of  the  ftetus,  assistance  is  not  timeously  afforded — 
particularly  in  the  Mare — the  young  creature  is  pushed  onwards  by  the 
violent  uterine  contractions,  and  should  it  enter  the  rectum  the  anus  is 
dilated ;  while,  if  the  expulsive  etTorts  are  continued,  the  sphincter  and 
all  the  tissues  between  it  and  the  vulva  are  greatly  stretched  and 
strained  until  they  tear.  Then  the  fcetus  is  finally  expelled — sometimes 
dead,  at  other  tinies  alive — and  there  remain  immense  lacerations  which 
convert  the  rectum  and  vagina  into  one  vast  opening,  in  which  the 
termination  of  the  digestive  and  genito-urinary  organs  open  in  common. 

In  rare  cases  the  injury  is  not  so  extensive,  owing  to  the  anal  sphincter 
being  sufficiently  elastic  to  yield  to  the  pressure  without  being  much 
torn,  in  this  way  exempting  the  periniEum  ;  so  that  there  is  only  a  wide 
recto-vaginal  fistula  to  deal  with. 

These  ruptures,  occurring  immediately  after  birth,  appear  two  or 
three  times  larger  than  they  are  some  days  afterwards,  when  the  dis- 
tended textures  have  contracted  somewhat ;  the  borders  of  the  lacera- 
tion are  sometimes  even,  in  other  cases  uneven,  ragged  and  shreddy. 

The  consequences  are  variable,  according  to  the  extent  of  the  injury. 
Moderate  laceration  does  not  usually  prove  very  prejudicial ;  but  if 
severe,  serious  inflammation  of  the  perina^um,  extending  sometimes  to 
neighbouring  tissues  and  organs,  sets  in.  If  the  tear  involves  the  anus 
and  its  sphincter,  there  will  be  involuntary  escape  of  ficcal  matters  and 
flatus  ;  and  in  the  most  formidable  cases — those  in  which  the  vagina 
and  rectum  form  one  wide  gaping  cavity — the  mucous  membrane  is 
irritated  by  the  free  admission  of  air  and  excreta,  inflammation  and 
suppuration  ensue,  fistulas  are  formed,  and  the  poor  animal  only  too 
often  presents  a  painful  and  repulsive  spectacle. 

In  other  instances,  partial  recovery  takes  place,  and  the  animals  do 
not  appear  to  be  much  affected  or  inconvenienced.  They  maintain  good 
health,  rear  their  progeny,  if  born  alive,  and  may  even  bring  forth 
young  again,  though  the  wound  has  not  cicatrised.  Indeed,  in  severe 
cases,  union  of  the  edges  of  the  wound  is  exceptional,  and  in  the  large 
majority  only  the  margin  of  the  tear  cicatrises,  and  a  gaping,  unsightly 
cavity  remains. 

The  treatment  will  vary,  according  to  circumstances.  If  there  is 
much  hiemorrhage,  styptics  must  be  employed  ;  if  the  bleeding  is  slight, 
cold  may  check  it ;  but  if  severe,  iron  perchloride  must  be  used. 

The  lacerated  margins,  if  much  torn,  nmst  be  freed  from  shreds  which 
are  likely  to  lose,  or  have  already  lost,  their  vitality.  They  must  then 
be  brought  together  by  sutures — either  of  metal,  carbolised  silk,  or 


618  ACCIDENTS  AFTER  PARTURITION. 

catgut.  Cold-water  dressings  may  then  be  applied  ;  or  styptic  colloid, 
iodoform,  boric  acid,  collodion,  or  carbolised  glycerine  may  be  employed. 
The  parts  must  be  kept  as  clean  as  possible,  and  the  animal  not  dis- 
turbed or  allowed  to  lie  down  until  union  has  been  effected.  With  this 
object  a  narrow  stall  is  to  be  preferred.  The  sutured  septum  should  be 
supported  from  the  vagina,  by  a  tampon  placed  therein.  This  will  tend 
to  prevent  the  pressure  of  faeces  tearing  away  the  sutures  in  the  floor  of 
the  rectum,  and  this  result  will  also  be  greatly  obviated  by  administer- 
ing enemas  frequently,  and  covering  the  mucous  membrane  with  lard. 
Sloppy  food  should  be  given  as  diet.  Fever  and  other  unfavourable  com- 
plications must  be  treated  according  to  their  indications.  Opiates  will 
prove  of  great  service  ;  if  there  is  much  local. disturbance  or  straining, 
suppositories  of  opium  are  to  be  recommended. 

Vesico-Vaginal  Fistula. — When  the  floor  of  the  vagina  is  ruptured, 
it  may  happen  that  the  neck  or  walls  of  the  bladder  are  involved  in  the 
lesion,  just  as  that  viscus  may,  as  we  have  seen,  become  prolapsed  or 
hernied  through  the  vaginal  rent.  When  rupture  of  the  bladder  occurs 
in  this  manner,  the  case  is  indeed  serious.  The  urine  is  no  longer  con- 
fined to  its  receptacle,  but  escapes  through  the  laceration  and  becomes 
infiltrated  in  the  pelvic  connective  tissue.  Hence  arise  most  serious 
complications — pelvic  cellulitis  and  urine-abscess,  which  rapidly  lead 
to  a  fatal  termination.  In  less  formidable  cases  the  urine  may  escape 
by  the  vagina,  but  involuntarily  ;  so  that  incontinence  of  urine  not  only 
proves  a  troublesome  infirmity,  but  the  constant  passage  of  this  fluid 
over  the  membrane  lining  the  vagina  gives  rise  to  intense  inflam- 
mation of  that  canal,  and  leads  to  the  formation  of  a  vesico-vaginal 
fistula.  This  fistula  may  also  be  produced  by  pressure  or  bruising. 
When  the  foetus  is  very  large  it  occasions  over-stretching  of  the  vagina, 
Ij  and  if  it  remains  for  any  length  of  time  in  the  passage  the  distention 

I  weakens  the  vitality  of  the  soft  tissues ;  so  that  the  compression  to 

which  they  are  submitted  between  the  foetus  and  the  floor  of  the  pelvis 
will  produce  mortification,  which  may  extend  to  the  neck  of  the  bladder. 
The  resulting  sloughing,  should  the  creature  survive,  will  establish  a 
direct  communication  between  the  vagina  and  bladder. 

An  animal  may  live  with  a  fistula  of  this  description,  provided  urine- 
abscess,  uraemia,  or  other  serious  complications,  do  not  occur. 

The  symptoms  need  not  be  specified.  The  chief  is  incontinence  of 
urine.  When  this  fluid  is  observed  to  be  constantly  dribbling  from  the 
vulva  after  parturition,  the  existence  of  the  accident  may  be  suspected, 
and  an  examination  j;cr  vaginam  will  confirm  the  suspicion. 

Treatment  must  be  mainly  palliative. 

I  Occlusion  of  the  Vagina. — This  has  occurred  after  parturition,  as 

'  a  result  of  injury  to  the  mucous  membrane  of  the  canal  during  delivery 

— union  taking  place  between  the  sides  of  the  vagina.     Occlusion  may 
jL  be    more  or  less  complete,  and  its  seat  at  any  part  of  the  canal,  but 

I  always  beyond  the  meatus  urinarius.     Such  cases  have  been  observed 

'  in  the  Mare  and  Cow.     A  careful  manual  examination  will  detect  the 

state  of  affairs,  and  if  cicatrisation  is  recent  the  new  tissue  may  be 
broken  down  by  the  finger,  finger-nail,  or  finger-knife  (figures  on 
pp.  535,  536)  ;  but  should  it  have  become  firm  and  unyielding,  then 
careful  dissection  will  be  necessary  to  separate  the  sides.  If  the  adhe- 
sion is  situated  some  distance  from  the  vulva,  the  operation  will  be 
facilitated  by  employing  a  vaginal  dilator. 


T/iAI'MAT/f  Lh'smxs  of  THE  HKSITAL  nl'jlASS,   KTV.  619 

III. — Thuomhus  of  the  Vagina  and  Vl'lva. 

Thrombus  or  lui'matoma  of  the  vagina  and  vulva,  is  sometimes 
obsei-ved  in  the  Mare  and  Cow  after  parturition,  and  is  due  to  an  infil- 
tration of  blood  into  the  connective  tissue  of  these  parts,  from  the 
almost  inevitable  injury  they  sustain  durinj:^  laborious  parturition. 

In  such  cases,  when  the  fcvtus  is  very  large  or  in  a  wrong  position, 
considerable  manipulation  and  traction  are  often  necessary  to  adjust 
and  remove  it  ;  and  this  leads  to  bruising  of  the  soft  parts  against  the 
pelvis,  and  laceration  and  rupture  of  the  bloodvessels  and  connective 
tissue.  The  bloodvessels  are  larger,  and  probably  more  numerous, 
during  pregnancy  than  at  other  times  ;  consequently,  there  results 
extravasation  of  blood,  and  considerable  tumefaction  of  the  genital 
canal,  particularly  in  the  vagina  and  vulva.  Sometimes  this  tume- 
faction appeai-s  during  parturition,  when  it  may  form  an  obstacle  to 
birth. 

The  mucous  membrane  is  raised  into  irregular  masses,  perceptible  to 
the  eye,  and  still  more  markedly  to  the  touch.  The  membrane  itself 
has  a  blue,  violet,  or  black  tint ;  the  labia  of  the  vulva  are  consider- 
ably swollen,  and  the  engorgement  may  extend  to  the  thighs  and 
croup. 

If  there  is  not  much  extravasation,  the  effused  blood  may  be  absorbed 
in  a  few  days  ;  but  if  the  thrombus  is  extensive,  the  blood  becomes 
decomposed,  gives  rise  to  inflammation,  which  may  run  on  to  gangrene, 
and  septic  infection  consequently  ensue. 

As  to  treatment,  scarifications  are,  above  all  things,  to  be  recom- 
mended. 

Samson, 1  who  has  had  much  experience  of  these  cases,  says  that  the 
labia  of  the  vulva  should  be  well  separated,  and  a  bistoury  plunged 
into  the  right  and  left  walls  of  the  vagina,  as  if  to  open  an  abscess  ;  the 
incisions  should  be  large,  and  proportioned  to  the  quantity  and  situa- 
tion of  the  clots ;  pressure  must  then  be  made,  so  as  to  remove  the 
latter. 

The  operation  appears  to  be  quite  innocuous  ;  though  a  case  is 
recorded  by  Cartwright,'-  in  which  a  stream  of  blood  issued  from  one  of 
the  punctures,  in  consequence  of  a  large  vein  being  wounded. 

When  all  the  extravasated  blood  has  been  removed  from  beneath  the 
mucous  membrane  or  skin,  cold  water  injections  and  sponging,  and 
weak  solutions  of  carl)olic  acid,  jiermanganate  of  potash,  or  other  deter- 
sive and  antiseptic  fluids,  should  be  resorted  to.  The  same  treatment 
is  to  be  adopted  when  suppuration  has  set  in,  only  more  attention  must 
be  paid  to  the  antiseptic  treatment. 

Should  haMnorrhage  from  the  incisions  prove  troublesome,  styptics 
— such  as  dilute  iron  perchloride — and  tampooning  the  vagina,  may 
be  had  recourse  to. 

IV. — Rklaxation  of  the  Pelvic  Symphysis. 

This  accident,  which  is  far  from  common  in  woman,  is  still  more 
rare  in  animals  ;  and  there  appear  to  be  only  two  cases  recorded,  both 
being  Cows. 

With  regard  to  the  cause,  there  is  probably  a  natural  tendency  to  the 

'   Reaifil  de  Malerinf  Vitcriimirr.,  1863,  p.  106. 
•*  VtUrinarian,  vol.  xi.x.,  p.  386. 


620  ACCIDEXTS  AFTER  I'ARTURITION. 

accident,  which  is  increased  by  pregnancy,  and  the  volume  and  malpre- 
sentation  of  the  foetus  no  doubt  lead  to  its  occurrence  when  parturition 
takes  place.  The  sacro-iliac  articulations  may  also  participate  in  this 
relaxation,  the  symptoms  of  which  are  deformity  of  the  pelvis,  and 
altered  movement  of  the  hind-limbs. 

The  animal  lies  almost  continually,  and  rises  with  great  difficulty. 
When  up,  it  can  scarcely  move,  and  the  hind-quarters  sway  from  side 
to  side — the  ilium  of  either  side  rising  or  falling  as  the  corresponding 
limb  sustains  or  is  relieved  from  weight.  The  hand,  passed  into  the 
rectum,  will  cause  pain  if  pressure  is  made  on  the  sacro-iliac  articulation. 
The  internal  angle  of  the  iliums  projects  much  beyond  the  spines  of  the 
sacrum,  and  when  the  animal  walks  movement. can  be  detected  between 
the  pubic  bones. 

The  condition  is  considered  incurable. 


V. — EUPTURE    OF    THE    BlADDEE. 

Eupture  of  the  bladder  alone,  during  parturition,  would  appear  to  be 
an  unusual  accident,  from  the  infrequent  mention  of  its  occurrence. 
That  it  may  happen,  however,  is  beyond  dispute,  and  the  cause  of  it  is 
obvious.  In  the  Mare  the  act  of  parturition  is  hurried  and  energetic, 
and  if  it  occurs  while  the  bladder  is  distended  with  urine,  the  pressure 
of  the  foetus  during  expulsion  may  rupture  this  viscus,  and  particularly 
if  the  rectum  above  is  also  full  of  fajces,  the  foetus  large,  and  perhaps 
in  a  wrong  position. 

The  extravasated  urine  gives  rise  to  peritonitis,  and  the  animal  will 
present  the  symptoms  of  that  most  painful  inflammation.  Death  is 
inevitable. 

VI. — ^EUPTUEE  OF  THE  INTESTINES. 

There  are  some  instances  recorded  in  which  rupture  of  the  intestines 
— small  and  large — has  occurred  during  parturition,  without  the  uterus 
or  other  organs  being  involved.  The  accident  may  have  been  due  to 
over-repletion  of  the  stomach  and  intestines  with  ingesta,  and  the 
energetic  action  of  the  abdominal  muscles  upon  these  organs  during  the 
labour  pains  ;  or  from  the  animal  throwing  itself  down  violently,  under 
the  sam^e  circumstances. 

Schaack  mentions  a  case  in  which  rupture  was  due  to  a  loop  of 
intestine  being  compressed  between  the  foetus  and  the  brim  of  the 
pelvis,  when  the  former  was  passing  through  the  genital  canal. 

Such  an  accident  is  beyond  remedy. 

Invagination  of  the  intestines — rectum  and  floating  colon — in  the 
Mai-e,  has  also  occurred  during  parturition,  due  probably  to  severe 
expulsive  efibrts. 

VII. — Eupture  of  the  Diaphragm. 

Eupture  of  the  diaphragm  is  a  rare  occurrence  during  parturition, 
and  I  can  only  find  three  cases  recorded.  They  were  probably  due  to 
the  same  causes  as  those  which  produce  rupture  of  the  intestines. 
Death  resulted. 


TRAUMATIC  LESIOys  OF  THE  <;HMTAL  OllUAXS,  ETC.  O'Jl 

\'III. — Rupture  of  thk  Audominal  Muscles, 

At  page  293,  when  treating  of  "  Hernia  of  the  Uterus  "  during  preg- 
nancy, it  was  explained  under  what  conditions,  and  tlie  manner  in  whicli 
rupture  of  the  abdominal  muscles  occurs.  The  accident  can  scarcely  be 
designated  as  one  consecutive  to  parturition  ;  but  its  treatment  may 
nevertheless  engage  the  attention  of  the  veterinary  surgeon,  after  the 
uterus  has  been  emptied  of  its  contents.  In  the  same  section  allusion 
was  made  to  the  appropriate  measures. 

IX. — Rupture  ok  the  Sacro-sciatic  Ligament. 

We  can  only  find  one  case  of  this  accident  on  record  ;  so  that  it  must 
be  extremely  rare.  It  is  given  by  Naylor,'  and  the  subject  was  a  three- 
year-old  cart  Mare,  which  had  a  malprcsentation.  The  animal  was 
down,  and  the  fore-feet  of  the  foetus  protruded  beyond  the  vulva,  but  the 
head  was  not  visible,  it  being  bent  back  to  the  side  of  the  chest ;  the 
young  creature  was  dead.  Embryotomy  was  resorted  to,  and  one  limb 
was  about  to  be  removed,  when  the  uterus  suddenly  contracted  with 
great  violence,  and  half  expelled  the  foal ;  traction  then  removed  it. 
"  All  attempts  to  get  the  tilly  up  were  ineffectual,  and  an  examination 
showed  that  a  rupture  of  the  sacro-sciatic  Ugament  on  the  right  side, 
with  other  lesions,  had  taken  place."  Stimulants  and  laxatives  were 
administered,  and  a  mustard  plaster  applied  to  the  loins.  "In  two  days 
she  was  on  her  legs,  and  tottering  about  the  yard.  Sufllice  it  to  say  that 
she  ultimately  recovered,  and  though  for  two  years  the  off-quarter  was 
less  in  size  than  the  other,  she  ultimately  got  quite  well,  and  had  two 
or  three  Foals.'' 

X. — Rupture  of  the  Heart. 

This  is  also  an  extremely  rare  occurrence,  and  I  can  only  find  one 
case — that  of  a  young  Cow  which  had  been  straining  violently  for  some 
hours,  and  suddenly  fell  down  and,  gasping,  died.  .\t  the  necropsy  a 
transverse  rupture,  two  centimetres  long,  was  discovered  in  the  right 
ventricle  of  the  heart.- 

'    Veterinarian,  vol.  xxxiii.,  p.  321. 

•  M&moirte  dt  la  SociiU  Centralt  tlr  Mrilrriw    I'ttiriimire,  vol.  v. 


622  PATHOLOGY  OF  PARTURITION. 

BOOK  V. 

PATHOLOGY  OF  PARTUEITION. 

Under  the  head  of  Pathology  of  Parturition,  it  is  intended  to  include 
those  diseases  which  accompany  or  follow  this  act,  and  are  more  or  less 
related  to  it.  Some  of  these  maladies  are  of  great  pathological  interest 
and  practical  importance,  and  deserve  the  closest  study.  The  parturient 
or,  if  the  term  might  be  employed,  puerperal  period,  is  a  very  remark- 
able and  critical  one  in  the  life  of  the  female  animal,  and  it  becomes  all 
the  more  so  as  the  creature  is  submitted  to  the  influences  of  domestica- 
tion, and  rendered  more  and  more  artificial  by  skilful  breeding  and 
management. 

During  pregnancy,  a  large  amount  of  nutritive  material  has  been 
abstracted  from  the  parent  to  nourish  and  develop  the  foetus,  and  when 
birth  takes  place  this  is  retained  until  the  lacteal  secretion  has  been 
fully  established.  Consequent  upon  this  reflux,  there  is  established  a 
kind  of  plethora  which,  together  with  the  nervous  excitement  and 
succeeding  prostration  induced  by  the  straining  and  pain  of  labour, 
renders  the  animal  more  susceptible  to  the  influence  of  morbific  causes 
of  various  kinds.  Hence  we  have  maladies  peculiar  to  the  parturient 
state,  or  if  witnessed  at  other  times,  at  least  much  aggravated  when 
they  appear  at  this  period.  Though  the  parturient  diseases  of  animals 
are  not  so  numerous  as  those  of  the  human  female,  yet  they  are  neither 
unimportant  nor  few" ;  and  it  is  possible  that,  with  the  advance  of 
veterinary  science,  their  number  will  be  increased — so  far  as  exact 
definition  and  differentiation  are  concerned. 

In  this  respect,  the  prominent  part  infection  by  septic  material- 
produced  by  the  action  of  micro-organisms — plays  in  the  development 
of  parturient  diseases  is  to  be  remarked.  It  is  but  recently  that  this 
agency  has  been  recognised  as  one  well  worthy  of  consideration  in 
veterinary  pathology  ;  and  the  closer  its  effects  are  studied,  so  the  more 
inclined  are  we  to  attribute  many  diseases— and  particularly  those  of 
the  parturient  state — to  one  common  source,  septic  infection. 

Of  course,  there  are  other  maladies  or  disturbances,  chiefly  of  a  local 
character,  the  etiology  of  which  cannot  at  present  be  traced  to  septosis, 
and  which  merit  notice  in  this  part  of  our  work. 

The  diseases  which  we  have  to  consider  are  :  1.  Vaginitis  ;  2.  Leu- 
corrlicea ;  3.  Metritis,  Metro-peritonitis,  a,\idi  Parturient  Fever;  4.  Par- 
turient Aiooplexy ;  5.  Post  piartum  Paraplegia;  6.  Parturient  Eclampsia ; 
7.  Epilepsia  Uterina  or  Mania  Pucrperalis  ;  8.  Parturient  Laminitis ; 
9.  Mammitis;  10.  Agalactia;  11.  Injuries  to  the  Teats ;  Diverse  Injuries. 


CHAPTER  I. 

Vaginitis. 

Inflammation  of  the  vagina  may  exist  independently,  but  it  is  generally 
an  accompaniment  of  inflammation  of  the  uterus,  or  "metritis,"  which, 
being  the  more  serious  evil,  masks  this  malady.  When  occurring  after 
parturition  it  is  generally  due  to  protracted  and  laborious  delivery, 


I'AaiMTlS.  (;2.3 

which  necessitates  manipulatory  eiforts,  the  use  of  instruments,  etc., 
the  passage  of  a  very  vohuninous  ftetus,  the  pressure  of  a  pessary,  or 
any  other  cause  that  may  lead  to  irritation,  bruising,  or  wounding  of 
the  mucous  membrane.  In  very  exceptional  instances,  the  inllanunation 
may  be  indirectly  due  to  the  action  of  cold  on  the  skin,  or  the  ingestion 
of  very  cold  water — though  this  is  more  likely  to  induce  metritis  or 
metro-vaginitis. 

The  inriammation  may  lead  to,  or  be  complicated  with,  ulceration, 
gangrene,  or  mortification  to  a  greater  or  less  extent. 

The  labia  of  the  vulva  and  the  lining  membrane  of  the  vagina  are 
more  or  less  swollen,  tlie  latter  being  of  a  deep  or  bright  red,  brown,  or 
livid  hue  ;  there  may  be  also  patclies  of  congestion  and  eccliymoses, 
with  wounds  or  abrasions,  and  in  rare  cases  phlyctiena;  may  be  observed 
on  the  surface  of  the  membrane.  The  temperature  of  the  canal  is  also 
gi-eatly  increased,  while  its  walls  are  dry  and  often  adhesive.  Micturi- 
tion is  generally  painful  and  dillicult,  constipation  is  often  present,  and 
there  is  sometimes  nmch  itching  in  the  region  of  the  vulva,  which  is 
indicated  by  the  continued  attempts  the  animal  makes  to  rub  the  part. 
If  the  inflammation  is  severe  and  extensive,  fever  will  be  present. 

When  the  intlanmiation  has  existed  for  one  or  two  days,  the  mucus 
secreted  by  the  membrane  is  gi'eatly  increased  in  quantity  ;  it  is  at  first 
a  serous  limpid  fluid,  sometimes  streaked  with  blood  ;  then  it  gradually 
becomes  thicker  and  sero-  or  muco-purulent,  soiling  the  tail  and  the 
thighs  and  hocks,  and  sometimes  becoming  so  acrid  as  to  cause  removal 
of  the  hair  and  excoriation  of  the  skin. 

Simple  vaginitis,  of  itself,  is  not  a  serious  affection,  and  the  inflamma- 
tion often  subsides  spontaneously  in  the  course  of  a  few  days,  or  rapidly 
yields  to  treatment.  In  some  instances,  however,  it  assumes  a  trouble- 
some, if  not  a  grave  character.  When  gangrene  ensues,  there  may 
be  also  infective  inflammation  in  tlie  surrounding  parts,  and  large  por- 
tions of  the  membrane,  or  even  the  skin  of  the  labia,  may  slough,  while 
the  discharge  is  sanious  and  foetid.  Baumeister  describes  a  diphtheritic 
form  of  vaginitis  which  he  observed  in  a  Cow  that  had  calved  a  few 
days  before,  and  which  died  on  the  third  day.  At  the  autopsy,  the 
vagina,  as  well  as  the  uterus,  was  found  full  of  pseudo-membranous 
productions.  Another  Cow  which  stood  beside  this  one,  and  which  had 
calved  four  weeks  earlier,  contracted  the  disease  a  few  days  after  the 
Cow  that  died,  and  also  perished — leading  to  the  supposition  that  this 
form  of  vaginitis  is  contagious. 

The  treatment  of  simple  vaginitis  does  not  merit  much  consideration. 
Cleanliness,  attention  to  diet,  and  injections  of  cold  or  tepid  water,  or 
mild  astringents,  into  the  vagina,  generally  succeed  in  subduing  the 
inflammation  ;  but  if  the  injections  induce  straining  they  siiould  only  be 
administered  in  small  quantity,  and  in  combination  with  anodynes. 
When,  however,  there  is  any  tendency  to  acute  inflammation  and  gan- 
grene, or  there  exists  ulceration,  sloughing,  or  even  abrasions,  antiseptic 
treatment  is  advisable — a  solution  of  carbolic  acid  (2  to  10  per  cent  ), 
permanganate  of  potass,  boric  acid,  or  chlorinated  or  tar  water,  being 
perhaps  the  best  local  applications.  General  constitutional  treatment 
may  also  be  necessary,  and  especially  if  the  fever  runs  high  and  there 
are  indications  of  septic  infection. 


624  PATHOLOGY  OF  PARTURITION. 

CHAPTEE  II. 

Leucorrhoea. 

When  inflammation  of  the  vagina,  and  perhaps  also  of  tlie  lining 
membrane  of  the  uterus,  becomes  chronic,  the  more  acute  symptoms 
disappear;  but  the  vaginal  discharge  continues,  and  may  even  increase 
in  quantity.  Usually  the  fluid  is  of  a  white,  glutinous,  and  odourless 
character  ;  or  it  may  be  purulent,  muco-purulent,  or  even  chocolate- 
coloured  and  sour-smelling,  or  sanious  at  times.  The  secretion  is  mainly 
composed  of  mucus.  Histologically,  vrefind  mucus  corpuscles,  an  abun- 
dance of  epithelial  cells,  probably  some  pus  corpuscles,  and  at  times 
micrococci  and  infusoria,  particularly  the  Trichomonas  vaginalis,  which 
is  also  found  in  healthy  mucus  from  the  vagina.  Sometimes  the  secre- 
tion is  only  manifest  in  an  intermittent  manner  —as  when  the  animal  is 
lying  down  or  in  movement,  or  during  micturition.  It  is  more  frequently 
observed  in  the  Cow— particularly  if  lymphatic — than  the  Mare,  and 
especially  if  there  is  bad  hygiene  ;  it  is  somewhat  rare  in  the  smaller 
animals.  The  appetite  is  in  many  cases  unimpaired,  and  the  creature 
does  not  appear  to  be  inconvenienced  in  any  way ;  in  other  instances, 
with  the  increase  in  the  discharge  and  the  duration  of  the  disease,  there 
is  loss  of  condition  and  appetite,  the  yield  of  milk  is  less,  and  it  may  be 
viscid  ;  signs  of  oestrum  are  more  frequently  present,  but  fecundation 
does  not  take  place  so  readily  as  in  health  if  the  os  and  uterus  are 
afi"ected  ;  if  it  does  occur,  the  chances  are  that  the  full  period  of  preg- 
nancy will  not  be  reached. 

^Yhen  the  discharge  is  chiefly  from  the  cervix  uteri,  it  is  more  trans- 
parent and  watery-looking  than  when  it  comes  from  the  vagina  or 
interior  of  the  uterus,  and  the  os  is  usually  rnore  or  less  dilated  when 
these  parts  are  involved,  while  the  uterus  itself  is  not  so  firmly  con- 
tracted as  when  in  a  sound  condition. 

The  mucous  membrane  of  the  genital  canal  is  pale,  relaxed,  and 
insensible  ;  in  other  cases  it  may  be  roughened  by  granulations  ;  and 
sometimes  it  is  tumefied  and  red.  Vaginal  catarrh  in  the  Bitch  is  often 
associated  with,  or  dependent  on,  the  presence  of  papillomata  or  epithe- 
liomata. 

In  rare  instances  the  tissues  forming  the  canal  become  indurated  and 
lardaceous,  while  its  calibre  is  diminished.  Lafosse  has  even  observed 
adhesions  between  the  sides  of  the  vagina  in  an  old  Mare. 

With  regard  to  treatment,  if  the  disease  is  not  of  very  long  duration 
it  may  yield  to  cleanliness  and  astringent  injections — such  as  solutions 
of  sulphate  of  zinc,  alum,  permanganate  of  potass,  tannic  acid,  etc. 
When  it  has  been  in  existence  for  a  long  time,  however  (it  may  continue 
for  months,  and  even  years),  it  is  generally  very  obstinate,  chiefly  from 
the  relaxed  condition  of  the  membrane.  The  uterus  or  vagina,  or  both 
if  affected,  should  be  thoroughly  washed  out  twice  or  thrice  daily  with 
warm  water,  which  ought  to  be  injected  until  it  flows  out  quite  clear.  A 
solution  of  carbolic  acid  or  cresyl  in  v;'arm  water  should  then  be  injected. 
A  solution  of  the  sulphate  of  iron  has  likewise  been  successfully  used. 
Nitrate  of  silver  has  also  been  efficaciously  employed  in  solution  (1  to 
10),  as  has  tannic  acid  (1  to  70). 

Tonics  should  be  freely  administered,  and  good  food  allowed. 

If  the  discharge  continues  after  two  or  three  weeks'  treatment,  it  may 
be  found  useful  to  apply  a  blister  to  the  loins,  croup,  or  thighs. 


METRITIS,  METRO-PERITONITIS,  AND  PARTURIENT  FEVER.       625 

CHAPTER   III. 

Metritis,  Metro-Peritonitis,  and  Parturient  Fever. 

Inflammation  of  the  uterus  [Metritis)  may  be  limited  to  one  or  more  of 
the  internal  layers  of  the  organ  {Kiulo-metritis),  or  it  may  extend  to  its 
outer  covering — the  peritoneum  {l[ctro-2)crito)iitis),  and  produce  certain 
signs  ;  while  the  introduction  of  septic  matters  into  the  blood,  which  is 
very  often  a  result  of  this  inflammation,  will  give  rise  to  symptoms 
of  septictcmia.  The  latter  complication,  from  the  febrile  indications 
which  accompany  it,  is  appropriately  distinguished  by  the  name  of 
"Parturient  Fever" — a  designation  applied  wi'ongly  to  another  and 
very  different  malady  of  this  period — Parturient  apoplexy  or  Puerperal 
collapse — and  which  will  be  studied  hereafter. 

It  is  true  that  we  may  have  metritis  and  metro-peritonitis  without 
septicnemia — at  least  to  any  very  marked  degree ;  but  the  symptoms  of 
fever  which  accompany  the  former  are  generally  more  or  less  apparent, 
and  it  is  often  difficult  to  discover  when  septic  infection  has  taken  place 
— the  high  temperature  and  greatly  accelerated  circulation  being  the 
first  notable  symptoms  observed,  and  they  often  appear  at  an  early  stage 
of  metritis.  And  septic  infection  may  take  place  without  metritis,  when 
putrid  matter  obtains  admission  to  the  circulating  fluids  through  a 
lesion  in  the  uterus  or  vagina. 

Inflammation  of  the  uterus  and  Se2)tic(cmia  pucrpcralis  occur  in  all 
the  domesticated  animals.  The  latter  would  appear  to  be  very  frequent 
in  the  Bitch  ;  but  the  Mare,  Cow,  Sheep,  Goat,  and  Sow  are  liable  to 
septic  infection,  either  as  a  result  of  metritis,  or  the  introduction  of 
putrefying  matter  into  the  blood  through  an  abrasion  or  wound. 

The  inflammation,  as  well  as  the  infection,  varies  in  intensity  from 
acute  and  sub-acute,  to  chronic. 

Symptoms. 

Inflammation  of  the  uterus  and  parturient  septicasmia  may  ensue  very 
soon  after  delivery — rarely  before  the  second  day  with  the  Cow,  and 
seldom  beyond  the  eighth  day.  With  the  Mare  and  Bitch,  according  to 
Franck,  the  development  of  these  conditions  may  be  later.  Immediately 
after  parturition  the  animal  may  appear  to  have  quite  recovered  from 
the  efiects  of  that  act — yields  milk,  takes  care  of  its  progeny,  and  there 
is  nothing  to  indicate  the  existence  of  disturbance.  The  temperature  in 
the  rectum  is  normal,  except  in  those  cases — far  from  rare — in  which 
birth  has  been  diflicult,  and  the  genital  canal  has  been  roughly  treated 
and  injured;  t^lien  the  rectal  temperature  may  be  higher.  In  simple 
metritis  there  is  tumefaction  of  the  vulva,  with  boat  and  redness  of  the 
vagina,  fever,  straining,  difficulty  in  micturition,  diminution  or  sujipres- 
sion  of  the  milk  secretion,  inappetence  and  dulness.  With,  and  often 
without,  treatment  this  condition  passes  ofif  in  a  few  days.  In  traumatic 
metritis  the  same  symptoms  are  observable,  but  soon  there  are  well- 
marked  rigors  and  horripilation  ;  if  a  Cow,  rumination  is  suspended  ; 
in  the  Cow  and  Mare  the  pulse  becomes  small,  hard  and  quick  ;  the 
secretion  of  milk  is  stopped,  and  the  udder  diminishes  in  size  and 
is  flaccid  ;  the  temperature  rises  rapidly,  and  the  respiration  is  hurried 
and  shallow  ;  the  mouth  is  hot  and  pasty,  and  the  visible  mucous  mem- 
branes injected  ;  while  the  horns  and  ears  are  veiy  warm. 

The  animal  grinds  its  teeth,  and  betrays  the  existence  of  colicky  pains 

40 


626  PATHOLOGY  OF  PARTURITION. 

by  lying  clown  and  getting  up,  stamping,  striking  at  the  belly  and  turning 
the  head  towards  the  flanks,  whisking  the  tail,  and  making  more  or  less 
energetic  expulsive  efforts.  Signs  of  pain  or  lameness  in  the  hind-limbs 
become  apparent.  When  the  uterus  is  more  inflamed,  the  animal  does 
not  lie  down,  because  of  the  increase  of  pain  produced  by  pressure  on 
the  abdomen.  The  smaller  animals,  however,  maintain  the  recumbent 
position. 

A  very  marked  symptom  is  tumefaction  of  the  vulva — the  labia  of 
which  are  separated — and  the  discharge  therefrom  of  a  fluid  at  first 
serous,  and  either  transparent  or  having  a  yellow,  chocolate,  or  reddish 
tinge ;  then  it  becomes  gradually  thicker  and  more  abundant,  and  is 
modified  according  to  the  termination  of  the  disease.  Manual  explora- 
tion of  the  vagina  discovers  it  to  be  very  hot  and  sensitive,  particularly 
towards  the  cervix  uteri ;  when  its  lining  membrane  is  exposed,  it  is 
observed  to  be  swollen  and  reddened,  and  sometimes  there  are  found 
diphtheritic  ulcers  and  croupous  deposits  on  the  inflamed  surface.  In 
some  cases,  when  the  uterus  is  very  much  swollen — and  particularly  in 
lean,  flat-sided  animals — the  inflamed  organ  can  be  felt  on  the  right 
side,  and  pressure  on  the  abdomen  often,  but  not  invariably,  causes  pain. 
Eectal  exploration  generally  discovers  the  uterus  larger  than  natural, 
and  more  or  less  distended  by  gas. 

Defsecation  is  painful,  and  the  faeces  are  hard. 

The  Mare  attacked  by  metritis  or  metro-peritonitis  generally  main- 
tains the  standing  posture,  with  the  back  arched  and  rigid,  and  marked 
indisposition  to  move— only  lying  down  on  the  approach  of  death,  or 
towards  convalescence  ;  whereas  the  Cow  persists  in  lying,  and  this  is 
supposed  to  be  due  to  paralysis  of  the  hind-quarters,  but  it  is  more  pro- 
bably owing  to  debility  or  prostration  induced  by  the  pain. 

In  Kuminants  there  is  generally  distension  of  the  rumen  with  gas ; 
there  are  also  acid  eructations,  and  even  regurgitations.  When  the  tem- 
perature rises  very  high — and  it  may  reach  107°  to  108°  Fahr. — death  is 
certain. 

In  metro-peritonitis  there  always  occurs — and  sometimes  very  rapidly 
— an  effusion  of  serum  into  the  abdominal  cavity.  When  this  is  in  great 
quantity,  the  abdomen  becomes  enlarged  and  rounded,  as  if  the  animal 
had  been  feeding  freely.  There  is  then  dulness  on  percussion  in  the 
lower  part  of  the  abdomen,  contrasting  markedly  with  the  tympanitic 
resonance  of  the  upper  regions  ;  while  sudden  pressure  by  means  of  the 
open  hand  on  one  part  while  the  other  hand  is  placed  at  another  point, 
will  cause  a  perceptible  movement  of  the  fluid. 

Terminations. 

The  course  of  metritis,  metro-peritonitis,  and  parturient  septicaemia, 
is  generally  very  rapid,  and  may  not  occupy  more  than  a  few  days — 
usually  three  or  four,  rarely  five  or  six  days.  In  some  cases  a  chronic 
form  may  be  met  with— and  particularly  in  simple  metritis,  due  to 
retention  of  the  fa?tal  membranes,  and  sometimes  to  abortion.  But 
these  exceptions  are  few,  and  the  disease  or  diseases  just  named  may  be 
designated  as  serious,  when  we  learn  that  death  carries  off  more  than 
one-half  of  the  number  of  animals  attacked. 

Though  so  serious,  however,  in  those  animals  which  are  about  to 
recover  convalescence  ensues  very  rapidly,  especially  with  the  Cow.  A 
few  hours  often  suffice  to  bring  alDout  such  a  change  for  the  better,  that 
one  could  scarcely  believe  it  unless  he  saw  it,  and  it  might  excite  a  doubt 


METFdTIS,  METRO-PERITONITIS,  AND  PARTURIENT  FEVER.       6l.'7 

as  to  whether  metritis  had  really  been  present.  In  the  evening  the 
animal  is  left  in  an  almost  hopeless  condition,  and  next  morning  it  is 
standing,  the  eye  limpid,  the  physiognomy  bright  and  cheerful,  and  it 
caresses  the  offspring  which  previously  was  unheeded  or  repelled.  The 
animal  has  not  recovered,  however,  but  it  is  out  of  danger,  and  with  a 
few  days'  care  it  may  be  on  the  way  to  convalescence.  The  decrease 
in  rectal  temperature  is  always  a  favourable  sign. 

But,  as  has  been  said,  death  is  the  most  frequent  termination  ;  and 
this  may  occur  in  two,  four,  or  six  days  from  the  commencement  of  the 
malady — rarely  later.  Then  all  the  symptoms  become  aggravated.  The 
tumefaction  of  the  genital  organs  increases,  and  extends  to  the  mamm^ 
and  hind-limbs  ;  the  vulva  is  covered  with  ecchymosed  patches  and  is 
cold  ;  the  vaginal  discharge  is  ichorous  and  brown  in  colour,  and  emits 
a  most  ftt'tid  odour  ;  the  temperature  suddenly  falls ;  the  surface  of  the 
body  is  covered  by  a  cold  glutinous  perspiration — especially  in  the  Mare 
— and  the  animal  expires  either  in  a  state  of  profound  coma,  or  in  con- 
vulsions. 

In  such  cases  death  may  be  due  to  the  violence  of  the  inflammation 
and  its  extension  to  the  peritoneum,  gangrene  of  the  uterus,  or  to 
septic  infection  by  absorption  of  the  putrid  matters  in  its  cavity,  and 
general  poisoning  therefrom.^ 

More  frequently  than  rapid  recovery,  the  malady  passes  into  a 
chronic  state.  Then  the  more  acute  symptoms  gradually  diminish, 
the  appetite  returns,  and  the  animal  does  not  exhibit  much  suffering. 
But  convalescence  is  not  established — the  mammaa  remain  flaccid,  and 
the  secretion  of  milk  is  either  very  scanty  or  altogether  suppressed ; 
the  sweUing  disappears  from  the  vulva,  but  the  discharge  therefrom 
persists  or  is  increased  in  quantity.  This  discharge  is  either  of  a  white 
glairy  character — leucorrhcjua  ;  grayish  and  grumous,  resembling  clotted 
milk  ;  or  red,  brown,  or  sanguinolent.  It  is  always  more  or  less  mal- 
odorous, and  sometimes  extremely  foitid  ;  more  particularly  is  this  the 
case  when,  as  often  happens  with  the  Cow,  the  discharge  is  mixed 
with,  or  derived  from  the  retention  in  the  uterus  of  the  foetal  envelopes, 
or  even  the  fa'tus  itself.  In  some  instances,  the  croupous  exudates 
which  have  been  formed  on  the  mucous  membrane  become  broken  up, 
and  are  cast  off  with  the  discharges.  Franck  states  that,  in  one  case, 
a  large  croupous  or  false  membrane,  which  had  covered  the  greater 
part  of  the  interior  of  the  utei-ua,  was  shed  in  this  way. 

In  other  instances  the  cervix  uteri  contracts,  though  the  mucous 
membrane  is  still  inflamed  ;  consequently,  the  muco-purulent  secretions 
are  retained  for  some  time,  and  the  discharge  from  the  vulva  ceases. 
But  when  the  organ  becomes  distended,  it  contracts,  or  it  is  pressed 
upon  when  the  animal  lies  down,  or  during  micturition  or  defecation  ; 

'  Franck  mentions  that  in  three  instances  the  dise-ose  manifested  itself  on  the  d.iy 
after  an  ea--y  jiarturitii>n,  and  it  liad  become  so  .severe  that  on  the  Rrcon<l  daj'  it  was 
necessary  to  slauuhter  the  animals.  On  the  inner  surface  of  the  vulvar  labia — which 
was  of  a  dark-red  hue — were  one  to  three  parturient  ulcers,  and  in  a  few  hours  there  had 
occurred  an  enormous  tumefaction  of  the  labia,  which  extended  to  the  pelvic  connective 
tissue  and  as  low  .is  the  b'Kks,  while  the  dependent  parts  of  the  body  were  al^o  involved. 
Deep  scarifications — which  caused  no  pain — were  useless,  and  were  not  followed  by 
bleeding.  On  examination  of  the  bodies  after  death,  thrombi  were  discovered  in  the 
uterine  and  ovarian  veins.  In  these  cases  the  infection  seemed  to  have  been  derived 
from  an  adjoining  Cow,  which  retained  the  placenta. 

Meyer  refers  to  a  ca^e  of  this  kind,  in  which  death  ensued  during  the  evening  of  the 
day  on  which  the  disease  manifested  itself.  He  found  a  large  blood-clot  in  the  uterus, 
and  ecchymoses  on  the  intestines. 


628  PATHOLOGY  OF  PARTURITION. 

then  the  os  is  forced  partially  open,  and  the  accumulated  fluid  escapes 
in  great  abundance.  Gohier,  Chouard,  and  other  veterinary  writers, 
give  instances  of  this  singular  form  of  chronic  metritis  ;  they  have  seen 
Mares  which  every  forty  days,  every  month,  or  at  shorter  intervals, 
expelled  fourteen,  sixteen,  and  even  as  much  as  twenty  pints  of  pus, 
after  exhibiting  symptoms  of  colic,  followed  by  more  or  less  marked 
expulsive  efforts. 

The  animal  soon  loses  condition ;  the  appetite  is  irregular,  the  skin 
is  unhealthy-looking  and  clings  to  the  bones ;  and  though  debility  is 
present,  oestrum  may  occur  far  more  frequently  than  in  health,  yet 
fecundation  is  not  possible.  Marasmus  sets  in,  with  febrile  attacks 
at  intervals — pyaemic  fever  ;  and  though  recovery  is  still  possible,  by 
skilful  treatment  and  long-continued  nursing,  yet  death  is  only  too 
often  the  sequel. 

Even  when  recovery  appears  to  be  progressing  favourably,  relapses 
may  occur,  sometimes  through  the  breaking  up  and  diffusion  of  venous 
thrombi,  which  give  rise  to  a  pyaemic  process,  as  in  the  case  recorded 
by  Contamine.  On  the  morning  after  an  easy  parturition,  the  after- 
birth having  also  been  expelled,  the  Cow  began  to  tremble  very  much ; 
the  udder  was  small  and  flaccid,  the  back  arched,  the  appetite  gone  ; 
there  was  anxiety,  with  colicky  pains,  constipation,  and  pressure  in 
the  right  flank  caused  pain  ;  the  labia  of  the  vulva  were  apart,  swollen, 
and  of  a  dark-red  colour.  In  three  days  the  animal  was  much  better ; 
but  after  three  weeks  there  was  a  relapse.  Petechiae  formed  on  the 
conjunctivas,  the  hind-limbs  became  swollen,  bleeding  ensued  from  the 
skin  and  nostrils,  and  there  was  cough.     The  Cow  finally  recovered. 

Occasionally  during  the  subacute  or  chronic  stages  of  metritis, 
metastatic  formations  occur  in  the  lungs,  liver,  joints,  and  other  parts ; 
not  infrequently  there  are  caseous  deposits  in  the  uterus,  which  may 
attain  such  a  thickness  in  its  walls  as  to  simulate  pregnancy. 

Pathological  Anatomy. 

In  those  cases  in  which  death  has  taken  place  and  an  examination 
of  the  body  been  made,  the  local  and  essential  lesions  are  found  in  the 
genital  organs  and  peritoneum,  and  when  puerperal  septicemia  has 
been  present  there  are  indications  of  general  infection  of  the  body. 
Decomposition  sets  in  early,  the  tissues  are  dark-green  and  foetid,  and 
meteorism  is  most  marked. 

In  simple  endo-metritis  such  pronounced  and  general  lesions  are  not 
found,  nor  is  the  peritoneum  involved.  In  the  more  acute  cases,  and 
particularly  those  in  which  there  has  been  septic  infection,  puerperal 
ulcers  of  a  dirty  greenish  hue  are  generally  met  with  in  the  vagina, 
often  in  the  vicinity  of  the  meatus  urinarius,  and  about  the  labia  of 
the  vulva.  The  mucous  membrane  is  of  a  dull  dai'k-red  hue,  and 
swollen  in  patches  by  diphtheritic  infiltration,  or  covered  in  parts  by 
croupous  exudates.  The  bladder  may  also  be  implicated,  though  not 
to  such  a  serious  extent,  and  especially  if  the  catheter  has  been  em- 
ployed. In  the  cavity  of  the  uterus  is  constantly  found  a  quantity  of 
chocolate-coloured  or  grayish  fluid,  composed  of  efl'used  blood,  remains 
of  fcetal  envelopes,  and  the  secretions  of  the  mucous  membranes — all 
in  a  more  or  less  advanced  state  of  decomposition,  and  emitting  the 
most  repulsive  odour.  This  fluid  contains  quantities  of  epithelial  and 
round  cells,  fat  globules,  and  septic  bacteria.      The  quantity  of  fluid 


METRITIS,  METRO-PERITONITIS,  AND  PARTl'lUKXT  F El' Eli.      629 

varies  considerably,  according  to  circumstances — amounting  sometimes 
to  many  gallons. 

The  uterus  itself  is  never  contracted  as  in  the  normal  condition,  and 
it  is  often  two  or  three  times  larger  than  it  ought  to  be. 

The  walls  of  the  organ  are  thickened,  friable,  softened,  intensely  red, 
and  infiltrated  with  sanguinolent  serosity,  inflammatory  products,  and 
pus  globules.  The  mucous  membrane  is  thickened,  of  a  dirty-brown 
or  dark-green  tint,  livid,  softened,  ecchymosed  in  places,  and  covered 
here  and  there  with  diphtheritic  or  fibrinous  exudates  and  blood-clots, 
the  latter  being  chielly  found — in  the  Cow — at  the  base  of  the  coty- 
ledons, which  are,  with  the  exudates  and  clots,  in  process  of  putre- 
faction, and  are  gray,  pulpy,  and  almost  detached.  Sometimes  portions 
of  decomposed  fcctal  membranes  yet  remain  attached  to  the  cotyledons  ; 
and  there  are  here  and  there  gangrenous  eschars,  in  the  form  of  green 
or  grayish  spongy  masses  of  a  diphtheritic  nature,  which  are  in  process 
of  softening  and  dissolution.  In  all  these  alterations  —  which  are 
usually  very  notable  in  the  cornu  that  contained  the  foetus — there  are 
the  characteristic  features  of  Endometritis  scptica. 

It  is  seldom  indeed  that  the  puerpei'al  or  septic  inflammation  is 
limited  to  the  mucous  membrane.  Nearly  always  it  extends  to  the 
submucous  connective  tissue  (Metritis  jyf'lcgmonosa),  which  is  infiltrated 
with  an  a^dematous  transudation  ;  or  it  becomes  the  seat  of  acute 
inflammatory  (t-dema,  in  which  the  tissue  swells,  becomes  tumid,  and 
its  interstices  tilled  with  fluid,  small  cells,  and  a  gelatinous,  semi-solid 
material  The  muscular  tissue  is  swollen  and  softened,  and  a  dark 
fluid  flows  from  it. 

The  subperitoneal  connective  tissue  of  the  uterus  may  suffer  in  like 
manner,  and  undergo  necrotic  softening  and  putrefaction  ;  while  the 
serous  membrane  itself  becomes  inflamed  (Metro-peritonitis). 

When  this  takes  place,  the  abdominal  cavity  contains  a  quantity  of 
reddish,  turbid,  sanious  serosity,  in  which  are  flakes  of  lymph.  The 
lining  membrane  of  this  cavity,  and  especially  that  covering  the  uterus, 
is  highly  inflamed,  and  its  surface  is  covered  with  pseudo-membranous 
layers  of  fibrin  ;  while  adhesion  may  have  taken  place  between  the 
different  organs  it  covers.  In  some  cases  the  inflammation  of  the  peri- 
toneum is  not  so  difluse,  and  is  more  or  less  limited  to  the  uterus  and 
organs  immediately  adjacent. 

In  other  cases,  again,  the  phlegmonous  inflammation  extends  to  the 
pelvic  connective  tissue  (raranictritis),  and  then  there  is  diffuse  acute 
cedeina,  inflltration  with  pus,  or  even  abscesses. 

Indeed,  in  the  uterine  connective  tissue  there  may  be,  in  different 
parts,  active  cell  proliferation  and  abscesses,  and  if  the  animal  chances 
to  live  beyond  a  certain  period,  these  terminate  in  caseous  inspissation, 
or  even  perforation  into  the  abdominal  cavity. 

A  very  important  pathological  lesion,  and  one  which  is  not  infre- 
quently noted  in  parametritis,  is  thrombosis  of  the  veins  and  lymphatics. 
Thrombosis  of  the  uterine  veins  has  been  observed  in  animals — solid, 
white,  or  yellowish  thrombi  adiiering  to  the  internal  surface  of  the 
vessels,  and  extending  towards  the  larger  venous  trunks — even  as  far 
as  the  posterior  vena  cava.  Sometimes  the  breaking-up  of  these 
thrombi  causes  relapse,  and  embolic  pyaemia  of  the  \un<j,s  or  neighbour- 
ing organs.  When  septic  infection  does  not  occur,  bruising  of  the  soft 
parts  during  diflicult  parturition  may  give  rise  to  thrombosis  of  the 
veins,  with  secondary  pyaemia.     This  may  explain  the  occurrence  of 


630  PATHOLOGY  OF  PARTURITION. 

abscesses  appearing  at  the  joints,  and  inflammation  of  the  feet  super- 
vening on  parturition.  Thrombosis  of  the  lymphatics  has  rarely  been 
observed  in  animals  ;  it  is  noticed  within  the  inflamed  spot.  "  The 
coagulated  lymph  either  uniformly  fills  the  vessel,  or  gives  the  appear- 
ance of  a  string  of  beads.  Sometimes,  also,  single  larger  dilatations  of 
lymphatic  vessels  are  seen.  The  thrombosis  may  be  due  to  the  direct 
influence  of  the  infecting  matter,  but  more  frequently  it  is  caused  by 
the  inflammation  of  the  connective  tissue  around  the  vessel.  The  pro- 
ducts also  of  the  inflammation  of  this  tissue  have  a  tendency  to  coagu- 
late, and  the  contents  of  the  vessels  participate  in  the  process," 
Sometimes  the  lymphatics  are  filled  vpith  pus  [Purulent  lymphangitis), 
and  the  neighbouring  glands  are  swollen  andsoftened.  This  thrombosis 
of  the  lymphatics  has  been  considered  a  favourable  circumstance,  since 
the  occluded  vessels  are  prevented  from  conveying  the  infecting 
materials  :  the  inflammatory  process  being  at  least  delayed  at  the 
nearest  group  of  lymphatic  glands.  The  lymphangitis  is  therefore  con- 
sidered an  accidental  change,  which  usually  remains  limited  to  the 
diseased  part,  and  may  disappear  ;  and  it  has  been  remarked  that  it 
rarely  extends  further  towards  the  thoracic  duct,  unless  there  are  other 
very  considerable  changes. 

Sometimes  the  thrombi  in  the  vessels  of  the  uterus  soften  ;  so  that, 
in  cutting  into  the  walls  of  the  organ,  they  appear  like  small  abscesses, 
varying  in  size  from  a  pea  to  that  of  a  nut.  They  can  only  be  dis- 
tinguished from  abscesses  by  their  smooth  walls,  since  the  afferent  and 
efl'erent  vessels  cannot  always  be  found. 

In  intense  parametritis,  with  extensive  infiltration  of  the  subserous 
connective  tissue,  other  organs  may  be  involved,  and  especially  those 
which  are  dirfectly  connected  by  means  of  this  tissue — such  as  the 
ovaries.  The  peritonitis  may  extend  through  the  diaphragm  to 
the  pleurae,  or  the  inflammation  in  both  membranes  may  be  due  to 
ichorrhsemia. 

In  those  eases  in  which  thrombi  in  the  bloodvessels  have  become 
detached  and  broken  up,  the  fragments  may  be  carried  in  the  circula- 
tion, and  give  rise  to  embolism  and  haemorraghic  infarcts,  or  to  meta- 
static abscesses  in  such  parenchymatous  organs  as  the  lungs,  liver, 
spleen,  kidneys,  etc. 

In  the  most  rapidly  fatal  cases,  in  which  death  is  due  to  septic  para- 
metritis, there  is  no  time  for  fibrinous  exudation,  and  there  are 
appearances  not  unlike  those  observed  in  splenic  fever.  The  blood  is 
dark-coloured  and  non-coagulable,  ecchymoses  are  found  in  various 
organs  and  tissues,  and  there  is  a  marked  tendency  to  rapid  putrefac- 
tion. The  elementary  structures  of  organs  show  the  commencement 
of  an  acute  inflammatory  process  —  the  fine  granular  infiltration 
or  "cloudy  swelling,"  fatty  degeneration,  or  even  disintegration  of 
cells. 

It  has  been  already  stated  that  there  is  nothing  exceptional  in  par- 
turient fever,  and  so  far  as  its  pathological  anatomy  is  concerned,  the 
same  alterations  are  observed  in  non-parturient  subjects.  Parturition 
only  predisposes  the  animal  to  its  occurrence,  from  the  fact  that  there 
are  wounds  and  bruises  inflicted  on  the  soft  tissues  of  the  genital  canal ; 
that  there  is  present  a  quantity  of  matters — fluid  and  solid — either  de- 
composed or  decomposing  ;  and  that  the  bloodvessels  and  lymphatics 
of  the  uterus  at  this  time  are  in  a  favourable  condition  for  the  reception 
and  action  of  this  septic  material.     In  animals  which  have  succumbed 


METRITIS,  METROPEIIITONITIS,  AXD  PARTURIENT  FEVER.       631 

after  the  operation  of  ovariotomy,  similar  pathological  alterations  arc 
found. 

With  regard  to  chronic  metritis,  various  changes  have  been  observed. 
In  some  cases  the  uterus  has  contained  a  considerable  quantity  of  fetid 
pus,  or  muco-pui-ulent  matter  of  a  white  or  gray  hue  ;  while  the 
mucous  membrane  has  been  gray  or  dark-coloured,  thickened  and 
softened,  and  the  cotyledons  infiltrated,  softened,  or  even  indurated ; 
the  vaginal  mucous  membrane  is  also  infiltrated  and  indurated  in  some 
cases. 

Causes. 

The  predisposing  cause  of  metritis,  metro-peritonitis,  and  parturient 
fever,  is  the  parturient  or  puerperal  state.  It  is  true  that  septic  infec- 
tion, with  its  train  of  symptoms,  may  occur  at  other  periods  and  from 
various  causes ;  but  metritis  and  its  complications  are,  as  a  rule, 
observed  only  after  abortion  or  parturition. 

The  occasional  causes  of  metritis,  and  therefore  of  metro-peritonitis 
and  fever,  are  injuries  to  the  genital  canal  or  interior  of  the  uterus, 
during  or  after  birth.  The  manipulations  necessary  for  the  ai'tificial 
removal  of  the  fojtus  or  its  envelopes,  and  by  which  the  mucous  mem- 
brane is  abraded  or  wounded,  are  a  frequent  cause  ;  inversion  of  the 
organ,  and  especially  when  it  has  been  exposed  for  some  time  to  the 
air  and  the  action  of  irritating  substances,  or  bruised  or  lacerated  in 
returning  it,  is  another  cause.  Ketention  of  the  foetus  or  foetal 
envelopes  has  also  been  given  as  a  cause  of  metritis. 

But  other  cases  have  been  noted  in  which  birth  was  easy  and  natural, 
and  at  the  usual  time  ;  and  yet  towards  the  second,  fourth,  or  sixth 
day  after  parturition,  the  animal  began  to  lose  its  appetite,  the  vulva 
became  swollen,  fever  set  in,  and  all  the  symptoms  of  metro-peritonitis 
became  rapidly  developed.  In  these  cases,  the  occurrence  of  disease 
has  been  attributed  to  some  imprudence  in  management,  which  brings 
about  derangement  in  the  functions  of  the  skin  or  digestive  organs — 
such  as  exposing  the  animal  to  wet  and  cold  out  of  doors  or  draughts 
of  cold  air  in  stables,  giving  it  cold  water  to  drink,  or  unsuitable 
food. 

Sometimes  the  disease  occurs  among  such  a  large  number  of  animals 
almost  simultaneously,  that  it  has  been  looked  upon  as  epizootic,  and  due 
to  a  miasma.  More  particularly  has  this  been  the  case  with  parturient 
fever,  but  which  must  now  be  considered  as  due  solely  to  the  absorp- 
tion of  septic  matter. 

The  production  of  parturient  fever  in  animals,  as  in  the  human 
female,  requires  two  conditions  :  (1)  a  fresh  wound  by  which  the  septic 
poison  can  enter.  The  wound  need  not  be  large,  but  it  appears  to  be 
almost  essential  that  it  is  recent — for  suppurating  or  granulating  sores 
do  not  absorb,  so  long  as  the  infecting  agent  does  not  destroy  the 
surface.  If  the  mucous  membrane  is  intact  and  protected  by  its 
epithelium,  absoi-ption  is  also  prevented  ;  (2)  an  active  septic  substance, 
either  produced  in  the  animal  which  is  to  be  the  subject  of  parturient 
fever — auto-infection,  or  introduced  from  without — external  infection. 

Birth  rarely  takes  place  in  animals  without  more  or  less  laceration 
or  abrasion  of  the  cen'ix  uteri,  vagina,  or  labia  of  the  vulva  ;  and  those 
injuries  which  are  on  the  floor  of  the  genital  canal  are  more  likely  to 
be  followed  by  septic  fever  than  those  on  the  sides  or  roof,  simply 
because  they  are  brought  more  directly  in  contact  with  the  decomposing 


632  PATHOLOGY  OF  PARTURITION. 

material.  Infection  less  frequently  takes  place  from  the  interior  of 
the  uterus  under  normal  conditions,  as  injury  is  not  so  likely  to  occur 
there  from  the  passage  of  the  foetus.  Exceptionally,  it  may  take  place 
in  the  uterus  through  the  cotyledons,  when  some  of  these  are  torn 
during  the  separation  of  the  foetal  membranes. 

As  has  been  mentioned,  the  parturient  period  is  eminently  favourable 
for  the  absorption  of  septic  matters ;  as  the  mucous  membrane  of  the 
genital  canal  is  exceptionally  vascular,  and  the  bloodvessels  and 
lymphatics  are  greatly  developed. 

Auto-infection  occurs  generally  when  there  is  a  fresh  wound,  and 
when  the  foetus  is  dead,  and,  still  retained  in  the  uterus,  has  become 
decomposed  through  the  access  of  air;  or  from  retention  and  putre- 
faction of  the  envelopes.  The  ichorous  putrefaction  of  wounds,  or 
new  growths  in  the  uterus  or  vagina,  may  also  lead  to  septic  in- 
fection. ^ 

Embryotomy,  when  the  foetus  is  decomposing,  is  a  dangerous 
operation  if  a  wound  chances  to  be  inflicted  during  its  performance. 
It  is  the  same  with  the  removal  of  the  foetal  envelopes. - 

With  the  Mare,  removal  of  the  foetal  membranes  does  not  appear  to 
be  dangerous,  and  their  retention  is  not  usually  followed  by  infection, 
for  it  is  not  until  the  second  or  third  day  after  parturition  that  their 
decomposition  usually  commences  ;  so  that  if  small  injuries  have  been 
produced  during  birth,  it  is  most  likely  that  they  will  be  suppurating 
or  granulating  by  that  time,  and  thus  be  proof  against  the  passage  of 
putrid  matter.  If,  however,  a  fresh  wound  is  made,  or  the  granula- 
tions are  injured  by  mechanical  means,  then  removal  of  the  putrid 
envelopes  is  full  of  risk.  Foelen  mentions  that  a  Cow  had  a  wound 
on  the  vulva,  and  this  was  infected  by  putrid  membranes ;  on  the 
fourth  day  after,  the  animal  died  with  all  the  symptoms  of  parturient 
septicaemia. 

External  infection  does  not  appear  to  be  so  frequent  as  auto-infection 
among  animals.     It  takes  place  when  septic  materials  are  brought  to 

^  Franck  gives  the  following  illustrations,  which  could  be  easily  and  largely  sup- 
plemented : 

1.  The  fcEtus  of  a  Heifer  was  dead  in  the  uterus,  and  much  distended  with  gas. 
Embryotomy  had  to  be  resorted  to  in  order  to  extract  it ;  and  this  was  accomplished, 
apparently,  without  causing  any  noticeable  injury  to  the  vagina.  On  the  third  day 
septicaemia  became  manifest,  and  the  animal  had  to  be  killed. 

2.  A  Cow  gave  birth  to  a  Calf  in  a  normal  manner  ;  but  the  hoof  of  the  young 
creature  on  its  passage  through  the  vagina  made  a  small  wound.  Twenty  four  hours 
afterwards  a  second  Calf  in  a  state  of  putrefaction  was  removed  by  manual  force,  but 
without  injuring  the  Cow.  In  two  days  the  latter  was  attacked  with  puerperal  fever, 
and  was  killed. 

3.  Mombrini  removed  a  dead  Calf  from  the  uterus  by  embryotomy.  Septic  inflam- 
mation of  the  uterus  and  peritoneum  set  in,  and  the  Cow  died  on  the  seventh  day. 

4.  It  is  well  known  that  Bitches  which  retain  the  foetus  in  the  genital  canal  for 
any  length  of  time  (eighteen  hours  or  thereabouts),  frequently  perish  from  SeptiJccemia 
pue7-peralis.  This  appears  to  be  due  to  the  fact  that  the  puppy  so  retained  quickly  dies : 
owing  to  the  shortness  of  the  umbilical  cord,  the  early  separation  of  the  placenta,  and 
birth  taking  place  in  the  amnion.  The  young  creature  also  speedily  putrefies,  and  the 
large  raw  surface  formed  by  the  maternal  placenta  is  a  ready  inlet  for  the  direct  in- 
troduction of  the  septic  material  into  the  blood.  Speedy  death  of  the  Bitch  is  the 
consequence. 

-  A  Cow  retained  the  fcetal  envelopes  for  five  days  after  parturition,  when  they  were 
removed.  The  operator  had  evidently  wounded  a  cotyledon  or  the  uterine  mucous 
membrane  in  doing  so,  as  his  hand  was  stained  with  blood.  In  three  days  the  animal 
was  affected  with  parturient  fever  and  died.  No  injury  to  the  uterus  could  be  detected 
on  post-mortem  examination. 


.^[ETRITIS,  .\fETROPERITOXITIS,  AM>  I'ARTUPdEXT  FEVER.      633 

the  recent  wounds  or  lacerations  of  the  genital  organs  by  any  means — 
as  directly  by  the  hand,  instruments,  sponges,  straw,  etc.,  or  indirectly 
through  the  atmosphere,  when  the  septic  micro-organisms  are  sus- 
pended therein — the  so-called  miasmatic  infection.  There  is  a  close 
relationship  between  abortion  and  parturient  fever — a  Cow  suffering 
from  the  latter  being  undoubtedly  dangerous  in  a  stable  or  pasture 
where  there  are  a  number  of  pregnant  cattle  ;  while  a  case  of  abortion 
or  placental  retention  occurring  in  a  stable,  might  be  considered  nearly 
as  serious  among  parturient  Cows. 

A  retained  and  decomposed  placenta  is  undoubtedly  a  fertile  source 
of  parturient  fever.  Franck  refers  to  three  instances,  in  which  the 
Cows  calved  in  a  normal  manner  and  the  fcctal  membranes  came  away 
in  four  hours  after  ;  but  a  trifling  wound  existed  in  the  mucous  mem- 
brane, at  the  entrance  to  the  vagina.  In  two  or  three  days  afterwards 
these  animals  showed  very  acute  symptoms  of  parturient  fever.  They 
stood  near  another  Cow  whose  uterus  contained  a  decomposing  placenta. 
The  emanations  from  the  vulva  or  discharges  of  this  animal  had,  there 
can  scai-cely  be  a  doubt,  infected  the  three  ;  or  the  soiled  straw  may 
have  been  the  means  of  conveying  the  septic  matter  to  the  vulvar 
wounds ;  the  tail  of  the  Cow  may  even  have  been  an  active  agent  in 
throwing  the  vaginal  discharges  about,  as  it  is  generally  much  soiled 
by  them. 

External  infection  may  also  be  conveyed  by  means  of  cords,  crotchets, 
and  other  obstetrical  appliances,  if  they  are  soiled  with  septic  matters — 
which  they  may  be,  if  previously  used  in  the  removal  of  a  decomposing 
foetus  ;  and  the  operator  himself  may  be  the  means  of  infecting.  An 
instance  of  this  kind  is  related  as  occurring  in  Switzerland,  during 
1861-63  ;  in  a  large  cowshed  containing  about  200  head  of  cattle, 
suddenly  a  number  died  of  parturient  fever,  though  they  had  no 
difficulty  in  calving.  For  a  long  time  afterwards  no  other  births  took 
place,  so  no  more  accidents  of  this  kind  were  observed ;  but  it  was 
strongly  suspected  that  the  herdsman  who  attended  the  first  sick 
animal,  cleaned  it,  etc.,  in  assisting  the  others  during  parturition,  had 
conveyed  the  infection  to  them.  And  it  is  quite  possible  that  many 
serious  and  wide-spread  outbreaks  of  parturient  fever  in  cattle  are 
due  to  an  obstetrist  who  has  been  engaged  in  removing  a  dead  fcx'tus 
or  a  retained  placenta.  The  same  cause  may  be  in  operation  among 
Ewes  during  the  lambing  season,  when,  as  is  well  known,  parturition 
occurs  in  the  flocks  within  a  limited  period,  and  under  circumstances 
favourable  to  the  spread  of  infection ;  and  not  infrequently  large 
numbers  of  Ewes  perish  from  parturient  septicicmia  ("  heaving  pains  "). 

We  have  mentioned  that  exposure  to  cold  is  supposed  to  be  one  of 
the  causes  of  parturient  fever.  Franck,  however,  is  of  opinion  that  real 
parturient  fever  cannot  be  so  produced,  and  in  this  he  is  correct ;  the 
malady  is  of  septic  origin,  micro-organisms  (the  Micrococcus  scpticiis 
])ucrperalis  of  Arloing?)  being  the  active  agents  in  engendering  the 
disease. 

General  infection  takes  place  when  there  are  parturient  sores  or 
ulcers  in  the  vulva,  vagina,  or  uterus,  and  this  infection  is  manifested 
externally  by  the  high  temperature  and  other  serious  symptoms.  In 
other  cases,  when  only  a  small  quantity  of  septic  matter  has  been 
absorbed,  the  symptoms  have  more  of  a  local  character ;  they  are 
less  severe,  and  though  the  fever  may  be  of  a  continuous  character, 
yet  it  is  not  so  acute,  and  indications  of  peritonitis  are  generally  absent. 


634  PATHOLOGY  OF  PAETUPJTIOX. 

Indeed,  we  may  have  simple   metritis  -without    much    constitutional 
disturbance. 

Prognosis. 

The  prognosis  of  parturient  fever  must  be,  in  the  majority  of  cases, 
unfavourable,  as  the  veterinary  surgeon  is  only  too  frequently  not  called 
in  until  too  late.  When  infection  is  but  slight,  or  when  the  local 
inflammation  is  not  very  severe,  then  careful  treatment  may  restore  the 
patient  to  health.  It  must  not  be  forgotten,  however,  that  what 
appears  at  first  a  mild  form  of  metritis,  may  become  a  very  grave  attack 
of  this  fever. 

Prophylaxis. 

From  what  we  have  said  with  regard  to  the  causes  of  parturient 
fever  and  metro-peritonitis,  it  will  be  seen  that  in  obstetrical  operations 
great  care  should  be  exercised,  so  as  to  avoid  wounding  the  genital 
canal,  and  especially  the  interior  of  the  uterus.  Should  injury  be 
unfortunately  inflicted,  cleanliness  and  careful  dressing  with  some  such 
antiseptic  as  carbolic  acid,  should  be  enforced.  This  is  especially 
necessary  when  extraction  of  a  dead  foetus  or  retained  placenta  takes 
place. 

No  person  who  has  been  handling  a  creature  suffering  from  partu- 
rient fever  or  any  decomposing  animal  matters,  should  be  allowed  to 
assist  animals  in  parturition  ;  and  the  same  rule  ought  to  be  observed 
with  regard  to  instruments  and  other  obstetrical  appliances,  unless  they 
have  been  thoroughly  cleansed. 

If  a  case  of  parturient  fever  should  occur  where  there  are  other  preg- 
nant animals,  or  animals  which  have  quite  recently  brought  forth,  these 
should  be  immediately  removed.  An  animal  which  retains  a  decom- 
posing foetus  or  fcEtal  membranes,  is  also  dangerous  among  them.  The 
same  remark  applies  to  animals — such  as  Ewes  and  Cows — at  pasture. 
The  soiled  ground  should  be  most  carefully  disinfected  with  lime,  when 
possible,  and  pregnant  or  parturient  animals  kept  away  from  it. 

Trcatvient. 

Metritis,  metro-peritonitis,  and  parturient  fever  being  gi'ave  disorders 
and  rapid  in  their  progress,  demand  prompt  and  energetic  treatment. 
Indeed,  it  is  well  in  all  cases  in  which  the  genital  canal  has  been 
injured,  or  the  placenta  or  dead  foetus  has  been  retained  until  putrefac- 
tion has  begun,  to  prevent  evil  effects  by  cleaning  out  and  injecting 
antiseptic  fluids  into  this  canal  and  the  uterine  cavity — such  as  solution 
of  corrosive  sublimate,  1  to  2,000 — 3,000.  The  first  thing  to  be  attended 
to  in  treatment  is  the  condition  of  the  uterus,  and  the  removal  of  any 
infective  matters  it  or  the  vagina  may  contain  ;  as  well  as  the  disinfec- 
tion of  any  wounds  or  abrasions  in  these  parts. 

The  genital  canal  should  be  thoroughly  cleansed  by  injections  of  warm 
water,  and  the  wounds  dressed  with  cresol,i  or  carboUc  acid  and  olive 
oil  (1  to  10),  applied  by  means  of  a  brush  or  feather ;  or  salicylic  acid 
1  part,  spirits  of  wine  20  parts,  warm  water  24  parts. 

After  the  interior  of  the  uterus  has  been  cleansed  by  injections  of 

1  Cresol,  cresj'l,  or  cresylic  acid,  which  enters  largely  into  the  composition  of  Jeje's 
Fluid,  has  been  extolled  as  an  excellent  antiseptic,  and  is  preferred  by  many  Continental 
veterinarians  to  corrosive  sublimate  and  carbolic  acid.  It  is  not  poisonous,  like  these,  and 
mixes  readily  with  water,  a  1  per  cent,  solution  being  a  most  powerful  antiseptic.  It  is 
also  recommended  for  internal  medication  instead  of  carbolic  acid,  and  for  the  same 
reasons. 


METiiiris,  METRn-rEiiiTuyrns,  AM)  PAirrrniEXT  fkvki:.     035 

warm  water,  an  injection  of  carbolic  acid  solution  (1  to  20 — 50)  boro- 
glycerine  (1  to  20—40  of  water),  or  the  above  solution  of  corrosive 
sublimate,  should  be  made  every  day,  and  the  wounds,  if  accessible, 
dressed  at  the  same  time.  Permanganate  of  potash  (1  to  .00  of  water) 
may  be  employed  to  inject  into  the  genital  canal,  when  the  disease  is 
less  acute. 

All  tluids  injected  should  be  warm — 80°  to  100'  Fahr.  ;  and  solution 
of  opium  or  extract  of  belladonna  may  be  advantageously  employed  in 
the  uterine  injections,  to  allay  pain  and  straining. 

The  external  treatment  must  be  hot  fomentations,  cataplasma,  or 
counter-irritation  to  the  surface  of  the  abdomen — or  all  three  combined. 
The  smaller  animals  may  have  linseed-meal  poultices  applied,  or  be 
immersed  in  hot  water. 

With  regard  to  the  constitutional  treatment  of  puerperal  septicaemia, 
this  must  be  directed  towards  neutralizing  the  effects  of  the  septic  matter 
by  the  exhibition  of  antiseptic  remedies,  and  reducing  the  high  tempera- 
ture ;  as  a  long  continuation  of  this  leads  to  rapid  waste  of  the  tissues, 
and  is  fraught  with  danger  to  the  system. 

There  is  no  specific  remedy  with  which  to  neutralize  the  action  of  the 
septic  matters  in  the  blood  and  tissues.  The  sulpliites  of  soda  and 
potash  have  been  recommended,  as  well  as  sulphurous  acid.  These 
appear  to  have  acted  favourably  in  some  cases.  Carbonate  of  soda  and 
permanganate  of  potash  have  also  been  well  spoken  of,  as  well  as  lai'ge 
doses  of  quinine.  Carbolic  and  salicylic  acids  are  now  most  in  repute, 
and  are  given  in  small  and  frequent  doses. 

If  there  is  a  tendency  to  constipation,  a  purgative  maybe  administered; 
indeed,  unless  special  circumstances  forbid  it,  a  purgative  may  prove 
most  serviceable  in  assisting  in  the  removal  of  the  septic  matter  through 
the  intestinal  canal.  Dogs  which  liave  been  poisoned  by  this  matter, 
often  recover  after  profuse  and  fcctid  diarrhoea ;  and  a  purgative  gener- 
ally reduces  the  temperature. 

In  acute  cases,  in  order  to  obtain  the  more  prompt  action  of  anti- 
septics, it  has  been  proposed  to  introduce  them  directly  into  the  circula- 
tion by  intravenous  injection.  Solutions  of  cresol,  carbolic  acid,  and 
iodine  have  been  employed  successfully  ;  and  in  woman  a  desperate 
case  has  recovered  after  the  intravenous  injection  of  liquor  ammoniac 
(1  to  3). 

As  a  last  resource,  and  to  substitute  healthy  for  poisoned  blood,  trans- 
fusion has  been  also  practised  in  woman,  and  with  good  results.  The 
experiment  is  worth  trying  in  the  parturient  fever  of  animals. 

With  regard  to  the  diminution  of  temperature,  quinine  has  been  highly 
lauded.  Bleeding  is  certainly  not  to  be  recommended.  If  the  tempera- 
ture continuously  remains  very  high,  then  the  application  of  cold  water 
to  the  surface  of  the  body  is  indicated.  The  cold  water  may  be  applied 
to  the  larger  animals  by  means  of  cold  wet  sheets  wrapped  round  the 
body,  and  kept  cold  for  an  hour  or  two  at  a  time  by  pouring  on  water, 
at  intervals,  by  means  of  a  small  vessel.  Smaller  animals  may  be  put 
into  a  gradually-cooled  bath. 

The  skin  must  be  well  dried  after  the  application  of  the  cold  water, 
and  with  the  larger  animals  a  dry  blanket  should  be  thrown  over  the 
body.  Food  should  be  sloppy  and  laxative.  The  stable  must  be  kept 
scrupulously  clean  and  well  ventilated. 

Tonics  and  good  food  must  be  allowed  when  recovery  is  taking  place, 
and  the  scquche  of  the  disease  treated  according  to  their  indications. 


636  PATHOLOGY  OF  PAETUPJTIOX. 

Peritonitis  may  be  combated  by  the  exhibition  of  large  and  frequent 
doses  of  calomel  Van  den  Eide  and  Clement  were  successful  in  treat- 
ing serious  cases  of  metro-peritonitis  by  administering  calomel,  and 
applying  mercurial  ointment  to  the  abdomen. 

When  the  pain  is  very  severe,  mustard  may  be  applied  to  the  surface 
of  the  abdomen,  and,  in  the  case  of  small  animals,  linseed-meal  poultices 
on  which  laudanum  has  been  sprinkled  ;  while  subcutaneous  injections 
of  morphia  may  be  freely  resorted  to.  When  great  exhaustion  or 
collapse  is  present,  large  and  frequent  draughts,  containing  diffusible 
stimulants,  must  be  administered,  with  nutritious  gruel.  To  the  smaller 
animals  milk  or  beef-tea  may  be  given. 

In  the  chronic  form  of  metritis,  the  same  treatment  may  be  adopted, 
so  far  as  the  genital  canal  is  concerned ;  and  if  there  is  vaginal  dis- 
charge, the  treatment  recommended  for  leucorrhoea  will  be  suitable.  If 
the  uterus  is  not  contracted,  this  may  be  promoted  by  the  exhibition  of 
preparations  of  ergot  of  rye. 

In  handhug  animals  suffering  from  parturient  fever,  or  in  examining 
the  carcases  of  those  which  have  died,  the  veterinary  surgeon  should  be 
on  his  guard  against  inoculation.  More  particulai'ly  is  this  necessary 
when  exploring  the  genital  canal  of  the  living  animal,  or  removing  a 
putrescent  foetus  or  foetal  envelopes.  The  arm  and  hand  should  then  be 
well  smeared  with  oil  or  lard,  and  thoroughly  cleaned  with  carbolic  acid 
soap  when  the  operation  is  completed. 


CHAPTEE    IT. 
Parturient  or  Puerperal  Apoplexy  or  Collapse. 

Peehaps  no  disease  affecting  animals  has  received  a  greater  amount  of 
attention,  or  given  rise  to  more  widely  divergent  opinions  as  to  its 
nature,  than  the  malady  to  which,  chiefly  for  convenience,  we  have 
given  the  designation  of  parturient  apoplexy  or  puerperal  collapse. 
Veterinary  literature,  since  the  commencement  of  the  century,  teems 
with  descriptions  and  discussions  relative  to  the  disease,  and  the  most 
eminent  veterinary  pathologists  still  appear  to  be  far  from  unanimous 
as  to  its  nature.  The  great  number  of  names  given  to  it — some  of  which 
either  indicate  the  opinions  prevalent  with  regard  to  its  pathology  or 
causes,  or  point  to  prominent  symptoms — are  evidence  of  the  un- 
certainty which  has  prevailed,  and  now  prevails,  with  regard  to  it.  For 
instance,  it  has  been  designated  puerperal  fever,  nervous  ov  paralytic  form 
of  puerperal  fever,  milk-fever,  puerperal  apoplexy,  paraplegia,  puerperal 
collapse,  vitulary  fever,  vitulary  apoiilexy,  vitulary  paralysis,  processus 
puerperal,  puerperal  typhus,  calf  fever,  dropping  after  calving,  eclampsia 
puerperalis,  etc. 

In  France  it  is  usually  designated  "  Vitulary  Fever,"  while  in 
Germany  it  is  commonly  known  as  "  Calving  Fever."  In  England  it 
is  usually  designated  "Parturient  Apoplexy,"  "Puerperal  Fever," 
"  Milk  Fever,"  etc. 

The  malady  appears  to  have  been  known  from  an  early  period,  but 
the  first  exact  description  of  the  symptoms  we  can  find  is  that  given  by 
Skellett,^  who  names  it  "  Milk  Fever,  or  Dropping  after  Calving  "3  in  the 

^  Practical  Treatise  on  the  Parturition  of  the  Coiv.     London,  1S07. 


PARTURIENT  APOPLEXY— PUERPERAL  COLLAPSE.  637 

following  year  it  is  alluded  to  by  Jorj;,!  who  evidently  knew  Skellett's 
work,  as  the  latter's  plates  are  copied.  Some  years  after  tliis  period 
the  disease  began  to  attract  much  attention,  as  with  improvement 
in  the  breeding  of  Cattle  it  gradually  became  more  prevalent,  until  now 
the  literature  of  the  subject  is  very  extensive. 

Without  entering  at  this  moment  into  a  discussion  as  to  the  nature 
of  the  disease,  it  may  be  suHicient  to  say  that  it  is  a  very  serious  and 
acute  affection,  almost  special  to  Cows  in  the  parturient  state — and 
particularly  those  of  the  improved  Milch  breeds,  in  which  it  is  frequent; 
that  its  invasion  is  sudden  and  its  course  rapid  ;  and  that  it  is  character- 
ized by  loss  of  consciousness  and  paralysis,  seldom  by  convulsions.  It 
is  extremely  fatal,  death  ensuing  in  a  very  short  time ;  or  if  recovery 
takes  place,  this  is  sometimes  nearly  as  rapid  as  the  attack  was  sudden. 
It  has  been  confounded  with  parturient  fever,  or  considered  to  be  only  a 
nervous  or  paralytic  form  of  that  malady  ;  while  Franck,  who  appears 
to  have  studied  it  very  carefully,  is  of  opinion  that  it  is  identical  with 
the  eclampsia  of  the  human  female,  and  considers  that  "puerperal 
eclampsia  "  {Eklampsic  in  Folgc  dcr  Geburt)  is  the  best  designation  for 
it.  He  asserts  that  to  look  upon  it  as  a  "  fever"  is  a  mistake,  as  a  high 
temperature — the  sure  sign  of  such  a  condition — is  not  pi-esent ;  while 
to  name  it  "  calving  fever  "  is  not  quite  exact,  as  it  has  been  known  to 
affect  oxen  and  other  domesticated  animals — though  seldom. 

We  shall,  however,  revert  to  this  question  presently. 

Symptovis. 

The  disease  sets  in  suddenly  after  calving,  and  without  any  premoni- 
tory symptoms.  It  may  attack  the  Cow  so  early  as  twelve  or  twenty 
hours  after  parturition,  but  it  is  most  frequent  on  the  second  or  third 
day,  and  generally  follows  a  rapid  and  an  easy  birth.  It  has,  though 
very  rarely,  manifested  itself  before  parturition,  and  also  during  that 
act.  It  is  seldom  that  it  appears  after  the  third  day ;  though  Harms 
says  it  may  occur  so  late  as  the  tenth  day  ;  Hess  records  an  instance  on 
the  fourteenth  day,  and  a  case  has  been  witnessed  in  the  fourth  week ; 
while  Gierer  states  that  he  saw  a  Cow  which  offered  all  the  symptoms 
of  the  disease  seven  weeks  after  calving. 

In  some  instances,  before  the  symptoms  commence,  the  lacteal  secre- 
tion is  either  diminislied  or  suspended.  Generally,  however,  the  first 
indications  are  the  Cow  hanging  back  in  the  stall,  or  the  head  drooping; 
there  is  uneasiness,  whisking  of  the  tail,  striking  at  the  belly  with  the 
hind-feet ;  the  appetite  is  suddenly  lost  and  rumination  ceases ;  the 
faeces  are  hurriedly  expelled,  and  the  animal  becomes  indifferent  to  its 
Calf.  There  is  often  a  shivering  fit,  but  this  is  not  followed  by  an 
increase  of  temperature.  In  a  few  cases,  congestion  of  the  brain  appears 
to  be  present  at  the  commencement ;  the  Cow  presses  its  head  to  the 
wall  or  leans  against  the  stall-post,  bellows,  looks  stupid,  its  mouth  is 
hot,  the  eyes  are  reddened  and  the  eyelids  wink,  and  it  half  uncon- 
sciously treads  with  the  hind-feet.  The  respiration  becomes  hurried 
and  plaintive,  though  the  pulse  may  be  normal  ;  and  if  the  animal  is 
conscious,  its  physiognomy  expresses  anxiety  and  suffering.  Unsteadi- 
ness and  staggering  are  manifested  ;  the  animal  can  no  longer  stand, 
and  it  either  lies  down,  or  falls  on  the  floor  of  the  stall.  There  it 
may  remain  tranquil,  merely  moaning  or  bellowing,  or  striking  with 
its  feet  at  the  belly  as  if  affected  with  colic,  and  making  convulsive 
^  Anltitung  zur  Ehier  Raiionelien  OeburUhiilfe,  etc., /ur  Thierdrzte. 


638 


PATHOLOGY  OF  PARTURITION. 


movements.  Other  signs  of  congestion  of  the  brain  may  be  more  or  less 
marked ;  the  ears  and  horns  may  be  warmer  than  natural,  and  in 
addition  to  the  redness  of  the  eyes,  tears  may  flow  down  the  cheeks. 

All  these  changes  generally  become  developed  in  a  very  few  hours ; 
so  that  an  animal  which  was  left  in  apparent  good  health  only  a  short 
time  before,  is  found  lying,  cannot  get  up,  and  is  in  a  soporific  con- 
dition. This  is  the  stage  of  the  malady  at  which  the  veterinary 
surgeon  is  usually  sent  for. 

Then  he  finds  it  lying  tranquilly  on  its  side,  fully  extended  or, 
which  is  far  more  frequent,  resting  on  the  sternum,  and  the  head 
turned  round  towards  the  shoulder  or  flank  (Fig.  220).  This  position 
of  the  head  is  supposed  to  be  due  to  contraction  or  tonic  spasm  of  the 
cervical  muscles  of  one  side  of  the  neck.  It  is  sometimes  observed  at 
the  commencement  of  the  attack,  even  while  the  animal  is  standing. 
The  neck  is  so  rigidly  bent  that  force  cannot  extend  it,  and,  the 
temperature  is  distinctly  increased  on  the  concave  side — that  on  which 
the  muscles  are  contracted. 


Fig.  220. 
Parturient  Apoplexy  :  Cow. 


From  time  to  time  it  may  attempt  to  rise,  but  it  cannot,  as  a  rule, 
do  so  ;  the  knees  may  be  flexed,  but  the  hind  parts  of  the  body  seem 
to  be  fixed  to  the  ground.  If  assistance  is  afforded,  it  cannot  avail 
itself  of  it ;  or  if  it  chances  to  be  raised,  it  falls  again  as  soon  as  let 
alone.  It  appears  to  be  insensible  to  blows  or  pain  of  any  kind ;  and 
if  the  head  is  lifted  and  let  go,  it  drops  an  inert  mass,  or  is  again 
pressed  round  against  the  shoulder.  The  teeth  are  ground  at  intervals, 
and  the  stupor  or  coma  becomes  more  marked.  The  animal  pays  no 
heed  to  surrounding  objects ;  the  eyes  are  half  closed,  and  they  either 
move  convulsively  in  their  orbits,  or  are  fixed,  dull,  and  lustreless ;  the 
hair  is  erect  and  dry,  and  flies  settle  on  the  surface  of  the  body. 

The  pulse  does  not  vary  much  in  the  earlier  stage ;  it  is  generally 
more  frequent,  and  may  number  fifty,  sixty,  or  seventy  beats  per 
minute ;  or  it  may  be  fewer  than  in  health,  but  it  is  very  full  and  soft. 
When  coma  is  well  advanced,  however,  and  paralysis  appears  to  be 
complete,  it  becomes  small  and  quick,  numbering  100  to  120,  and  at 
last  is  irregular  and  almost  imperceptible. 


PARTURIENT  APOPLEXY'— PUERPERAL  COLLAPSE.  639 

The  respirations  may  be  increased  to  eighty  or  ninety  per  minute, 
and  this  occurs  more  particularly  when  tliere  is  pneumonia,  duo  to  the 
passage  of  foreign  matters  into  the  bronchi — an  accident  frequently 
noted  in  this  disease.  When  the  coma  and  paralysis  are  very  marked, 
the  respirations  are  often  slow  and  deep — from  eight  to  live  in  the 
minute,  sighing  or  stertorous — indicating  paralysis  of  the  soft  palate  ; 
at  other  times  it  is  calm  and  regular.  All  these  variations  may  be  ob- 
served in  the  same  animal — the  hurried,  stertorous  breathing  succeeding 
the  quiet  and  deep  respirations  in  a  very  abrupt  manner.  As  the  pulse 
increases  in  frequency  the  breathing  sometimes  becomes  slower. 

The  temperature  of  the  body  is  not  increased,  as  a  rule ;  on  the 
contrary,  it  is  very  often  below  the  normal  standard  when  coma  sets 
in — Harms  and  Adams  have  found  it  as  low  as  35'  Cent.  (95'  Fahr,). 
According  to  Thomassen,^  it  may  be  102-2^  to  103°  Fahr.  at  the  com- 
mencement, and  in  a  few  hours  fall  to  100',  or  even  9G\  to  rise  again 
when  there  is  improvement.  Cases  have  been  reported  in  which  it 
was  as  low  as  89"6'  and  90',  and  in  the  latter  it  ascended  in  three 
hours  to  100',  the  animal  recovering.  It  is  possible  that,  in  the  cases 
in  which  these  very  low  temperatures  were  noted,  the  anal  sphincter 
has  been  relaxed,  so  that  the  air  passing  into  the  rectum  would  make 
it  cooler.  The  extremities  are  generally  icy  cold,  and  the  surface  heat 
of  the  trunk  is  irregularly  distributed. 

The  nmcous  membrane  of  the  mouth  is  pale,  and  saliva  accumulates 
about  or  flows  continually  from  it  (hence  the  disease  is  soinetimes 
designated  Ahtropfeln  aus  dcm  Manic  by  the  Germans).  Food  and 
water  are  refused,  and,  indeed,  at  an  early  period  there  appears  to  be 
paralysis  of  the  pharynx  and  oosojihagus,  and  if  care  is  not  taken  the 
solids  or  fluids  attempted  to  be  administered  may  And  tlicir  way  into 
the  air-passages,  and  if  they  do  not  quickly  produce  asphyxia,  they 
will  probably  give  rise  to  pneumonia.  When  fluids  are  administered, 
they  pass  down  the  oesophagus  with  a  gurgling  sound.  The  functions 
of  the  rumen  and  digestive  system  are  more  or  less  suspended,  and 
the  peristaltic  movement  of  the  intestines  decreased.  Hence  we  have 
tympany,  eructations,  and  constipation.  The  eructations  may  carry 
fluid  and  food  from  the  rumen  into  the  pharynx,  and  even  into  the 
nostrils,  and  they  may  pass  thence  into  the  trachea.  So  that  we 
may  have  pneumonia  from  this  cause  alone,  and  without  attempts 
having  been  made  to  administer  food  or  medicine.  Constipation  is 
also  a  marked  feature  of  this  paralysed  condition,  and  if  tympany 
appears  at  an  early  period,  it  is  considered  an  unfavourable  sign  by 
some  practitioners. 

All  these  changes  in  the  functions  of  the  digestive  apparatus,  together 
with  those  of  the  respiratory  and  circulatory  organs,  show  that  the 
pneumogastric  nerves  are  seriously  involved. 

Micturition  is  also,  as  a  rule,  suspended  from  the  commencement ; 
consequently,  urine  accumulates  in  the  bladder,  and  it  usually  contains 
sugar  and  a  certain  quantity  of  albumin. 

The  secretion  of  milk  may  be  diminished  or  suspended,  and  some- 
times very  suddenly,  even  before  the  voluntary  muscles  are  paralysed ; 
in  other  instances  it  may  be  unintemipted. 

W' hen  the  animal  is  about  to  recover,  these  symptoms  may  persist 
for  some  hours,  or  even  for  two,  three,  or  four  days.     Then  it  appears 
to  rouse  up  suddenly  from  the  stupor  into  which  it  was  plunged ;  the 
^  Reaitil  dt  Midtcine  Veteritiaire,  1889,  p.  491. 


640  PATHOLOGY  OF  PARTURITION. 

tongue  is  moved  about ;  the  head  is  raised ;  attempts  are  made  to  get 
up ;  it  elevates  the  fore-part  of  the  body,  and  after  some  struggles 
finally  gets  on  its  hind-legs  and  stands.  The  first  favourable  indications 
are  elevation  of  temperature  and  resumption  of  the  intestinal  peristalsis. 
The  latter  is  assured  vs^hen  the  rectum  is  found  to  be  filled  with  ftBces, 
after  it  has  been  emptied. 

The  animal's  physiognomy  changes,  and  becomes  natural — though 
it  may  still  look  half  stupefied;  it  drinks  and  seeks  food,  and  is  not 
long  in  commencing  to  ruminate  ;  its  calf  is  caressed  ;  urine  and  fseces 
are  passed ;  and  recovery  sets  in  so  promptly,  and  goes  on  so  quickly, 
that  in  many  cases  it  is  scarcely  possible  to  believe  that  the  animal, 
v^hich  twenty-four  hours  previously  appeared  to  be  dying,  is  now  not 
only  recovering,  but  apparently  completely  recovered  without  being 
convalescent. 

When  death  is  about  to  take  place,  the  more  serious  symptoms  are 
still  more  marked.  The  collapsus — the  coma — becomes  more  and 
more  complete.  The  nose  rests  on  the  ground  as  if  the  animal  could 
no  longer  support  the  head,  and  at  times  sways  from  side  to  side. 
The  decubitus,  instead  of  being  sternal,  becomes  lateral,  and  the 
body  is  stretched  out  at  full  length.  The  eye  is  glassy,  and  there 
is  no  movement  of  the  eyelids  when  the  cornea  is  touched ;  the  body 
and  mouth  are  colder  ;  the  tympanitis  increases ;  the  pulse  becomes 
small,  irregular,  intermittent,  and  very  quick,  until  at  last  it  is 
imperceptible ;  the  breathing  is  puffing,  slower,  and  more  stertorous, 
and  the  animal  dies  without  a  struggle,  or  in  the  midst  of  slight  com- 
vulsions. 

In  some  cases  there  are  epileptiform  movements,  or  there  may  be 
symptoms  of  delirium  :  the  animal  throws  its  head  about  violently 
from  side  to  side,  or  bends  it  rigidly  backwards,  struggles,  bellows, 
groans,  extends  the  limbs  convulsively  as  if  undergoing  an  electric 
shock,  and  appears  to  be  unconscious  ;  the  breathing  is  deep  and 
spasmodic,  and  apoplexy — parturient  apoplexy — seems  to  be  the  cause 
of  death. 

Dtiration,  Terminations,  and  Complications. 

The  duration  of  the  disease  is  very  brief.  There  are  instances  on 
record  in  which  it  has  been  less  than  twenty-four  hours ;  but  two  or 
three  days  is  the  ordinary  term  ;  it  has  rarely  extended  to  five  or  six 
days. 

If  there  are  no  complications,  the  terminations  are  death  or  recovery. 
The  chief  complications  are  broncho -pneumonia,  milk -metastasis, 
amaurosis,  temporary  or  permanent  paralysis  (sometimes  in  the  form 
of  monoplegias),  gangrene  of  certain  parts,  and  swellings  in  the  region 
of  the  thigh  and  hocks. 

Pneumonia  is  due  to  the  passage  of  foreign  matters — either  food  or 
medicine — into  the  air-passages  during  the  period  when  the  animal 
cannot  swallow,  or  when  it  is  comatose,  and  meteorismus  and  eructa- 
tions are  present.  This  is  often  a  cause  of  death  when  the  Cow  has 
recovered  from  the  pai^turient  malady.  Indeed,  the  animal  may  perish 
from  suffocation  alone  when  the  quantity  of  matter  that  passes  through 
the  larynx  is  considerable.  And  not  infrequently,  when  the  creature 
has  lingered  for  a  few  days  and  is  then  killed,  the  existence  of  pneu- 
monia from  this  cause  will  be  discovered  on  making  an  examination 


PARTURIENT  APOPLEXY— PUERPERAL  COLLAPSE.  G41 

of  the  boily.  Ailani^  believes  that  ten  per  cent,  of  the  Cows  which 
recover  from  parturient  collapse  eventually  die  of  pneumonia,  due  to 
extraneous  matters  introduced  during  the  paralysed  condition  of  the 
pharynx.  Sometimes  the  animal  appears  to  be  almost  recovered  from 
the  attack  of  parturient  apoplexy,  when  symptoms  of  lung  congestion 
or  intiammatiou  are  suddenly  developed,  and  death  soon  occurs. 
Paralysis  of  the  a>sophagus,  which  may  persist  for  some  days  after 
recovery,  has  in  some  cases  been  the  cause  of  death  from  choking. 

Another  complication  of  parturient  apoplexy,  is  the  so-called  milk- 
metastasis  which  does  not  appear  to  have  been  noted  in  this  country, 
but  which  is  alluded  to  by  Violet  in  France,  Bentele,  Born,  and  Franck 
in  Germany,  and  AUemani  in  Italy.  Occasionally  there  is  observed 
after  an  attack  of  the  disease,  a  white,  milky-looking  emulsion  similar 
to  chyle,  expelled  as  urine,  or  as  a  discharge  from  the  nostrils  ;  and  at 
one  time  it  was  imagined  that  this  was  the  milk  which,  instead  of 
being  got  rid  of  by  the  mammie,  was  absorbed  or  retained  in  the  blood, 
acted  upon  the  nervous  centres,  and  was  then  expelled  in  this  vicarious 
manner. 

Though  no  analyses  appear  to  have  been  made  of  this  fluid,  Franck 
is  of  opinion  that  the  fluid  is  only  the  normal  secretions  mixed  with 
lymph.  The  milk-metastasis  theory  is  untenable,  as  it  is  quite  opposed 
to  what  we  know  of  the  lacteal  secretion,  especially  during  this  disease.'-' 

With  regard  to  parah/sis,  this  is  not  evident  until  the  animal  recovers 
consciousness,  and  begins  to  look  bright  and  anxious  for  food,  when  it 
is  found  that  it  cannot  be  made  to  rise.  The  paralysis  may  affect 
various  parts,  but  it  is  usually  limited  to  one  limb,  to  the  two  hind- 
limbs  (parapkiiia),  or  to  one  side  of  the  body  {hemiplegia).  Saake  says 
he  has  sometimes  seen  instances  in  which  the  fore-limbs  were  paralysed, 
while  the  posterior  ones  could  be  moved  freely.  In  certain  cases  the 
paralysis  of  limbs  is  accompanied  by  muscular  atrophy. 

Amaurosis  is  readily  discovered  from  the  animal  being  blind.  It  is 
generally  persistent.  Breulet,  Gabler,  Dommelen  and  Festal  have 
recorded  instances. 

Gangrene  of  certain  parts — feet  and  teats — is  often  met  with  in  some 
parts  of  Holland.  The  Cow  will  have  recovered  from  an  attack  of 
parturient  collapse  from  ten  to  fifteen  days,  when  a  fcetid  fluid  is  found 
exuding  from  between  the  claws  and  around  the  coronets  of  the  hind- 
feet  ;  soon  a  line  of  demarcation  forms  about  the  middle  of  the  shanks, 
and  this  is  quickly  followed  by  complete  sphacelus  of  the  extremities. 

*    Worhen-^rhrijl  fiir  T/iier/ieilhinilf,  1S70-71. 

-  I5entele  (  Wochenarhrift  fur  ThierUtilkundc,  IS.')?,  p.  145)  states  that  a  Cow  attacked 
by  calvingfever,  lay  for  sixty  hours  in  a  state  of  lethargy.  The  urine,  which  was  passed 
six  hours  afterwards,  waa  milk  (?)  with  clots — as  if  boiled — in  it.  The  animal  recovered 
from  the  attack,  but  some  weeks  later  it  had  to  be  killed  in  con8c<{Uence  of  diseased  lungs 
— proK-ibly  pm-nmonia  from  extraneous  m.itters. 

Born  (Anacker's  I hifrnrzt,  1871,  ]).  270)  relates  a  case  in  which  milk  flowed  from  the 
nostrils  of  %  Cow  that  was  affected  with  calving-fever. 

Allemani  (//  Moliro  Vftf.rinar'ta,  1870,  p.  289)  tells  us  of  a  Cow-proprietor  who 
believed  one  of  his  CoW'*  pa-nsed  milk  instead  of  urine.  The  supposed  milk — which  w.is 
of  a  yellowish- white  clour — contained  epithelium  from  the  bladder,  a  large  (piantity  of 
epithelium  from  the  kidney,  lymph-corpuscles,  and  albumin.  After  some  days  this 
condition  disappeared.     The  fluid  did  not  coagulate  spontaneously. 

Violet  (Saint-Cyr"s  TraiU  d'Obsttfnque  Vileriiiaire,  p.  1072)  found  a  similar  condition 
of  the  urine.  This  came  away  through  the  catheter  with  much  force,  and  it  was  so 
white  that  the  attendants  thought  it  was  milk.  It  was  also  foamy  and  effervescent,  like 
champagne  or  bottled  beer.  The  animal  recovered,  but  the  urine  was  slightly  effervtscent 
for  some  days. 

41 


642  PATHOLOGY  OF  PARTURITION. 

The  animals  are  slaughtered.     From  time  to  time  in  the  same  country, 
dry  gangrene  of  the  teats  is  reported  as  a  sequel  of  collapse. 

Stoellings  in  the  region  of  the  thigh  and  hock,  and  laceration  of  certain 
muscles — chiefly  of  the  hind-limbs — have  been  observed  in  many  cases. 
Sometimes  both  limbs,  and  at  other  times  only  one  limb  is  involved,  the 
injury  being  generally  so  serious  that  the  animals  have  to  be  killed.  In 
all  probability  the  damage  is  due  to  the  struggling  and  slipping  that  takes 
place  before  the  animal  becomes  unconscious  and  immovable  ;  and  the 
damage  is  not  discovered  until  consciousness  returns  and  it  is  observed 
that  it  cannot  get  up. 

Prognosis. 

The  prognosis  of  parturient  apoplexy  is  generally  unfavourable,  as  a 
fatal  termination  occurs  in  a  very  large  proportion  of  cases.  Of  721 
cases  treated  by  various  methods,  Franck  states  that  294  either  died  or 
were  slaughtered — 40-8  per  cent.  Of  course,  no  definite  conclusion  can 
be  drawn  from  these  figures ;  as  it  is  possible  that  some,  if  not  many, 
of  the  cases  may  have  been  parturient  fever,  while  of  those  killed  prob- 
ably a  few  recoveries  might  have  been  noted  if  treated.  Saint-Cyr,  in 
466  cases  gives  45  per  cent,  deaths  ;  Stockfleth  gives  50  per  cent. ;  and 
Violet  25  per  cent.  Some  practitioners  have  a  large  percentage  of 
recoveries,  while  others  are  unfortunate  in  obtaining  only  a  small 
number. 

Often  cases  which  appear  very  trifling  at  first,  have  a  rapidly  fatal 
termination  ;  while  others  which  commenced  with  alarming  symptoms, 
quickly  recover.  Therefore  it  is,  that  perhaps  in  no  other  disease  of 
animals  is  a  reliable  prognosis  more  difficult  to  be  arrived  at,  not  only  in 
the  earlier  stages,  but  during  the  whole  of  its  course.  "  There  is  no 
absolute  critermm,"  says  Lanzillotti-Buonsanti,  "  by  which  we  can 
positively  say  whether  we  can  cure  the  case,  or  whether  death  will 
ensue  ;  and  it  often  happens  that  the  result  contradicts  the  prognosis." 
And  Allemani  states  that  he  has  seen  cases  which  looked  so  favourable 
as  to  lead  him  to  believe  they  would  recover,  suddenly  become  aggra- 
vated without  any  apparent  cause,  and  succumb  ;  while  others  which 
exhibited  the  gravest  symptoms  in  all  their  intensity,  and  gave  no  hope 
of  recovery,  have  been  restored  to  health. 

This  is  probably  the  experience  of  everyone  who  has  had  to  contend 
with  the  disease  ;  it  is  in  consequence  of  this  uncertainty,  and  the 
fatality  attending  the  malady,  that  the  butcher  is  so  frequently  called 
in,  and  the  animal  is  killed  and  its  flesh  sold  as  food.  As  to  the  pro- 
priety of  utilising  the  flesh  in  this  manner,  there  have  been  difierent 
opinions  ;  but  provided  the  animal  has  not  been  drugged  to  any  con- 
siderable extent  before  death,  and  it  is  killed  early,  there  is  no  evidence 
that  the  flesh  possesses  pernicious  properties  when  utilised  as  food. 
But  with  regard  to  using  the  flesh  of  animals  which  have  been  affected 
with  parturient  feve?- — a  disease  with  which  parturient  apoplexy  is  so 
often,  and  has  been  for  so  long,  confounded — that  is  quite  another 
matter,  as  in  this  we  have  a  blood  poison — sepsin. 

Though  the  prognosis  is  generally  so  uncertain,  yet  there  are  several 
manifestations  which  may  assist  us — at  any  rate  to  some  extent — in 
forming  an  opinion  as  to  the  probability  of  recovery  or  death.  Thus, 
the  earlier  the  attack  occurs  after  parturition,  the  more  serious  the  case 
may  be  considered ;  while  the  longer  its  invasion  takes  place  after  that 
act,  so  is  it  less  likely  to  be  fatal.     When  it  appears  within  twenty-four 


PAUTriUKXT  APnl'LEXY—rrEIU'EnAL  COLLAl'SE.  013 

hours  after  calving,  then  it  nearly  always  terminates  in  death.  It  is  the 
same  when  the  attack  is  very  sudden  and  severe  ;  when  there  is  marked 
coma,  rapid  and  general  loss  of  heat,  great  distension  of  the  rumen 
(which  may  speedily  cause  asphyxia),  violent  convulsions,  deep  mucous 
niU\s  in  the  trachea  and  bronchi,  lustreless  eyes — insensible  to  light  or 
touch  ;  paralysis  of  the  digestive  organs — indicated  by  meteorismus, 
torpidity  of  the  bowels,  so  that  the  rectum  remains  empty  when  it  has 
been  evacuated  ;  as  well  as  paralysis  of  the  pharynx  and  cisophagus — 
shown  by  inability  to  swallow;  suspended  lacteal  secretion,  relaxed 
sphincters,  putling  breathing  by  the  mouth,  pendulous  lower  jaw,  and 
total  suppression  of  milk. 

The  favourable  indications  are  maintenance  of  the  normal  tempera- 
ture in  body  and  limbs,  or  the  slightest  elevation  when  this  is  low ;  natural 
tint  of  the  mucous  membranes;  expulsion  of  the  urine  either  spontane- 
ously or  when  the  linger  is  introduced  into  the  urethra ;  and,  according 
to  Schaack,  "  a  mode  of  respiration  in  which  the  animal  retains  its 
breath  for  an  instant,  then  allows  the  air  to  escape  by  a  long  and  slightly 
plaintive  expiration." 

It  is  likewise  a  very  favourable  sign  when  the  faeces  are  passed.  A 
return  to  consciousness  is  also,  of  course,  a  happy  omen,  and  particularly 
if  the  animal  attempts  to  rise,  desires  food  or  drink,  and  the  lacteal 
secretion  begins  to  reappear. 

In  some  cases,  however,  there  appears  to  be  slight  recovery,  and  yet 
fatal  relapse  takes  place.  The  pulse  will  also  aid  in  forming  an  opinion 
as  to  the  probable  termination  of  the  malady. 

The  longer  the  disease  continues,  so  the  more  hope  there  is  of  re- 
covery ;  though  there  is  all  the  more  danger  of  pneumonia  from  extrane- 
ous matters  in  the  bronchi,  if  the  coma  or  the  paralysis  of  the  muscles 
of  deglutition  lasts  for  some  days.  Weigand  says  that  when  an  animal 
continues  lying  for  six  to  eight  days,  unless  it  can  eat  and  drink,  it 
should  be  killed. 

Causes. 

The  unanimous  opinion  with  regard  to  this  disease  is  that  it  is  peculiar 
to  the  puerperal  condition,  and  that  it  has  a  close  relation  to  the  state 
of  the  Cow  previous  to  parturition,  and  to  a  more  or  less  marked  breed  or 
individual  predisposition.  So  far  as  breed  is  concerned,  it  is  a  fact  that 
the  Cows  most  liable  to  be  attacked  are  those  in  which  the  secretion  of 
milk  is  abundant — "deep  milkers" — and  which  are  in  a  more  or  lees 
plethoric  condition.  \Vith  the  perfecting  of  Cows  for  the  production  of 
milk,  this  disease  has  become  vastly  more  prevalent.  Numerous 
observers  testify  to  this  fact.  "  Since  in  Algau,"  writes  Bentele,  "  the 
Cow  has  been  so  largely  utilised  for  the  production  of  cheese — converted 
into  a  milk  machine,  in  fact — the  previously  unknown  calving-fever  has 
appeared." 

So  it  is,  that  in  countries  or  districts  where  Bovines  arc  reared  more 
for  their  Hesh  than  their  milk,  parturient  apoplexy  is  not  a  very  common 
malady,  and  the  losses  from  it  are  comparatively  small.  It  is,  therefore, 
a  disease  almost  peculiar  to  the  best  breeds  of  milch  Cows,  and  the 
malady  has  extended  with  the  extension  of  these  breeds.  For  instance, 
in  North  Ilolland  it  appears  to  have  been  completely  unknown  forty  years 
ago ;  but  when  attempts  were  made  to  improve  the  milking  qualities  of 
the  Cows  by  importing  numbers  from  South  Holland — where  they  are 
"  deep  milkers,"  and  where  the  disease  is  very  frequent — then  it  showed 


6ii  PATHOLOGY  OF  PAETURITION. 

itself,  much  to  the  surprise  of  the  veterinary  surgeons  and  cattle-owners, 
who  were  previously  unacquainted  with  it.  And  it  is  supposed  that  the 
greatly-increased  prevalence  of  puerperal  apoplexy  in  other  countries — 
as  Italy,  Spain,  France,  and  the  United  States  of  America — is  due  to  the 
introduction  of  these  South  Holland  Cows. 

In  our  own  country  there  are  districts  in  which  it  is  rarely  seen, 
while  in  others  it  is  quite  frequent. 

With  regard  to  individual  predisi^osition,  there  can  be  no  doubt  that 
even  in  these  predisposed  breeds  there  are  animals  which  suffer  from 
parturient  apoplexy  more  than  others ;  and  instances  are  reported  of 
Cows  being  attacked  after  several  consecutive  births. 

Plethora,  no  doubt,  exercises  a  great  influ-ence  in  the  production  of 
the  disease  ;  for  it  is  chiefly  among  well-fed  Cows — particularly  those 
kept  for  milk  in  the  vicinity  of  large  towns,  which  seldom  or  never  leave 
their  stable,  and  are  abundantly  nourished  immediately  before  calving 
— that  parturient  apoplexy  prevails  most  seriously  and  extensively. 
Even  among  Cows  at  pasture,  when  the  herbage  is  luxuriant,  the 
disease  is  far  from  infrequent,  and  the  fatal  cases  are  numerous.  It  is 
true  that  it  may  attack  milch  Cows  in  moderate,  or  even  in  compara- 
tively poor  condition  ;  but  then  it  will  be  found  that  their  hygienic 
management  is  at  fault.  They  may  be  Cows  which,  having  been  scantily 
fed  during  a  long  winter,  are  abundantly  supplied  with  food  in  the 
spring ;  or  they  are  Cows  which,  purchased  in  low  condition,  receive  a 
large  supply  of  food  from  their  new  owner.  Kohne^  states  that  he  had 
occasion  to  observe  eighty  cases  of  this  disease  at  Kemper  (Ehenish 
Prussia),  and  that  the  majority  were  Cows  which,  bought  lean  in 
Holland,  some  time  before  parturition,  had  passed  without  any  gradual 
transition  from  the  Dutch  pastures  to  the  stables  of  the  Ehenish  feeders, 
where  they  received  a  large  amount  of  food.  Kniebusch-  and  others 
have  made  similar  observations.  It  has  also  been  remarked  that  a 
uniform,  and  even  abundant  diet,  is  less  dangerous  than  an  abrupt 
change  from  scarcity  to  generous  allowance. 

When  pregnant  Cows  which  have  been  for  some  time  at  pasture, 
are  taken  into  the  stable  a  few  days  before  calving,  they  are  often  seized 
when  age  and  other  circumstances  predispose  them  to  the  disease. 

The  risk  is  all  the  greater  if  the  secretion  of  milk  has  been  suspended 
for  some  time  before  calving,  the  Cows  meanwhile  receiving  the  same 
amount  of  food. 

Permanent  confinement  in  the  stable  also  acts  in  a  similar  manner  to 
abundant  and  stimulating  food,  by  inducing  plethora  and  laxity  of  fibre. 
Thus  it  is,  that  while  the  disease  is  prevalent  in  the  cowsheds  of  towns, 
or  in  those  from  which  the  cattle  are  seldom  driven  out  to  graze  or  for 
exercise,  it  is  almost,  if  not  quite  unknown  in  hilly  pastures. 

Age,  or  rather  the  developvient  of  lactation,  has  also  a  powerful 
influence.  When  the  secretory  function  has  reached  a  certain  point, 
the  Cow  appears  to  become  much  more  predisposed  to  an  attack.  Thus, 
it  is  asserted  that  parturient  apoplexy  has  scarcely  ever  been  observed 
in  a  primipara,  and  very  rarely  indeed  before  the  third  Calf,  when  the 
lactiferous  system  has  almost  attained  its  maximum  development  in  the 
more  precocious  breeds.  In  29  cases  reported  by  Haycock,^  3  occurred 
after  the  third  Calf,  5  after  the  fourth,  16  after  the  fifth,  2  after  the 

1  Maqazin  fiir  Tlderhtillcunde  und  Viehzucht,  1855. 

-  Ibid. 

^   Veterinarian,  1851. 


PARTURIENT  APOPLEXY— PUERrERAL  COLLAPSE.  G45 

sixth,  3  after  the  eighth.  After  the  third  Calf,  or  even  previous  to  its 
birth,  dairy-keepers  are  averse  to  purchasing  the  bettor-bred  milch  Cows, 

Temperature  is  supposed  to  influence  the  production  of  the  disease, 
and  especially  exposure  to  cold.  The  suppression  of  the  cutaneous 
functions,  and  the  determination  of  the  blood  from  the  surface  of  the 
body  to  the  internal  organs,  nmst  favour  congestion  of  these  organs. 
Therefore  it  is  that  currents  of  cold  air,  lying  on  cold  ground,  and  cold 
fluids  ingested  innnediately  after  parturition,  have  been  looked  upon  as 
powerful  occasional  causes.  Sanson  thinks  that  the  sudden  expulsion 
of  the  blood  so  abundantly  contained  in  the  uterine  mucous  membrane 
and  cotyledons — and  which  should  bo  only  slowly  diffused — forces  that 
fluid  into  the  neighbouring  vessels,  and  surcharges  them  beyond  measure; 
while  Ayrault  is  of  opinion  that  the  cold  air,  entering  the  uterine  cavity 
by  its  partially  dilated  os,  drives  the  blood  from  the  mucous  membrane 
into  the  other  viscera,  suddenly  checks  the  lochial  secretion,  and  thus 
gives  rise  to  the  disease.  This  lochial  secretion  plays  an  important 
part  in  the  genesis  of  the  malady,  according  to  several  authorities. 

Other  writers  suppose  that  the  disease  is  more  common  during  warm 
than  cold  seasons.  In  fact,  it  prevails  in  the  most  diverse  temperatures, 
and  it  is  as  serious  in  cold  as  in  warm  w^eather.  Sometimes  the  number 
of  cases  is  very  great,  without  any  reference  to  heat  or  cold;  then  almost 
suddenly  they  subside,  and  no  more  outbreaks  occur  for  some  time. 
This  has  led  to  the  supposition,  again,  that  it  depends  for  its  develop- 
ment on  a  peculiar  condition  or  epizootic  constitution  of  the  atmosphere, 
but  in  what  this  consists  no  one  has  attempted  to  explain.  K()hne  says: 
"  It  is  certain  that  when  one  of  these  periods  of  vitulary  fever  prevails, 
a  change  of  atmosphere  has  occurred  or  is  about  to  take  place,  though 
the  converse  is  not  true — for  when  an  atmospheric  change  takes  place 
we  cannot  predict  an  invasion  of  this  fever.  But  if  it  happens  that 
several  cases  of  the  malady  follow  each  other  immediately  during  a 
certain  atmospheric  constitution,  we  may  assuredly  predict  a  change  in 
the  weather.  This  change  most  frequently  consists  in  a  transition  from 
settled  to  rainy  weather,  bringing  about  a  diminution  in  the  barometric 
pressure." 

Some  veterinarians  have  ascribed  the  disease  mainly  to  infection — 
assimilating  the  puerperal  fever  of  woman  to  the  parturient  processes  in 
the  Cow,  but  of  this  there  is  little  evidence  indeed ;  wliile  others,  as 
already  mentioned,  imagine  that  it  is  merely  a  nervous  form  of  parturient 
fever,  and  due  to  blood-poisoning. 

Giinther,  very  many  years  ago,  and  a  few  others  more  recently,  fancied 
it  was  produced  by  a  moral  infiiiencc — the  removal  of  the  Calf  soon  after 
birth,  which  distressed  the  Cow.  But  it  was  forgotten  that  tlie  malady 
sometimes  occurs  when  the  Calf  is  with  the  Cow,  and  sucking  ;  and 
that  other  creatures  in  which  the  moral  faculties  are  more  highly 
developed,  and  which  exhibit  great  anxiety  and  distress  on  being 
deprived  of  their  progeny,  do  not  suffer  from  parturient  apoplexy. 
Besides,  the  disease  is  no  more  prevalent  in  those  countries  or  districts 
where  the  Calves  are  taken  away  from  the  Cows  at  an  early  period, 
than  where  they  arc  allowed  to  remain  with  them. 

Others  also  have  attributed  the  occurrence  of  the  disorder  to  mental 
excitement  during  the  act  of  parturition  ;  but  surely  this  excitement 
must  be  greater  with  the  first  Calf  or  with  the  second — when  the 
disease  seldom  appears — than  with  the  third,  fourth,  or  fifth  Calf,  when 
it  is  so  frequent.    Not  only  this,  but  it  is  a  notorious  fact  that  parturient 


■646  PATHOLOGY  OF  PARTURITIOX. 

apoplexy,  in.  almost  every  case,  follows  an  easy  and  rapid  expulsion  of 
the  foetus  without  assistance,  and  ejection  of  the  foetal  membranes  at  the 
ordinary  time.  Indeed,  parturition  is  generally  wonderfully  easy  and 
the  opposite  of  abnormal.  So  much  is  this  the  case,  that  Kohne  boldly 
asserts  that  a  difficult  or  protracted  delivery  is  never  followed  by  this 
disease ;  and  another  authority  (Banderschieren)  is  no  less  positive  in 
declaring  that  if  a  Cow  has  a  difficult  calving,  or  if  the  placenta  is  re- 
tained, there  is  little  reason  to  apprehend  an  attack  of  the  disease.  But 
this  statement  is  not  absolutely  correct. 

The  more  rapidly  the  uterus  contracts  and  resumes  its  normal  size, 
so  the  more  danger  there  is  of  parturient  apoplexy  ;  while  the  longer  it 
remains  relaxed  or  the  membranes  are  retained  in  it,  so  the  chances 
are  diminished.  In  the  examination  of  the  bodies  of  Cows  which  have 
died,  the  uterus  is  generally  found  very  firmly  contracted.  Before  the 
expulsion  of  the  foetal  membranes,  the  disease  is  exceptionally  rare.  In 
a  very  few  cases,  the  attack  has  commenced  during  parturition,  and  in 
still  fewer  before  birth,  when  the  lacteal  secretion  had  not  appeared. 

Constipation  and  gastric  repletion  have  been  held  by  one  or  two 
writers  to  be  causes,  and  others  attribute  it  to  over-repletion  immediately 
before  parturition. 

These  are  the  chief  causes  which  have  been  given  as  operating  in 
the  production  of  this  grave  affectiota ;  and  it  will  be  seen  that  they 
are  sufficiently  numerous  and  diversified  to  prove  that  the  nature  of 
the  disease  is  obscure — so  far  at  least  as  its  etiology  is  concerned. 
The  chief  points  to  be  remembered  may  be  stated  as  follows  :  parturient 
apoplexy,  as  a  rule,  attacks  Cows  within  one  to  five  days  after  parturi- 
tion, and  especially  when  that  act  has  been  easy,  prompt,  and  natural ; 
the  animals  which  are  affected  are  those  of  the  higher  breeds,  good 
milkers,  in  a  state  of  plethora,  and  pluriparse ;  one  attack  predisposes 
to  another.  This  leads  to  a  consideration  of  the  iMthological  anatomy 
and  nature  of  the  malady. 

Pathological  Anatomy. 

Notwithstanding  the  numerous,  characteristic,  and  striking  symp- 
toms which  mark  this  disease,  the  post  mortem  appearances,  no  matter 
whether  the  animal  has  been  killed  or  allowed  to  die,  are  for  the  most 
part  of  a  somewhat  varied  character.  In  the  majority  of  the  descrip- 
tions there  is  much  confusion,  the  lesions  of  parturient  fever  being 
mistaken  for  those  of  parturient  apoplexy,  and  vice  versa,  just  as  the 
two  diseases  are  confounded  with  each  other.  In  this  malady  the 
generative  organs  are  usually  little  changed ;  the  uterus  may  be  con- 
gested— which  it  always  is  immediately  after  parturition,  or  it  may 
even  be  paler  than  usual ;  but  it  is  generally  firmly  contracted. 

The  digestive  organs  are  also  usually  normal,  or  their  bloodvessels 
are  much  distended — perhaps  due  to  paralysis  of  the  vaso-motor  system 
of  nerves.  The  rumen  is  distended  with  gas  in  many  cases,  and  the 
third  compartment  of  the  stomach  is  often  filled  with  hard  dry  food 
between  its  leaves,  while  the  intestines  contain  somewhat  hardened 
faeces.  The  gall-bladder  is  sometimes  much  distended.  The  lungs 
are  normal,  perhaps  slightly  emphysematous  ;  at  other  times  they  are 
congested,  or  in  different  stages  of  pneumonia  if  foreign  matters  have 
obtained  access  to  the  air-passages.  The  examination  of  the  brain 
has  not  yielded  very  satisfactory  or  constant  results.  Some  authorities 
have  not  discovered  any  pathological  lesions  worthy  of  note,  either  in 


PARTURIENT  APOPLEXY— PUERPERAL  COLLAPSE.  647 

the  brain  or  spinal  cord,  or  their  envelopes ;  while  others  have  found 
well-marked  and  important  lesions.  These  varied  from  venous  con- 
gestion to  oedema,  ana)mia,  and  exudation.  Violet,  in  addition  to 
finding'  a  (juantity  of  foul-smellin;^'  reddish  lluid  in  the  uterus  (which 
was  not  intlamed),  observed  congestion  of  the  pia  mater  with  very  dark 
blood  ;  there  was  also  congestion  of  the  vessels  in  the  brain  tissue,  and 
a  long  clot  in  the  great  vena  Galcni.  In  other  instances  a  similar  con- 
dition was  observed ;  but  in  all  the  spinal  cord  appeared  to  bo  healthy. 
Bragard  and  others  have  constantly  found  injection  of  the  brain  and 
its  meninges.  Saake  and  Festal  have  also  witnessed  congestion  of  the 
vessels  of  the  encephalon,  sub-arachnoideal  effusion,  extravasation,  and 
blood-clots  on  the  surface  of  the  cerebrum  and  cerebellum.  Others 
have  seen  serous  effusion  in  the  lateral  ventricles  and  traces  of  spinal 
meningitis  ;  while  Binx  has  observed  sanguineous  extravasation  and 
gelatinous  matter  at  the  origin  of  the  sympathetic  nerve,  and  Fabry 
blood-clots  at  the  base  of  the  brain,  with  serum  in  the  cavity  of  the 
arachnoid. 

In  one  instance  Schaack  met  with  a  clot,  three-fourths  of  a  line  in 
thickness,  covering  the  left  side  of  the  medulla  oljlongata,  and  serous 
effusion  into  the  lateral  ventricles ;  and  in  another  instance  an  in- 
flammatory exudate  on  the  right  side  of  the  cerebellum.  Harms  has 
found,  in  many  cases,  air  in  the  cerebral  bloodvessels ;  and  Noquet 
and  others  have  reported  alterations  in  the  spinal  cord,  which  was 
reddened,  congested,  more  rarely  covered  with  exudate — chiefly  in  its 
lumbar  portion,  and  sometimes  the  sciatic  plexus  of  uerves  has  been 
involved. 

Nahire. 

With  regard  to  the  nature  or  efTicient  cause  of  the  disease,  thei-e  has 
been  a  great  diversity  of  opinion,  and  even  now  the  most  eminent 
veterinary  authorities  are  not  at  all  agreed  as  to  its  pathology.  With 
some  it  is  a  fever — a  nervous  or  paralytic  form  of  parturient  fever — 
closely  allied  to  the  puerperal  fever  of  woman,  and  due  to  blood- 
poisoning,  the  two  forms  only  differing  in  degree.  But  it  should  be 
remarked  that  in  this  Bovine  malady  there  is  no  fever;  that  the 
temperature  is  generally  below  the  normal  standard  ;  and  that  recovery 
is  often  rapid,  if  not  sudden. 

Other  writers  have  imagined  it  is  a  grave  form  of  gastric  fever, 
because  there  is  constipation,  and  imi)action  of  the  digestive  organs 
with  hard  dry  food.  But  such  impaction  nuiy  occur  at  any  time,  and 
it  does  not  give  rise  to  the  symptoms  of  parturient  collapse,  neither 
does  it  cause  death  so  rapidly. 

The  more  prevalent  opinions  as  to  the  essence  of  the  disorder  may 
be  classed  under  live  heads :  1.  Ilyperaimia  of  the  nerve-centres  ; 
2.  Anirmia  of  the  nerve-centres  ;  3.  Derangement  or  paralysis  of  the 
nerv'e-centres  ;  4.  Alterations  in  the  constituents  of  the  blood ;  5.  The 
presence  of  something  abnormal  in  the  blood  that  leads  to  the  develop- 
ment of  the  symptoms  and  lesions  observed. 

1.  HVPER.EMIA  OF  THE  Nerve-Centres. — Sincc  1847,  when  Festal 
read  a  memoir  before  the  Central  Veterinary  Society  of  France  on 
this  disease,  the  opinion  has  been  held  by  a  large  number  of  veterinary 
authorities  that  it  is  due  to  plethora,  and  consequent  congestion  or 
apoplexy  of  the  nen-e-centres.     Festal  found  blood-clots  beneath  the 


648  PATHOLOGY  OF  PARTURITION. 

cerebral  arachnoid  membrane,  which  he  attributed  to  hyperaemia.  In 
1853,  Noquet  attributed  the  congestion  of  the  trisplanchnic  nerves  and 
cerebro-spinal  nervous  system  which  he  constantly  found,  to  plethora, 
engorgement  of  the  stomach,  and  intensity  of  the  milk-fever. 

For  Sanson,!  the  collapsus  of  parturition  is  the  consequence  of  a 
sudden  disturbance  in  the  physiological  condition  of  the  uterus  after 
parturition,  consisting  in  the  abrupt  removal  of  blood  which  congested 
the  organ  at  that  time ;  as  during  gestation  a  large  portion  of  that 
fluid  is  diverted  towards  the  pelvic  region,  where  the  uterus  is  lodged. 
After  parturition  the  mucous  membrane  and  cotyledons  of  the  organ 
have  lost  their  function,  and  the  enormous  quantity  of  blood  they  con- 
tained is  suddenly  thrown  into  the  circulation,  surcharges  the  neigh- 
bouring vessels  beyond  measure,  and  produces  collapse  ;  this  diversion 
of  the  blood  is  greatly  favoured  by  cutaneous  chills.  In  proof  of  this, 
at  the  autopsies  he  made,  Sanson  affirms  that  the  mucous  membrane 
and  cotyledons  were  always  found  bloodless,  and  of  a  pale-yellow 
colour. 

This  theory  has  much  analogy  to  that  of  Franck,  which  will  be 
alluded  to  presently.  In  1858,  Ayrault  believed  that  the  cerebro- 
spinal congestion  was  brought  about  by  the  direct  action  of  cold  on 
the  uterus,  from  which  the  blood  was  repelled.  Felizet,  in  1866, 
advanced  the  theory  that  this  congestion  was  the  moral  result  of 
removing  the  Calf  from  the  Cow  immediately  after  parturition.  Pro- 
fessor Violet  is  satisfied  that  an  easy  birth  suddenly  diminishes  the 
intra-abdominal  blood  -  pressure,  which  aifects  the  heart  so  much 
during  pregnancy,  and  to  which  it  and  other  organs  have  to  accom- 
modate themselves.  Birth  taking  place  rapidly,  the  heart  continues 
to  act  in  a  fashion  to  which  the  bloodvessels,  particularly  the  capillaries, 
are  not  accustomed,  so  that  they  gradually  become  distended,  and 
finally  congested ;  hence  ruptures  and  haemorrhages  may  occur,  and  a 
fatal  termination.  Others — among  them  Deneubourg — trace  the  com- 
mencement of  the  disease  to  milk-fever,  the  intensity  of  which, 
originated  by  a  rapid  and  easy  delivery,  is  in  proportion  to  the  develop- 
ment and  secretory  power  of  the  mammae.  The  resulting  disturbance 
is  spread  over  the  entire  economy,  and  favoured  by  the  repletion  of 
the  stomach  and  the  pre-existing  plethora — suddenly  increased  by  the 
mass  of  blood  which  goes  to  the  uterus  during  pregnancy — as  well  as 
by  the  state  of  the  nervous  system  in  general  which  the  pains  of  labour 
have  induced,  excites  grave  disturbance  in  the  important  functions  of 
digestion,  circulation  and  innervation.  Hence  arise  disorders  as  much 
more  sudden  and  serious  as  the  repletion  of  the  stomach  and  the 
plethora  are  great ;  the  blood  is  rich  and  plastic,  and  the  irritability 
of  the  nervous  system — especially  the  ganglionic — is  excited.  Con- 
sequently, there  is  a  general  functional  disturbance  resulting  from  the 
"congesting"  action  of  all  the  cerebro-spinal  and  trisplanchnic  or 
ganglionic  nerves. 

Some  have  considered  the  disease  to  be  essentially  an  encephalitis, 
myelitis,  meningo- cephalitis,  or  a  cerebral  or  medullary  apoplexy, 
according  to  the  character  or  seat  of  the  lesions  found  after  death. 
But  some  of  these  opinions  are  opposed  by  the  fact  that  many  of  the 
lesions  on  which  they  are  based  are  seldom  observed,  and  that  the 
recovery  of  affected  Cows  is  often  very  rapid. 

1  Journal  de  Veterinaii-es  du  Midi,  1854. 


PJin-nUEXT  AFOI'LEXy—Pi'EUPKlLiL  VOLLAl'.sE.  619 

Professor  Trasbot  asserts  that  the  disease  is  the  result  of  spinal  con- 
gestion, with  consecutive  paralysis. 

In  England  the  opinion  has  long  prevailed  that  puerperal  collapse 
is  the  consequence  of  cerebral  con^'estion,  generally  terminating  in 
hieniorrhage,  and  that  the  peculiar  distribution  of  the  cerebral  blood- 
vessels in  the  Cow  predispose  to  this  accident.  It  may  be  noted  that 
a  similar  arrangement  of  these  vessels  is  present  in  the  Pig,  and  that, 
according  to  some  German  veterinarians  a  disease  very  like  the  puerperal 
collapse  of  the  Cow  is  observed  in  Sows  after  parturition  in  North 
Germany ;  but  Thoraassen^  points  out  an  important  difference,  inas- 
much as  in  the  Sows  the  paralysis  is  not  complete,  there  is  intense 
fever,  and  the  animals  generally  recover. 

2.  Anj::mia  of  the  Nekve-Centres. — Many  years  ago,  Haubner 
came  to  the  conclusion  that  puerperal  collapse  was  due  to  cerebral 
anirmia  resulting  from  an  ex  vacuo  hyperucmia  of  the  abdominal  organs, 
as  Cows  of  a  certain  age  were  predisposed  to  this  congestion  from  want 
of  contractile  power  in  their  abdominal  parietes.  Werner  and  Prehr 
were  also  of  opinion  that  cerebral  aniomia  was  owing  to  abdominal 
congestion.  Billings-  supposed  that  an  exaggerated  sensibility  of  the 
uterine  nerves,  induced,  in  a  reflex  manner,  spasm  of  the  arterioles  of 
the  brain  and  kidneys,  and  so  caused  auicmia  of  these  organs.  Franck 
believed  the  condition  to  be  owing  to  secondary  anaemia  succeeding 
congestion  of  the  brain,  occurring  in  Cows  which  had  an  easy  and 
rapid  delivery.  The  sudden  contraction  of  the  uterus  and  its  diminished 
capacity  brought  about  by  the  post  ixirtum  pains,  causes  great  disturb- 
ance in  the  blood  circulation.  The  organ  receives  much  less  blood,  and 
this,  in  ordinary  cases,  is  compensated  for  by  the  increased  aOlux  to 
the  mamniic  and  the  skin  ;  but  a  chill  to  the  latter  may  upset  this 
physiological  compensation,  and  tlie  repelled  blood  is  diverted  else- 
where ;  if  this  be  to  the  brain,  then  there  is  cerebral  congestion  and 
consequent  oedema,  resulting  in  aniumia  by  compression  of  the  blood- 
vessels. There  is  a  predisposition  to  serous  effusions  in  animals  after 
parturition,  because  of  the  hydricmic  condition  of  their  blood,  and 
especially  when  there  is  passive  congestion  of  the  kidneys  and  albu- 
minuria towards  the  termination  of  pregnancy.  Tlio  great  frequency 
of  cerebral  hyperiemia  in  the  Cow,  was  regarded  by  Franck  as  a  con- 
sequence of  the  division  of  the  internal  carotid  into  a  number  of  small 
vessels  before  it  enters  the  cranial  cavity,  as  well  as  the  formation  of 
the  rctc  viirahilc  from  a  common  branch  that  gives  off  the  cerebral 
arteries. 

This  theory  is  adopted  by  Goring,  who  edits  the  second  edition  of 
Franck's  work  on  "  Veterinary  Obstetrics,"  and  is  accepted  by  many 
practitioners. 

Werner's''    theory'    is    somewhat    analogous    to    that    of    Franck. 
The   vascular   system    is   involved,    as    shown   by  the    diminution  of 
temperature  and  the  lacteal  secretion,  as  well  as  the  nervous  system — 
manifested  by  the  general  depression,  loss  of  sensation,  inactivity  of  the 
spinal  cord  in  the  dorsal  region,  suspended  digestion,  quickened"  action 
of  the  heart  and  slowing  of  the  respiration.     Too  rapid  evacuation  of 
the  contents  of  the  uterus  causes  descent  of  the  abdominal  viscera, 
^  Reriidl  dc  Mt'lecine  Veierinaire,  18S0,  p.  784. 
-  American  Journal  ot' Comparative  Medicine,  1584. 
^    Wochenschrijtfur  Thierheilkunde  und  I'iehzucht,  1868,  p.  363. 


650  PATHOLOGY  OF  PARTURITION. 

dilatation  of  the  posterior  aorta,  and  slowing  of  the  circulation.  The 
primary  cause  of  all  this  is  bad  management  of  the  Cows,  and  pressure 
of  the  foetus  on  the  stomach  and  intestines,  diaphragm,  vena  cava,  and 
posterior  aorta. 

3.  Derangement  or  Paralysis  op  the  Nerve-Centres.  —  Many- 
high  authorities — among  them  Kohne,  Binz,  Carsten-Harms,  Wan- 
novius,  Busch,  Bull,  Bychner,  Baumeister-Bueff,  Barlow,  and  others — 
have  maintained  that  the  disease  is  primarily  a  derangement  or 
paralysis  of  the  ganglionic  nervous  system,  which  affects,  or  is  extended 
to,  the  spinal  cord  and  brain  during  the  course  of  the  disease.  The 
following  explanation  is  offered  in  support  of  this  opinion.  A  too  easy 
birth  throws  out  of  play  a  certain  amount  of  the  nervous  force  destined 
to  the  accomplishment  of  this  act.  Hence,  there  is  a  disproportion 
between  the  polar  tension  of  the  force  conveyed  by  these  nerves  and 
the  muscular  irritability,  and  consequently  an  obstacle  to  the  conducti- 
bility  of  the  nerves  charged  with  the  distribution  of  this  superfluous 
portion  of  the  nerve  force.  Barlow  thought  that  this  disturbance  in 
the  function  of  the  sympathetic  nerves  produces  arrest  of  secretion  and 
general  congestion,  especially  of  the  brain  and  spinal  cord.  Contamine 
is  more  or  less  a  partisan  of  this  theory,  as  he  explains  the  origin  of  the 
disease  by  stating  that  a  reserve  of  nervous  influence  which  is  not 
expended  in  the  animals  that  calve  easily,  by  a  reflex  movement  acts  at 
first  upon  the  spinal  cord,  and  afterwards  on  the  brain. 

4.  Alterations  in  the  Constituents  of  the  BLooD.^The  opinion 
has  been  emitted  that  the  collapse  is  due  to  an  undue  preponderance 
of  water  in  the  blood  of  some  Cows,  during  the  later  stages  of  pregnancy, 
and  that  this  results  in  cerebral  oedema  after  parturition.  Another 
opinion  is  that  the  collapse  is  a  kind  of  leucocytha^mia,  from  the  increase 
of  white  corpuscles  in  the  blood  during  pregnancy,  and  after  par- 
turition. 

But  neither  of  these  opinions  can  be  reconciled  with  the  symptoms 
or  post  mortevi  features  of  the  malady. 

A  third  opinion  attributes  the  disease  to  an  excess  in  the  proportion 
of  red  corpuscles,  and  this  certainly  is  more  acceptable  than  those  just 
noticed. 

5.  The  Presence  of  something  Abnormal  in  the  Blood,  which 

LEADS  TO  THE  DEVELOPMENT  OF  THE  SyMPTOMS  AND  LeSIONS  OBSERVED. 

— It  has  long  been  a  popular  notion  in  several  countries  that  puerperal 
apoplexy  is  caused  by  the  absorption  of  the  milk  into  the  blood  circula- 
tion ;  hence  the  designation  of  "milk-fever"  given  to  the  disease  in 
England,  France,  Germany,  etc.  Lafosse's  theory  had  something  of 
this  notion  in  it.  According  to  him,  the  malady  is  due  to  the  circum- 
stance that  the  milky  fluid  secreted  by  the  cotyledons,  and  absorbed  by 
the  chorial  villi  for  the  nutrition  of  the  foetus,  being  no  longer  separated 
from  the  blood  after  parturition,  remains  in  the  circulation  and  accumu- 
lates there  until  the  mammary  glands  eliminate  it.  When  these  glands 
act  promptly,  the  fever  is  imperceptible  or  almost  nil ;  but  if  they  are 
slow  in  secreting,  then  arises  a  more  or  less  intense  morbid  disturbance, 
due  more  especially  to  the  presence  in  the  blood  of  a  product  foreign  to 
its  normal  composition.  Without  commenting  at  any  length  on  this 
theory,  it  may  be  sufficient  to  mention  that  in  some  cases  of  parturient 
apoplexy  the  function  of  the  mammary  glands  is  not  suspended;  though 


rAIiTUniEXT  ArorLKXV—PUEni'ERAL  COLL  APSE.  G51 

the  theory  would  seem  to  receive  some  support  from  the  fact,  that  when 
the  milk  is  abundantly  secreted  the  animal  usually  recovers  rapidly. 

Carsten- Harms  considered  it  an  airiemia,  air  havin<^  entered  the 
uterine  bloodvessels  by  aspiration,  after  shedding  of  the  placenta ;  and 
in  proof  of  this  he  asserts  he  detected  the  presence  of  air  in  the  cerebral 
vessels. 

Stocktleth,  Lanzillotti-Buonsanti,  Zundel,  Raynaud,  and  others,  have 
maintained  the  hypothesis  that  the  absorption  of  septic  matters  formed 
in  the  uterus  from  the  locliia,  blood-clots  or  tissue  debris,  acted  upon 
the  central  nervous  system  and  produced  the  rapid  and  characteristic 
alterations  that  mark  the  disease. 

Abadie  thought  it  was  a  mephitic  poisoning,  induced  by  the  absorp- 
tion into  the  blood  of  gases  evolved  in  the  stomach  by  indigestion  ; 
while  Hartenstein  attributed  the  malady  to  absorption  of  certain  matters 
formed  in  the  muscular  tissue  of  the  uterus,  and  especially  to  the  pro- 
duction of  uric  acid  during  parturition. 

In  1885,  SchmidtMiUheim  published  a  theory  with  regard  to  the 
genesis  of  the  disease,  which  has  since  been  adopted  by  some  veterinary 
notabilities.  According  to  this  authority,  it  is  of  toxic  origin,  and  is 
analogous  to  the  condition  observed  in  j^lan,  and  known  as  Botulism, 
due  to  the  ingestion  of  sausages  and  llesh  in  which  a  ptomaine  or 
leucomaine  has  been  developed.  These  animal  alkaloids  produce 
paralysis  of  the  tongue,  palate,  pharnyx,  larynx,  oesophagus,  etc.,  and 
even  of  the  digestive  organs  and  bloodvessels,  and  the  author  of  this 
theory  fancied  he  could  trace  the  same  morbid  symptomatology  in  the 
Cow  as  in  Man.  The  toxine,  he  believed,  was  generated  from  the 
albuminoid  matters  contained  in  the  closed  uterus.  The  supporters  of 
the  view  that  the  active  agent  is  a  poison  elaborated  by  an  excessive 
cytolysis  or  histolysis  of  tissue — processes  which,  it  is  pointed  out,  are 
extremely  rapid  at  the  pre-parturient  and  parturient  periods — appeal  to 
clinical  facts  in  its  favour.  The  disease  is  most  frequently  seen  in 
plethoric  animals,  which  also  yield  a  large  quantity  of  milk,  in  which 
the  act  of  parturition  has  been  brief  and  easy,  chiefly  because  the 
progeny  is  small,  and  in  which  the  lacteal  secretion  is  partially  or 
entirely  suspended  ;  while  it  is  rarely  witnessed  in  lean  Cows  which 
give  a  comparatively  small  quantity  of  milk,  are  moderately  fed,  have 
exercise,  and  are  allowed  to  suckle  their  Calves, 

To  the  objection  that,  at  the  parturient  period,  tissue  changes  are 
equally  active  in  other  species,  it  is  stated  that  the  great  ditTerence  in 
the  placenta  of  the  Cow  as  compared  with  that  of  these  creatures,  the 
larger  vascular  development,  and  the  relatively  enormous  size  of  the 
udder,  with  its  vast  secretory  capacity,  predispose  to  such  a  malady. 
At  the  parturient  period,  it  is  argued,  cell  destruction  in  the  Cow  must 
go  on  at  a  rate  quite  disproportionate  to  that  at  which  it  proceeds  in 
other  animals,  and  that  in  every  case  the  products  of  this  cell  change 
must  in  a  greater  or  less  degree  gain  access  to  the  circulation.  Under 
certain  influences — dietetic,  thermometric,  or  barometric — the  milk- 
forming  functions  of  the  udder  may  be  arrested,  and  the  gland-cells  be 
diverted  from  their  natural  function.  The  products  of  cell  change  being 
absorbed  in  undue  quantity,  may  act  primarily  as  nerve  excitants,  and, 
secondai'ily,  as  nerve  depressants.  Still  further  to  confirm  this  hypo- 
thesis, the  striking  analogy  between  puerperal  collapse  and  haimoglo- 
binuria  in  the  Horse  is  adduced  ;  and  the  fact  that  both  diseases  can 
frequently  be  arrested  or  their  violence  ameliorated  in  the  early  stages 


652  PATHOLOGY  OF  PARTURITION. 

by  evacuants,  with  external  and  internal  stimulants,  is  offered  as  addi- 
tional proof ;  though  it  is  not  contended  that  the  toxic  agent  is  the 
same  in  both  maladies — the  agent  in  haemoglobinuria  acting  alike  on 
the  nervous  and  vascular  systems,  while  in  puerperal  collapse  its  direct 
action  is  exerted  on  the  nervous  system  only — any  vascular  phenomena 
observed  post  mortem  being  merely  the  result  of  vaso-motor  paralysis 
{Walley). 

But  it  may  be  observed  that  even  this  hypothesis  does  not  meet  all 
the  requirements  of  the  pathologist ;  for  if  the  malady  were  due  to  a 
toxine,  surely  the  flesh  of  affected  animals  would  prove  toxic  when  used 
as  food.  Such  is  not  the  case,  however,  as  all  experience,  experimental 
and  other,  goes  to  show  ;  and  there  are  other  facts  as  important  which 
cannot  be  explained  by  this  hypothesis. 

In  trying  to  account  for  the  evolution  of  the  malady,  it  is  necessary 
to  remember  that  it  exclusively  affects  Bovines  of  the  female  sex  ;  that 
it  is  observed  chiefly,  if  not  entirely,  in  well-bred  and  well-fed  animals 
which  yield  a  large  quantity  of  milk,  are  of  a  certain  age,  and  usually 
after  they  have  had  their  third  calf  ;  that  it  most  frequently  becomes 
manifest  in  two  or  three  days  after  parturition,  rarely  before  that  event, 
and  always  after  an  easy  and  quick  delivery ;  that  its  advent  is  sudden 
and  course  serious  and  rapid,  the  terminations  being  death  or  speedy 
recovery,  generally  without  any  period  of  convalescence. 

It  may  well  be  questioned  whether  an  animal  toxine  in  the  blood 
would  produce  the  phenomena  denoting  this  disease  under  such  circum- 
stances, apart  from  the  fact  of  the  innocuousness  of  the  flesh  of  affected 
animals  when  consumed  as  food. 

It  must  be  remembered  that  the  predisposed  Cow  during  pregnancy 
and  before  parturition  occurs,  is  in  a  state  of  exalted  physiological 
plethora  and  high  vascular  tension,  much  beyond  that  of  the  females 
of  any  other  species  at  the  same  period,  owing  to  her  organization 
and  the  great  artificial  development  of  the  lacteal  apparatus.  In 
other  female  animals  when  birth  takes  place,  the  extra  blood  de- 
manded for  the  development  of  the  foetus  in  utero,  is  now  diverted 
to  the  mammary  glands  to  supply  it  with  the  nourishment  it  needs 
for  a  certain  time  after  it  is  born  ;  in  this  way  the  vascular  system 
is  enabled  to  maintain  its  equilibrium  immediately  after  parturition, 
and  gradually  to  resume  its  normal  condition  as  the  young  creature 
is  competent  to  subsist  independent  of  its  parent.  In  the  non-predis- 
posed Cow  under  natural  conditions  this  also  occurs,  and  nothing 
different  is  observed  from  what  is  seen  in  the  Mare,  Sow,  Bitch, 
or  other  creature  at  the  post-parturient  period.  But  when,  from  any 
cause,  the  excess  of  blood  which  was  required  for  the  growth  of 
the  foetus  is  not  diverted  to  its  natural  purpose  after  the  young  animal 
is  born,  there  is  a  rapid  transition  from  physiological  action  to  patho- 
logical processes  in  all  animals,  as  well  as  in  woman,  in  whom,  owing 
to  constitutional  fault,  or  causes  interrupting  the  due  course  of  involu- 
tion, the  work  of  metabolism  or  conversion  of  the  now  superfluous 
tissues  formed  during  pregnancy,  and  of  absorption  and  elimination,  is 
imperfectly  performed. ^ 

Predisposed  as  is  the  Cow  by  artificial  management,  and  possibly  by 

anatomical  and  physiological  peculiarities,  the   pathological    changes 

which  ensue  more  or  less  promptly  after  parturition  when  the  vascular 

tension  is  not  reduced,  and  the  substitution  of  absorption  and  milk 

^  Dr.  Barnes,  The  Lancet,  December  1,  1894. 


PARTURIENT  APOI'LEXy— PUERPERAL  COLLAPSE.  653 

secretion  for  construction  does  not  take  place,  are  chiefly  located  in  the 
nervous  system,  and  especially  in  the  brain.  Conj^estion  of  the  cere- 
bral vessels  at  first,  which  may  speedily  lead  to  effusion  of  serum  or 
hicmorrhage,  is  indicated  by  the  symptoms  and  lesions  observed  in 
many  cases  ;  while  the  rapidity  with  which  recovery  sets  in,  and  the 
reported  success  attending  the  adoption  of  a  certain  method  of  treat- 
ment, supports  this  opinion,  and  negatives  that  of  septic  infection  or 
the  presence  of  ptomaines  in  the  blood  as  the  cause  of  the  disease — did 
not  the  history  and  symptoms  otherwise  contra-indicate  such  influences. 

The  mechanical  effect  on  the  blood  circulation  of  a  sudden  diminution 
of  pressure  on  the  bloodvessels  in  the  abdominal  cavity,  if  a  factor  in 
the  causation  of  puerperal  collapse,  would,  it  might  be  e.xpeoted,  be 
witnessed  in  other  animals  in  which  distension  of  that  cavity  during 
pregnancy  is  quite  as  exaggerated  as  in  iiovines.  Besides,  there  is  no 
evidence  that  vascular  engorgement  of  the  abdominal  organs  is  a  con- 
stant feature  in  necropsies  of  Cows  which  have  succumbed  to  the  disease; 
neither  is  auicmia  of  the  bi-ain  always,  or  even  often  observed. 

That  puerperal  collapse  in  the  Cow  is  chiefly,  if  not  entirely,  due  to 
vascular  disturbance,  may  be  inferred  from  the  physiological  condition 
of  the  animal  previous  to  attack,  the  clinical  history,  and  the  necro- 
scopical  appearances,  no  less  than  from  the  results  of  therapeutical 
measures  in  certain  cases  ;  and  that  this  disturbance  assumes,  primarily, 
the  form  of  congestion  of  the  nerve-centres  may  also  be  accepted,  as 
this  theory  forms  a  good  basis  for  the  adoption  of  a  rational  system  of 
prevention  and  cure. 

DiofjHosis. 

Puerperal  collapse  has  been  confounded  with  parturient  fever  and 
metritis,  jjoA'^  ;;a?7»»i  paralysis,  as  well  as  with  parturient  eclampsia; 
so  that  a  distinction  from  these  is  important,  especially  with  regard  to 
medical  and  sanitary  measures. 

The  symptoms  of  parturient  fever  and  metritis  or  metro-peritonitis, 
as  we  have  described  them,  when  compared  with  those  of  the  disease 
now  under  consideration,  differ  so  widely  that  a  mistake  should  not  be 
made  if  ordinary  care  is  exercised  ;  the  thermometer  will  establish  the 
chief  difference,  while  sensibility  and  consciousness  being  present  in 
one  affection  and  suspended  in  the  other,  should  fix  the  diagnosis. 

In  jiost  partum  paralysis,  the  animal  is  conscious,  often  bright  and 
attentive  to  surroundings,  generally  free  from  fever,  and  eats  and  drinks 
as  usual ;  the  only  symptoms  usually  noticeable  being  inability  to  get 
up,  and  to  stand  when  raised. 

By  some  authorities,  and  especially  by  Franck,  it  has  been  maintained 
that  puerperal  collapse  and  eclampsia  are  one  and  the  same  disease. 
But  as  will  be  noted  when  the  last-named  malady  conies  to  bo  dealt 
with,  there  is  a  difference  between  these  diseases,  though  a  mistake  is 
more  pardonable  here  than  with  the  preceding  disorders.  In  eclampsia 
there  are  successive  and  alternating  attacks  of  convulsions  and  coma; 
whereas  puerperal  collapse  is  marked  in  its  later  stages  by  coma  only. 

Prophylaxis. 

In  view  of  the  great  and  rapid  fatality  attending  puerperal  collapse, 
and  knowing  that  the  subjects  of  it  are  hearty-feeding,  deep-milking 
Cows  in  a  state  of  extreme  physiological  plethora,  with  a  strong 
tendency  to  vascular  congestion  of  important  organs,  there  is  every 


€54  PA  THOL  OG  Y  OF  PARTURITIOX. 

reason  to  lay  great  stress  on  preventive  treatment,  and  to  combat  the 
predisposition  to  the  malady  by  strict  attention  to  hygiene,  particularly 
during  the  last  months  of  pregnancy  and  immediately  after  parturition. 
The  diet  should  be  soft  and  easily  digested,  so  as  to  avert  constipation, 
and  the  allowance  ought  to  be  rather  sparing.  "When  it  is  possible  to 
permit  exercise  for  some  time  before  parturition,  this  should  not  be  with- 
held. Nothing  is  so  likely  to  prevent  an  attack  of  the  disease  than 
keeping  the  Cow  in  as  natural  and  free  a  condition  as  possible,  with  all 
the  functions  of  secretion  and  excretion  in  full  jDlay,  more  especially  at 
birth  and  immediately  after  that  occurrence.  Exposure  to  cold  and 
currents  of  air,  and  everything  likely  to  diminish  the  functions  of  the 
skin,  should  likewise  be  avoided. 

More  special  precautions  have  been  recommended  by  various  authori- 
ties, founded  generally  on  the  opinions  they  may  have  entertained  as  to 
the  pathology  of  the  disease ;  but  the  utility  of  these  prophylactic 
measures  has  been  more  or  less  disputed.  Bleeding  during  the  month 
before  parturition  has  been  highly  lauded,  but  there  is  every  reason  to 
believe  that  it  is  more  injurious  than  useful.  Others  recommend  the 
administration  of  nux  vomica,  tartar  emetic,  nitrate  of  potass,  sulphate 
of  soda  or  magnesia,  and  laxatives  of  various  kinds — all  of  which  may 
prove  more  or  less  useful ;  while  others,  again,  speak  favourably  of  milk- 
ing the  Cow  by  hand  a  few  days  before  calving,  and  thrice  instead  of 
twice  a  day  for  a  short  time  after  that  event,  if  the  Calf  is  removed  or 
cannot  abstract  sufficient  milk.  This  they  more  particularly  insist  upon 
doing  if  the  udder  is  largely  developed  or  distended. 

As  Cows  which  have  had  difficulty  in  calving,  and  whose  genital 
organs  are  more  or  less  irritated  or  injured,  are  rarely  attacked  by 
puerperal  collapse,  it  has  been  suggested  that  a  counter-irritant,  such 
as  mustard,  should  be  immediately  applied  to  the  loins  or  hind-quarters 
of  those  which  have  calved  easily  and  are  likely  to  become  affected. 

x\s  there  may  be  danger  if  the  newly-calved  Cow  is  allowed  to  drink 
much  cold  water,  this  should  either  be  very  sparingly  given,  or,  better 
still,  warm  gruel,  in  small  but  frequent  quantities,  may  be  substituted. 

Curative  Treatment. 

The  different  methods  of  treatment  enumerated  for  the  cure  of  this 
disease  are  completely  bewildering,  and  they  are  so  diametrically 
op].osed  to  each  other — from  the  obscurity  which  prevails  as  to  the 
nature  of  the  malady,  it  may  be  inferred — that  we  can  scarcely  be 
astonished  to  find  that  they  are  all  more  or  less  unsuccessful,  and  that 
the  majority  of  the  most  observant  practitioners  are  inclined  to  believe 
that  recovery  has  followed  most  frequently  when,  without  adopting 
active  measures,  the  attendant  has  waited  for  the  curative  effects  of 
nature — usually  decided  about  the  second  or  third  day,  only  attempt- 
ing to  combat  certain  morbid  conditions  w'hich  might  aggravate  the 
case. 

Nevertheless,  it  is  evident  that  some  mode  of  treatment  must  be 
resorted  to ;  and  that  this  should  be  based  on  the  indications  furnished 
by  the  symptoms  during  the  course  of  the  malady,  or  upon  what  we 
know  of  its  pathology,  is  obvious.  We  shall  glance  at  some  of  the 
means  which  may  be  employed  in  the  curative  treatment  of  the 
disease. 

Previous  to  doing  so,  however,  attention  must  be  directed  to  the  ■position 
of  the  affected  animal,  and  we  cannot  do  this  in  better  terms  than  those 


PARTURIENT  APOPLEXY— PUERPERAL  COLLAPSE.  655 

of  Williams  }  "  If  the  Cow  is  already  down  when  lirst  seen  by  the 
practitioner,  his  first  care  must  be  to  see  that  she  is  made  to  lie  as  near 
the  natural  position — on  the  sternum — as  possible  ;  and  this  he  will  do 
by  liaving  her  packed  up  at  the  side  by  bundles  of  straw,  or,  what  is 
better,  sacks  tilled  with  straw,  tirmly  wedged  under  the  quarter  and 
shoulder,  the  head  at  the  same  time  being  properly  propped  by  the 
same  means,  and  care  being  taken  at  all  times  that  the  Cow  is  prevented 
from  injuring  her  head  by  striking  it  against  hard  bodies."  It  may  be 
added  that  some  practitioners  are  particularly  careful  to  have  the  head 
well  raised  above  the  other  parts  of  the  body,  especially  when  the 
animal  is  comatose  ;  and  this  is  sometimes  effected  by  means  of  a  halter 
on  the  head,  or  a  rope  round  tlie  base  of  the  horns,  the  other  end  being 
passed  over  a  beam  in  the  stable.  This  elevation  of  the  head  prevents 
increased  congestion  of  the  brain,  and  facilitates  the  return  of  blood 
from  that  organ. 

It  is  often  beneficial  to  alter  the  position  at  intervals — every  two  or 
three  hours  ;  and  Williams  recommends  that  the  mammary  gland  be 
also  "stripped  (emptied)  and  hand-rubbed." 

The  abstraction  of  blood  has  found  much  favour  with  many  authorities. 
Williams  says  :  "  In  the  earlier  stages,  whether  the  animal  is  standing 
or  lying  prostrate  and  in  a  state  of  coma,  if  the  pulse  be  not  excessively 
weak  and  the  heart's  action  almost  fluttering,  recourse  must  be  had  to 
venesection.  Slow  and  deep  breathing,  with  a  tendency  to  stertor,  add 
greatly  to  the  necessity  for  immediate  bleeding.  The  beneficial  action 
of  the  withdrawal  of  blood  is  shown  by  the  pulse  becoming  fuller, 
stronger,  and  better  in  tone.  The  opening  into  the  jugular  is  to  be  a 
large  one,  in  order  that  the  blood  may  How  freely  to  relieve  the  conges- 
tion— to  check,  if  possible,  a  further  extravasation  of  blood  or  effusion 
of  serum,  and  to  divert  its  active  flow  into  the  head;  but  it  must  not  be 
carried  out  so  as  to  debilitate  the  heart's  action.  When  the  pulse 
becomes  fuller  and  stronger,  the  bleeding  is  to  be  stopped ;  from  three 
to  five  quarts  will  generally  be  sufficient." 

Theoretically,  venesection  is  to  be  commended.  If  the  theory  be 
accepted  that  the  condition  is  due  tohypera^mia — audit  has  been  shown 
that  this  opinion  has  a  better  foundation  tlian  any  other,  then  a  sudden 
depletion  of  the  vascular  system,  by  which  the  pressure  is  diminished, 
must  stop  the  attack.  It  is  known  from  experience,  says  Schroeder, 
that  after  venesection  the  quantity  of  the  blood  soon  becomes  the  same, 
through  the  serum  taken  from  all  the  tissues,  whilst  the  quality  is 
gi-eatly  deteriorated  by  the  abstraction  of  blood.  A  short  time  after 
venesection,  we  shall  expect  to  find  the  former  blood-pressure  in  the 
arterial  system,  but  the  blood  far  more  watery  than  jireviously.  From 
this  theoretical  consideration,  it  follows  that  abstraction  of  blood  must 
be  attended  by  an  immediately  favourable  result,  and  under  certain  cir- 
cumstances the  whole  disease  may  surely  be  cut  short  by  it.  But  if  all 
other  conditions  remain  the  same,  the  blood-pressure  will,  after  some 
time,  again  reach  its  previous  height ;  the  quality  of  the  blood  has,  in 
the  meantime,  been  greatly  deteriorated,  and  consequently  the  danger 
of  the  disease  will  be  increased. 

Williams  adds:  "  The  bleeding  is  for  the  purpose  of  removing  pressure 

from  the  brain,  and  although  the  pulse  may  indicate  stimulants  rather 

than  depletion,  it  will  be  found  that  as  the  blood  flows  the  tone  of  the 

pulse  will  improve  ;  for  the  weakness  of  the  pulsation,  the  want  of 

*  Principles  and  Practice  of  Veterinary  Medicine,  p.  418. 


656  PATHOLOGY  OF  PARTURITION. 

impulse,  and  debility  of  the  heart's  action,  are  results  of  brain-pressure. 
If,  however,  the  surface  of  the  body  be  cold,  if  the  animal  be  tympanitic, 
the  heart's  action  fluttering,  and  the  pulse  almost  undetectable,  bleed- 
ing is  calculated  to  do  more  harm  than  good,  as  the  heart's  action 
would  now  be  further  impaired,  and  the  amount  of  arterial  blood  sent 
to  the  brain  diminished.  For  it  must  be  remembered  that  the  cerebral 
congestion  is  now  less  due  to  an  over-abundant  supply  of  arterial  blood 
than  to  pressure  upon  it  by  venous  or  capillary  engorgement ;  that,  in 
fact,  the  brain — engorged  as  it  may  seem — is  in  an  anaemic  condition  in 
regard  to  its  arterial  supply  ;  and  when  this  is  the  case,  paralysis  of  the 
heart  is  to  be  prevented,  if  possible,  by  the  use  of  stimulants." 

If  abstraction  of  blood  is  made  from  the  jugular  vein,  the  neck  should 
be  constricted  as  little  as  possible  in  "  raising"  the  vessel,  and  as  soon 
as  it  is  opened  the  constriction  ought  to  be  removed,  lest  it  add  to  the 
cerebral  engorgement ;  indeed,  to  avoid  the  risk  of  this  it  has  been 
recommended  to  open  the  mammary  or  other  superficial  veins. 

A  principal  indication  in  the  treatment  of  the  disease,  viewing  it  in 
the  light  we  have  done,  is  to  favour  the  cutaneous  circulation  and  stimu- 
late the  shin  by  every  means  in  our  power,  and  thus  relieve  those  organs 
in  which  the  blood-pressure  is  too  considerable.  With  this  object  in 
view,  the  skin  is  to  be  well-rubbed  with  straw  wisps,  and  then  warmly 
clothed.  Or  the  course  of  the  spine  and  for  some  distance  on  each  side, 
may  afterwards  be  stimulated  with  strong  ammonia  liniment.  Some 
authorities  recommend  the  application  of  a  mixture  of  croton-oil  with 
oil  of  turpentine ;  others  employ  a  thick  layer  of  mustard,  after  the  skin 
has  been  well  cleansed  with  warm  water  and  the  hair  removed ;  others, 
again,  resort  to  sacks  steeped  in  boiling  water  applied  to  the  spine — 
sometimes  after  deep  scarifications  have  been  made.  In  addition  to 
the  applications  of  turpentine  or  mustard  to  the  spine,  they  are  often 
made  to  the  limbs. 

In  some  cases,  a  hot  iron — the  laundress's  flat  iron — has  been  applied 
to  the  back  in  an  "  ironing"  fashion,  and  at  a  somewhat  high  tempera- 
ture, a  piece  of  flannel  being  interposed  between  it  and  the  skin.  The 
action  of  the  skin  can  be  greatly  augmented  by  covering  the  body  with 
a  wet  sheet,  and  above  this  a  thick  woollen  one,  surrounding  the  animal 
with  plenty  of  litter. 

Cold  water  or  ice  may  be  applied  to  the  head  ;  but  this  application 
requires  care,  as  the  resulting  coryzaand  other  complications  may  prove 
very  serious,  should  the  animal  recover  from  the  collapse. 

But  it  must  be  i-emarked  that  this  hydropathic  treatment  has  proved 
a  great  success  in  the  hands  of  some  practitioners,  who  were  unsuccess- 
ful with  other  methods.  Hartenstein  and  Mauri, ^  for  instance,  have 
cured  cases  which  appeared  to  be  hopeless,  by  first  abstracting  a  quantity 
(4  kilogrammes)  of  blood,  then  placing  a  wet  sheet,  folded  in  four,  over 
the  head  and  along  the  back,  and  keeping  this  constantly  drenched  with 
cold  water.  When  the  animal  began  to  recover  this  douching  was 
stopped,  the  body  was  rubbed  dry  and  covered  with  warm  rugs.  In 
twenty-four  to  thirty-six  hours  recovery  was  complete  without  any 
medicine — another  proof  in  favour  of  the  congestive  nature  of  the 
disease,  and  against  its  being  due  to  sepsin,  ptomaines  or  leucomaines. 

With  regard  to  the  tijmjxinitis  which  is  so  often  present  as  a  conse- 
quence of  the  torpidity  in  the  digestive  organs,  this  should  be  combated 
in  the  ordinary  way,  by  the  administration  of  stimulants.  These  are 
^  Revut  Vetermaire,  June,  1889. 


i^uiTrniKxr  ArcrLKXY—rrKni'KHAL  ci'Lljj'sk.  nr.: 

most  effective  and  rapid  in  their  action  when  given  in  the  fluid  form,  if 
the  animal  can  swallow.  If  it  cannot,  then  they  may  be  administered 
by  means  of  the  stomach-pump  or  proban^',  or  even  in  bolus.  \Villiams 
reconnnends  giving  carbonate  of  ammonia  in  bolus  ;  the  hand,  being  well 
oiled,  is  to  be  pushed  as  far  as  possible  into  the  pharynx,  when  the  dose 
"  will  slowly  gravitate  into  the  rumen."  Should  the  medicine  not  act 
promptly,  or  the  tympanitis  be  so  great  that  suffocation  is  to  be  appre- 
hended, then  the  rumen  ought  to  be  punctured  without  delay.  This 
may  be  effected  by  the  ordinary  trocar  and  cannula,  the  latter  being 
allowed  to  remain  in  the  rumen  for  some  time.  It  may  be  closed  by  a 
cork,  which  is  to  be  withdrawn  when  the  gas  accumulates.  If  care  is 
exercised,  fluid  medicaments  may  be  introduced  into  the  stomach  through 
the  cannula. 

Even  when  the  tympanitis  is  not  extreme,  but  the  animal  is  comatose 
and  there  is  gastric  regurgitation,  it  will  be  advisable  to  puncture  the 
rumen  ;  as  by  this  means  the  entrance  of  food  into  the  trachea  may  be 
prevented,  by  allowing  the  gases  to  escape  through  the  cannula,  instead 
of  by  the  oesophagus. 

Enemas  are  as  essential  as  counter-irritation.  The  rectum  should 
first  be  emptied  manually,  and  then  either  enemas  of  warm  water,  or 
those  of  a  stinmlant  or  laxative  nature,  administered.  By  the  rectum 
enemas  of  linseed-oil,  common  salt,  sulphate  of  soda  or  magnesia,  aloes, 
tobacco,  oil  of  turpentine,  camphor,  etc.,  have  been  administered.  The 
rectum  forms  a  safe  and  convenient  channel  for  the  introduction  of 
medicines,  and  especially  those  intended  to  act  upon  the  torpid  digestive 
organs,  when  the  animal  can  no  longer  swallow.  Powdered  camphor  in 
small  quantities  has  even  been  introduced  into  the  rectum  to  stimulate 
the  intestines,  when  drugs  exhibited  by  the  mouth  have  failed  to  etTect 
this.  Knemas  may  be  given  as  frequently  as  necessary  without  danger  to 
the  animal,  and  with  ease — advantages  not  available  by  mouth  adminis- 
tration. 

The  urine  should  be  frequently  removed  from  the  bladder,  either  by 
pressure  on  the  viscus  through  the  rectum,  the  introduction  of  the 
catheter  or  nozzle  of  the  ordinary  injection  syringe  into  the  urethra,  or 
even  by  passing  the  finger  into  that  canal. 

As  has  been  mentioned,  the  milk  should  be  often  removed,  and  the 
udder  completely  emptied.  Even  when  there  is  no  milk,  the  teats  should 
be  well  and  repeatedly  stripped. 

runjativcs  are  in  nearly  every  case  necessary  (though  some  authori- 
ties deny  this),  and  they  should  be  active,  and  given  in  larger  doses 
than  in  ordinary  circumstances;  constipation  being  a  constant  and 
serious  symptom,  while  action  of  the  bowels  may  be  considered  a  most 
favourable  sign.  The  most  common  are  sulphate  of  magnesia  or  soda, 
aloes,  chloride  of  sodium,  cream  of  tartar,  linseed-oil,  castor-oil,  tartar 
emetic,  ipecacuanha,  croton-oil,  etc. 

In  the  great  majority  of  instances  these  agents  are  not  given  alone, 
but  in  combination  with  other  substances. 

A  very  favourite  compound  in  Germany  is  that  mentioned  by  Kohne, 
the  composition  of  which  is  as  follows  : 

Nux  vomica  -  -  -  -  8^  drams. 
Tartar  emetic  -  ...  2  ounces. 
Sulphate  of  soda  -         -         -       l.S        ,, 

Common  salt       -         -         -         -         4^      ,, 

42 


658  PATHOLOGY  OF  PARTUEITIOX. 

These  are  boiled  together  for  about  a  quarter  of  an  hour  in  four  pints  of 
water,  and  one-fourth  given  every  hour  or  every  two  hours. 

Harms  places  great  confidence  in  tartar  emetic.  He  gives  eight  and 
a  half  drachms  in  about  two  pints  of  water,  in  four  hours  three  drachms 
in  a  pint  of  water,  and  in  five  hours  two  drachms.  In  one  serious  case 
he  gave  as  much  as  two  ounces  in  fourteen  hours.  In  thirty-seven 
cases  of  the  disease,  only  two  died. 

When  it  is  desired  to  increase  the  activity  of  any  of  the  ordinary 
purgatives,  croton-oil  is  generally  added  in  the  proportion  of  six  to 
twelve — or  even  forty — drops,  or  oil  of  turpentine  one  or  two  ounces. 

Some  practitioners  extol  nux  vomica  in  tolerably  large  doses,  to  aid 
in  rousing  the  action  of  the  intestines. 

Stim2ilants  —  a,s  ammonia — are  often  administered,  and  in  conjunc- 
tion with  bleeding  they  may  prove  of  the  greatest  service  at  the  com- 
mencement of  the  attack,  or  they  may  be  associated  with  the  purgatives. 
If  given  alone,  they  should  be  exhibited  in  small  doses  and  very  often. 
Chloral  hydrate  has  been  commended. 

Other  medicaments  have  been  employed  —  as  aconite,  bryonia, 
camphor,  phosphorus,  datura,  quinine,  gentian,  digitalis,  etc. — with 
varying  success.  The  subcutaneous  injection  of  some  of  these  medica- 
ments has  been  much  resorted  to,  and  some  of  the  reports  as  to  their 
eifects  are  in  their  favour.  Strychnine  has  been  administered  in  this 
way,  also  veratrine  and  eserine,  and  their  utility  has  doubtless  been 
due  to  their  action  on  the  bloodvessels,  more  especially  the  arteries  and 
capillaries. 

When  recovei'y  commences,  small  doses  of  stimulants  may  be  bene- 
ficial if  there  is  much  debility,  and  the  animal  can  swallow  readily.  But 
in  the  administration  of  fluids  when  the  animal  is  comatose  or  degluti- 
tion is  impeded,  the  greatest  care  is  necessary  to  prevent  their  entering 
the  trachea — an  accident  which  might  prove  fatal.  To  test  whether 
the  animal  can  swallow,  a  little  cold  water  may  be  poured  into  the 
mouth  from  a  bottle.  If  swallowing  is  difficult,  then  the  only  safe 
mode  of  administration  is  by  the  stomach-pump  or  probang,  or  directly 
into  the  rumen  by  the  trocar  and  cannula.  Large  quantities  of  fluids 
are  objectionable,  and  the  amount  in  any  single  dose  should  not  exceed 
a  pint. 

It  must  also  be  remembered  that,  if  it  is  probable  the  animal  will  not 
recover,  but  will  be  killed  and  its  flesh  consumed  as  food,  drugs  of  a 
poisonous  kind,  or  likely  to  flavour  the  meat,  should  not  be  given. 
Many  cases  are  recorded  in  which  people  have  been  poisoned,  through 
eating  of  the  flesh  of  Cows  which  had  received  large  quantities  of 
poisonous  medicines  before  being  killed  by  the  butcher. 

Electricity  has  been  employed  with  success,  both  in  the  comatose 
stage  and  when  paralysis  has  remained  after  the  attack.  Neumann, 
Holden,  and  others  relate  instances  of  recovery.  The  Leyden  jar,  or, 
better,  the  induction  coil,  may  be  employed. 

To  sum  up,  the  treatment  of  parturient  collapse  consists  chiefly  in 
relieving  the  congestion  of  the  brain  (at  the  commencement),  restoring 
the  functions  of  and  stimulating  the  skin,  promoting  the  action  of  the 
intestines,  and  removing  the  milk  or  stimulating  the  function  of  the 
mammary  gland. 

All  violent  and  heroic  treatment  should  be  avoided,  as  well  as  large 
doses  of  medicine. 

Consecutive  congestion  or  inflammation  of  the  lungs  must  be  treated 


POST  PARTUM  PAUALYSIS.  659 

according'  to  circumstances  ;  and  paralysis  will  be  best  combated  by 
stimulation  to  the  loins,  and  the  subcutaneous  injection  of  strychnine, 
with  diuretics  and  purgatives. 

Easily  digested  food  in  small  quantities  should  alone  be  allowed 
immediately  after  recovery,  and  the  animal  must  not  be  given  any 
indigestible  food,  nor  be  permitted  to  eat  hay  or  litter. 

To  prevent  injuxy  to  the  surface  of  the  body,  it  is  well  to  change  the 
position  of  the  animal  two  or  three  times  a  day,  if  soft  litter — such  as 
peat  moss — cannot  be  procured.  In  turning  from  one  side  to  another, 
the  movement  should  be  on  the  under  part  of  the  trunk  after  the  limbs 
have  been  doubled  under  the  body — not  on  the  back  ;  and  care  should 
be  taken  that  tympanitis  is  not  interfering  with  the  respiration. 

In  some  cases  there  remains  a  certain  degree  of  paresis  or  inertia, 
after  the  more  urgent  symptoms  have  disappeared — indeed,  when  the 
animal  looks  bright  and  well,  so  that  it  will  not  or  cannot  rise.  This 
condition  has  been  combated  successfully  and  promptly  by  the  adminis- 
tration of  an  enema  containing  a  quantity  (10  to  15  ounces)  of  oil  of 
turpentine. 

It  is  judicious  not  to  breed  from  a  Cow  which  has  suffered  from  par- 
turient collapse,  unless  every  precaution  is  taken  towards  the  next 
calving  period. 


CHAPTEK  V. 

Post  Partum  Paralysis. 

In  treating  of  the  diseases  peculiar  to  pregnancy,  allusion  was  made  to 
paraplegia  (p.  187)  as  one  of  these.  Paralysis  of  the  hind-quarters  is 
more  frequent  previous  to  birth  than  after  that  event,  and  is  generally 
observed  in  the  Cow.  After  birth,  paralysis  is  comparatively  rare,  and 
may  affect  nearly  the  whole  of  the  body,  or  both  or  only  one  of  the 
hind-limbs.  Tlie  Cow  is  also  the  animal  which  oftenest  exhibits  i)ost 
partnvi  paralysis.  The  affection  may  be  due  to  parturient  apoplexy  or 
collapse— as  already  noticed  ;  it  may  also  be  a  result  of  metritis  ;  or  it 
may  follow  ditVicult  parturition,  and  especially  after  the  birth  of  a  large 
Calf,  or  if  the  latter  has  been  in  a  wrong  position.  Franck  has  often 
witnessed  its  occurrence  after  delivery,  when  the  uterus  has  been  half 
twisted.  Williams  gives  an  instance  in  which  paralysis  appeared  to  be 
due  to  mental  disturbance  ! 

Sjpnptonis. 

The  symptoms  are  similar  to  those  of  ante  partum  paralysis. 
The  animal  continues  to  lie,  and  one  or  both  hind-limbs  may  be 
moved  in  a  convulsive,  irregular  manner,  or  they  are  completely  in- 
capable of  movement.  In  the  majority  of  cases,  however,  the  animal  is 
able  to  turn  itself  over  at  intervals  from  side  to  side — particularly  during 
the  night.  Sometimes  only  one  leg  is  paralysed.  Apparent  paralysis 
is  at  times  observed  in  Cows,  which  persist  in  lying  after  parturition, 
and  though  they  can  move  their  limbs  readily,  yet  they  will  not  attempt 
to  get  up  ;  their  appetite  is  unimpaired,  they  exhibit  no  symptoms  of 
disease  or  suffering,  but  yield  plenty  of  milk,  and  the  excretions  are 
normal. 

This  condition  may  continue  for  weeks  or  months,  and  often  animals 
have  to  be  killed  in  consequence  of  it. 


660  PATHOLOGY  OF  PARTURITION. 

Diagnosis. 

There  should  be  no  difficulty  in  diagnosing  this  condition  from  puer- 
peral collapse,  metritis,  or  other  affection  incidental  to  parturition.  If 
the  paraplegia  does  not  appear  until  a  short  time  after  that  event,  and 
no  accident  has  occurred  to  cause  it,  then  it  has  been  suggested  that 
myelitis  has  probably  set  in,  and  especially  if  the  paralysis  follows 
mammitis  ;  in  that  case  there  is  not  only  the  loss  of  power,  but  also 
diminished  sensation  in  the  hind-limbs.  But  if  due  to  a  sprain  of  the 
back  from  slipping,  then  sensation  is  not  impaired,  and  pain  may  be 
indicated  on  pressure  of  the  part  injured. 

When  due  to  fracture  of  the  pelvis,  crepitation  may  be  heard  on 
movement,  or  an  examination  per  rectum  will  detect  the  damage  ;  or  if 
there  is  dislocation  of  the  hip-joints  the  accident  will  be  manifest  on 
moving  the  limbs.  Injury  to  the  hind-limbs  from  fruitless  attempts  to 
rise  when  recovering  from  puerperal  collapse,  can  be  detected  on 
examining  them.  When  parturition  has  been  very  difficult,  and  great 
force  has  been  employed  in  removing  the  foetus,  serious  injury  may 
have  been  done  to  the  organs  in  the  pelvic  cavity,  and  the  lumbar  nerves 
themselves  may  be  involved.  Congestion  of  the  spinal  cord  will  produce 
the  same  symptoms,  but  there  are,  in  addition,  fever,  pain,  and  sometimes 
convulsive  movements  of  the  limbs. 

Pathology. 

Little  is  known  as  to  the  nature  of  this  affection.  Harms  and  others 
thought  it  was  due  to  injury  inflicted  on  the  sacral  and  other  nerves 
during  difficult  parturition.  The  sciatic  nerves  are  particularly  liable 
to  injury.  Post  mortem  examination,  however,  has  only  furnished  nega- 
tive evidence  of  this.  Franck  thinks  that  injury  to  the  cervix  uteri  may 
give  rise  to  reflex  paralysis ;  this  has  been  witnessed  in  a  Bitch  ;  and 
reflex  paralysis  of  the  legs  has  been  seen  in  woman,  and  ascribed  to 
uterine  injury  or  derangement — when  this  was  remedied  the  paralysis 
disappeared.  It  is  not  at  all  improbable  that  the  same  causes  will  pro- 
duce the  same  effects  in  animals. 

In  some  cases  the  spinal  cord  has  been  found  injured  and  its  vessels 
congested,  with  blood-clots  in  the  spinal  canal ;  and  in  others  the  roots 
of  the  abdominal  nerves  have  been  surrounded  by  serous  efi'usion. 

It  can  easily  be  understood  how  paralysis  is  induced  in  parturient 
apoplexy.  Williams  states  that  it  is  due  to  inflammation  and  red 
softening  of  the  spinal  cord  in  the  lumbar  region. 

Prognosis. 

The  prognosis  must  necessarily  depend  upon  the  diagnosis.  The 
paraplegia,  real  or  simulated,  is  due  to  various  causes,  and  therefore 
the  likelihood  of  recovery  must  be  based  upen  the  nature  and  degree  of 
the  injury. 

If  it  is  only  simple  congestion  of  the  spinal  cord,  recovery  may  take 
place  in  a  few  days ;  but  if  decubitus  persists  after  a  week,  there  is 
reason  to  apprehend  haemorrhage  as  a  complication  of  the  congestion ; 
though  injury  to  the  pelvic  nerves  will  also  cause  the  same  symptoms 
and  prolonged  inability  to  get  up.  These  cases  are  generally  hopeless, 
as  are  the  great  majority  of  fractures. 

Whatever  be  the  cause,  if  the  animal  can  remain  standing,  when  got 
up,  for  ever  so  short  a  time,  it  will  in  all  probability  recover,  though  it 
may  be  lame  in  one  or  both  limbs  for  a  considerable  period. 


POST  PARTUM  PARALYSIS.  601 

Treatment. 

Treatment  must  also  depend  upon  the  diagnosis.  When  the  para- 
plegia is  due  to  congestion  of  the  spinal  cord,  cold  water  may  be  applied 
to  the  loins  continuously  by  means  of  rugs  kept  saturated,  or  at  fre- 
ijuent  intervals  by  a  large  syringe  or  garden  hose.  After  a  few  days, 
blisters,  or  even  the  actual  cautery,  should  be  applied  to  the  loins,  and 
the  subcutaneous  injection  of  strychnia  resorted  to.  The  condition  of 
the  bowels  and  bladder  must  be  attended  to ;  the  former  being  regulated 
by  feeding,  and  if  necessary  by  laxatives,  the  latter  by  diuretics. 
Electricity  may  be  useful  in  some  cases,  and  particularly  when  only  one 
limb  is  involved. 

In  all  cases,  the  state  of  the  uterus  should  be  ascertained,  and  if  it 
is  unsatisfactory,  then  remedial  measures  should  be  adopted  with  regard 
to  it. 

When  the  animal  cannot  turn  itself,  this  must  be  done  by  its 
attendants ;  and  if  it  is  a  valuable  one,  and  the  paralysis  is  likely  to 
continue  for  some  time,  slinging  for  a  short  period  every  day  may  be 
tried. 

When  due  to  other  causes,  the  treatment  must  be  adapted  to  the 
circumstances  of  the  case  ;  with  Cows,  however,  unless  there  are  special 
reasons  to  the  contrary,  and  if  they  are  in  good  condition,  it  is  often 
advisable  to  have  them  killed  for  food. 


CHAPTER  VI. 
Eclampsia. 

Thkre  can  be  no  doubt  that  tlie  malady  described  in  this  work  as 
parturient  apoplexy  or  puerperal  collapse,  has  often  been  confounded 
with  the  disease  known  in  woman  as  "eclampsia,"  and  which  is  also 
witnessed,  with  some  slight  ditTerences,  in  animals.  For  it  seems  to 
be  now  admitted  that  the  eclampsia  of  woman  and  the  malady  of  the 
Cow  are  nearly,  if  not  altogether,  identical ;  and  the  same  or  similar 
causes  may  be  in  operation  in  the  production  of  both.  In  the  first 
place,  the  eclampsia  of  woman  is  essentially  epileptic  or  convulsive,  the 
convulsions  being  of  a  tonic  and  clonic  nature  ;  and  in  animals  con- 
\'ul3ions  are  generally  present,  and,  indeed,  maybe  regarded  as  a  constant 
symptom. 

The  symptomatology  of  the  disease  in  the  human  female  and  in 
animals  differs  in  some  particulars,  owing  no  doubt  to  differences  in 
organization.  In  woman  there  are  premonitory  signs — such  as  uneasi- 
ness, headache,  nausea,  twitch  ings,  sudden  vertigo.  Then  the  attack 
begins  by  rapid  contractions  of  the  muscles  of  the  face,  eyelids,  and 
eyeballs,  the  latter  rolling  about  in  their  orbits.  These  movements 
soon  extend  to  the  head,  neck,  and  other  parts  of  the  body,  and  are 
rapidly  replaced  by  tonic  contraction  of  all  the  extensor  muscles  either 
of  the  trunk  or  limbs.  The  respiration  is  stertorous  or  suspended  ;  the 
pulse — at  first  full  andstrong— isso  weak  that  it  is  scarcely  perceptible; 
the  tongue  is  protruded  from  the  mouth,  and  often  bitten ;  foam  appears 
between  the  lips,  and  unconsciousness  is  complete.  The  attack  may  last 
for  twenty  or  thirty  seconds  ;  then  the  tonic  convulsions  are  replaced 
by  those  of  a  clonic  kind,  preceded  by  a  general  state  of  rigidity.  The 
movements  are  jerking,  and  so  convulsive  that  they  shake  the  whole 


662  PATHOLOGY  OF  PARTURITION. 

body.  The  respiration  gradually  returns  to  its  normal  state,  and  the 
pulse  resumes  its  natural  rhythm  ;  the  jerking  of  the  limbs  and  body 
subsides,  perspiration  appears,  and  in  from  one  to  five  minutes  all  is 
tranquil ;  the  comatose  condition  which  supervenes  varies  in  duration, 
but  the  patient  awakes  greatly  exhausted,  and  complaining  of  pain  in 
the  limbs.  (Edema  of  the  face  and  limbs  has  been  observed.  Exception- 
ally, there  is  only  one  attack  ;  generally  there  are  several,  which  may 
succeed  each  other  quickly,  when  the  patient  may  remain  comatose 
between  the  pauses,  and  at  the  height  of  an  attack  death  may  take  place 
from  oedema  of  the  lungs  or  apoplexy.  In  favourable  cases  the  intervals 
become  longer,  the  attacks  themselves  more  imperfect  and  shorter,  until 
they  finally  cease.  The  malady  is  considered  very  serious  when  it  occurs 
during  pregnancy,  and  it  has  been  estimated  that  one  case  occurred  in 
every  350  cases  of  labour. 

It  will  be  seen  presently  how  far  these  symptoms  in  woman  correspond 
to  and  differ  from  those  observed  in  animals. 

The  disease  affects  the  Cow,  Goat,  Bitch,  and  perhaps  the  Sow.  It 
has  been  studied  by  a  considerable  number  of  observers  on  the  European 
Continent,  and  in  this  country  cases  of  it  have  been  reported,  chiefly  by 
Storrar,  Eolls,  and  Clark.  I  have  only  seen  one  case  of  it,  the  animal 
being  a  Bitch  suckling  too  many  Puppies. 

Syvij)ioms. 

In  the  Cow  the  disease  occurs  at  all  ages,  and  may  appear  occasionally 
before  parturition,  but  is  most  frequently  observed  after  that  event,  and 
soon  ;  though  it  may  be  delayed  so  long  as  the  twenty-sixth  day. 
PrimiparaB  often  suffer,  and  it  is  said  to  be  most  frequently  witnessed  in 
Cows  in  poor  condition.  It  is  not  always  recurrent  at  subsequent 
pregnancies,  in  this  respect  diilering  from  the  affection  in  woman,  in 
which  it  is  also  more  commonly  seen  before  parturition.  When  it 
attacks  the  Cow  ante  partum,  it  is  believed  to  be  usually  about  mid-term, 
and  convalescence  and  recovery  may  follow  without  labour  being 
induced. 

The  symptoms  are  not  so  urgent  as  in  woman,  and  the  disease  is  far 
less  fatal — though  during  the  attack  consciousness  is  abolished,  as  in 
her,  in  at  least  the  great  majority  of  cases. 

In  the  cases  reported  by  Clark, ^  the  attack  was  usually  sudden,  and 
without  warning,  though  the  Cows  had  not  been  altogether  well  for  a 
day  or  two  previously — this  period  probably  corresponding  with  that  of 
the  preliminary  malaise  experienced  by  woman.  The  symptoms  were  : 
"  foaming  at  the  mouth,  champing  of  the  jaws,  prominent  staring  eyes, 
excited  expression,  head  very  often  turned  to  the  side  ;  sometimes  lick- 
ing at  the  fore-leg,  stall,  or  some  imaginary  object.  Some  Cows  I  have 
heard  bellow,  others  do  not  do  so  ;  there  was  twitching  of  the  body  and 
limbs  (clonic  spasm),  difficulty  in  respiration  according  to  intensity  of  the 
attack.  The  convulsions  generally  last  two  or  three  hours,  and  in  the 
majority  of  cases  do  not  reach  the  stage  of  coma,  although  I  have  had 
cases  which  have  done  so." 

In  a  somewhat  typical  case  described  by  Professor  Mauri,-  the  Cow  was  four  years 
old,  and  a  jjriniipara,  which  had  cahed,  the  placenta  being  expelled  two  hours  after- 
wards. On  the  following  morning  the  animal  was  seized  with  tremblings,  refused  all 
food,  manifested  breathlessness,  and  looked  anxious.     On  being  led  to  the  pasture,  it  was 

1  Journal  of  Comparative  Patholofjy  and  Thtrapentics,  1893,  p.  28. 
-  Revue  Vtltrinaire,  1876,  p.  t>5. 


ECLA.MI'Sr.L  668 

perceived  that  it  was  weak  in  the  hind-quarters,  and  in  the  short  distance  it  had  tn  travel 
it  fell  se\eral  times.  It  was  put  in  a  shed  with  a  northern  exposure,  and  its  Calf  being 
broujjht,  it  remained  completely  indifferent  to  it.  At  two  o'clock  ic  fell,  and  Mauri  was 
sent  fur.  He  found  it  lying  extende<l  on  the  right  side,  the  respiration  appeared  to  be 
entirely  diaphragmatic,  and  it  was  rlitticiilt  to  perceive  the  movements  of  the  Hanks  ; 
the  pulse  was  imperceptible,  but  the  heart's  beats  were  strong.  The  tongue  iuing  out  of 
the  mouth,  and  the  air  expelled  carried  a  large  (juantity  of  foamy  saliva  with  it.  The 
senses  appeared  to  be  completely  abolished,  and  the  eyeballs — turned  trreatly  upwards — 
Kxiked  fixed  in  a  remarkable  manner.  The  limbs  were  rigidly  extended,  and  they,  with 
the  trunk,  jerked  in  such  a  violent  manner,  that  the  whole  body  was  shaken  without 
being  displaced.  The  udder  was  not  Haccid,  and  milk  of  a  good  (piality  was  readily 
obtained  Irom  it. 

Mauri  thought  it  was  a  case  of  parturient  collapse,  and  ordered  the  necessary  treat- 
ment. After  six  o'clock  in  the  evening,  while  jireparations  were  being  made  to  carry 
out  his  prescriptions,  the  Cow  got  up  and  stumbled  towards  the  side  f)f  the  hhed  where 
its  Calf  wa.s  standing.  During  the  night  it  ate  and  ruminated.  Next  morning  at  eight 
o'clock  there  was  another  attack.  The  premonitory  symptoms  lasted  for  about  half  an 
hour,  and  the  animal  lay  until  half-p;xst  nine.  At  midday  it  did  not  present  any  signs 
of  disease.  It  had  no  more  attacks,  but  the  owner,  apprehensive  of  future  danger,  sold 
it  two  months  afterwards,  and  Mauri  lost  sight  of  it. 

Calmettes'  mentions  that  a  four-yearold  Cow  gave  birth  to  a  Calf  during  the  night  in 
quite  a  natural  manner,  and  during  the  following  day  it  ate  and  ruminated  as  usual. 
Tov.ards  six  o'clock  in  the  evening  it  suddenly  commenced  to  tremble  and  stagger  in  its 
hind  liudw,  so  that  it  could  only  walk  with  the  greate-t  ditticulty.  At  seven  o'clock 
Calmettes  noted  that  the  hind-iiuarters  were  veiy  feeble  ;  the  general  sensibility 
appeared  to  be  increased,  and  pressure  on  the  dorsodumbar  region  cau.^^ed  much  pain  ; 
the  skin  was  very  hot,  an<l  the  respiration  deep  and  hurried  ;  the  pulse  was  strong  and 
([uick,  the  mucous  membranes  somewliat  red<lentd,  and  the  muffle  damp.  Counter- 
imtiints  were  applied  to  the  hind-ipiarters,  and  draughts  and  emollient  enemas  adminis- 
tered. At  one  o'clock  in  the  morning  he  was  again  called.  The  animal  had  fallen  on 
its  side  ;  the  general  .sensibility  was  diminished,  and  the  skin  wjus  very  cold.  From 
time  to  time  it  was  remarked  that  all  the  extensor  muscles  of  the  limbs  were  convulsed, 
which  threw  the  latter  into  rigid  extension  ;  though,  when  seized  by  the  hand^,  they 
could  be  Hexed  and  moved  alx)ut.  The  sensorial  functions  were  completely  abolished, 
and  the  skin  could  be  pricked  or  incised  without  inducing  the  least  movement  ;  the  eye, 
which  wa.s  generally  fixed,  pirouetted  in  its  orbit  from  time  to  time,  while  it  could  dis- 
tinguish nothing,  and  could  be  touched  without  betraying  any  sensation  ;  there  was  also 
loss  of  hearing.  At  this  time  the  respiration  was  about  normal — eighteen  to  twenty 
respirations  in  the  nnnute  ;  the  pulse  was  small  and  imperceptible  ;  the  heart's  beats 
strong  ;  the  mucous  membrane  rather  pale  than  red,  and  the  muHle  dry.  During 
expiration  there  was  a  labial  xoiijih,  and  an  abundance  of  foamy  ealiva  escaped  from  the 
mouth.     The  animal  remained  in  this  condition  for  six  hours. 

Towards  .seven  o'clock  next  morning,  when  al)out  to  send  for  a  butcher,  the  limbs 
becauje  rigid  and  were  seized  with  convulsions,  which  extended  to  the  entire  body.  .iVs 
if  by  enchantment,  the  animal  placed  itself  on  its  sternum,  rai.-ed  its  head  to  the  normal 
position,  and  Hnally  got  up,  though  with  diHiculty.  It  had  been  in  a  somewhat  de«>p 
coma  for  about  an  hour. 

In  the  evening  it  had  u  second  attack,  there  being  ceneral  agitation,  with  hurried 
respiration  and  weakness  of  the  hind-quarters.  Soon  it  fell,  had  numerous  convidsions, 
and  manifested  the  same  general  insensibilitv  it  dispUyed  in  the  morning.  This  con- 
tinned  for  only  three  hours.      Next  morning  it  ajijieared  to  be  quite  recovered. 

Fifteen  months  previously,  and  eight  days  after  parturition,  this  C'ow  had  another 
attack  when  returning  fn)m  pasture  ;  bein^'  suddenly  seized  with  tremblings,  it  stag- 
gered and  fell.  In  half  an  hour  afterwards  it  was  conqiletely  insensible,  an'i  sensa- 
tioidess  ;  the  respiration  was  almost  normal,  the  pulse  iinjxjrceptibl-,  though  the 
contractions  of  the  lieart  were  powerful,  and  all  the  symptoms  already  enumerated  were 
pres.Mit,  but  became  more  rapidly  developed.  The  convulsions  continued  for  two  and  a 
half  hours. 

Lafitte-  makes  mention  of  a  Cow  that  calved  in  the  most  favourable  manner,  and  four 
hours  afterwards  became  agitated  and  restless  :  soon  afterwards,  there  were  con  vuNions  of 
the  muscles  of  the  trunk  and  limbs,  anil  so  much  weakness  set  in  that  the  animal  could  not 
stand.  The  t«mgue  was  often  projected  from  the  mouth  and  foam  flowed  therefrom  : 
the  Cow  could  hear  and  see  during  the  attack.  The  pidse  was  intermitt>nt,  and  the 
respiration  moderately  increased.  In  about  ten  hours  it  arose  and  gradually  recovered. 
Two  days  after,  it  had  another  and  a  final  attack,  which  lasted  for  three  hours. 


Revue  Vitirinuirt,  1876,  p.  67.  •  Ibid.,  p.  70. 


664  PATHOLOGY  OF  PARTURITIOX. 

Tlie  same  writer  alludes  to  another  Cow,  which,  a  few  hours  after  calving,  was  seized 
with  persistent  convulsions  and  great  general  weakness,  which  rendered  standing  im- 
possible—presenting, in  fact,  all  the  symptoms  of  the  previous  case.  This  attack  con- 
tinued for  three  hours,  and  another  followed  on  the  same  day.  Then  an  interval  of  a 
day  elapsed,  when  the  fits  succeeded  each  other  so  frequently,  and  with  so  much 
intensity,  that  the  animal  died  from  asphyxia. 

These  cases  afford  an  illustration  of  the  usual  symptoms  observed  in 
this  disease  as  affecting  the  Cow.  The  urine  appears  to  have  been 
examined  in  only  one  instance,  and  then  albumin  was  present  during 
the  crisis,  which  lasted  for  three  days ;  but  it  was  not  found  when  con- 
valescence had  set  in. 

In  the  Goat  only  one  case  has  been  reported — that  by  Lafitte.^  The 
animal  had  been  affected  with  metro-peritonitis  following  parturition, 
and  for  which  it  had  been  appropriately  treated.  Two  days  subse- 
quently it  appeared  to  be  agitated  and  restless  ;  all  the  muscles,  and 
particularly  those  of  the  jaws,  were  convulsed  ;  the  eyes  rolled  about ; 
there  was  abundant  salivation,  etc.,  and  the  creature  could  not  stand. 
There  was  only  one  attack,  which  lasted  for  several  hours. 

The  disease  has  been  observed  most  frequently  in  the  Bitch. 

Hertwig,-  who  was  the  first  to  describe  the  malady  as  it  affects  the 
Bitch,  and  Zundel,'^  give  a  similar  account  of  the  symptoms  in  that 
animal.  The  latter  had  never  witnessed  premonitory  signs  of  the 
disease,  though  Hertwig  had.  He  says  that  with  Bitches  which  are 
suclvhng,  and  particularly  those  kept  in  the  house  and  well  fed,  it  is 
not  rare  to  observe  a  state  of  tetanic  rigidity  and  incomplete  paralysis, 
with  the  following  symptoms  :  The  animal  suddenly  commences  to  be 
uneasy  and  anxious  ;  the  ej^es  are  haggard,  sometimes  the  nose  is  a  little 
hot ;  the  respiration  is  very  short  and  quick,  though  pressure  on  the 
chest  or  abdomen  does  not  cause  any  pain.  In  a  short  time — about  a 
quarter  of  an  hour  after  the  difficulty  in  respiration  was  observed — the 
animal  cannot  stand,  but  falls  on  its  side,  and  lies  with  the  limbs 
extended :  even  when  raised  it  cannot  stand.  The  breathing  becomes 
still  quicker — from  60  to  100  per  minute ;  while  the  pulse  is  100, 
small,  hard,  and  irregular.  Consciousness  appears  to  be  retained,  but 
the  animal  refuses  food  and  drink,  and  the  alvine  and  urinary  excretions 
are  suppressed.  The  mammary  glands  are  greatly  engorged,  hot,  and 
abundantly  provided  with  milk,  the  quality  of  which  does  not  appear  to 
be  altered  or  injurious  to  the  young,  which  usually  continue  to  suck  as 
before.  This  state  continues  for  forty-eight  hours,  wlien  death  generally 
occurs  from  apoplexy  and  paralysis ;  though  by  proper  treatment  the 
disease  may  always  be  quickly  cured.  Zundel's  description  is  almost 
the  same,  except  that  he  says  there  are  tonic  convulsions,  with  clonic 
spasms  extending  rapidly  to  the  whole  of  the  body ;  sometimes  there  is 
trismus,  with  grinding  of  the  teeth  ;  constantly  there  is  a  white  foam  at 
the  mouth  and  muscular  tremblings  of  the  jaws  ;  the  breathing  is 
stertorous,  and  sensibiUty  much  diminished.  There  are  cases  in  which 
the  eclampsia  appears  to  be  merely  partial,  affecting  only  the  hind- 
limbs,  for  instance,  and  the  animal  sits,  the  head  being  unaffected,  and 
whines.  The  disease  is  continuous  and  without  intermissions,  the 
attacks  lasting  for  one  or  two  days.  If  no  relief  is  afforded,  the  creature 
dies  from  total  paralysis,  due  to  congestion  of  the  meninges  of  the  brain, 
or  from  asphyxia  after  a  spasm  of  the  glottis. 

^  Revue  Vettrinaire,  1876,  p.  71.  -  Kranhhdlen  dtr  Hunde,  1853. 

■^  Dictiounaire  de  Med.  de  Chir.  et  d'Hyjiene  Vetirinaires  ;  article  '  Eclampsie. ' 


ECLAMrsIA.  «>"•• 

Mauri,  in  giving  a  similar  description  of  the  syaiptonis  in  the  several 
cases  he  observed,  lays  stress  on  the  dillicult  respiration,  which  is  very 
quick,  irregular,  noisy,  and  spasmodic,  the  ribs  being  fixed  in  their 
movements,  as  in  the  horse  affected  with  tetanus.  The  eyes  were 
deviated  to  the  left  in  one  of  his  cases,  and  the  limbs  were  convulsed 
as  if  the  animal  were  receiving  a  succession  of  electric  shocks. 

There  may  be  only  one  attack,  lasting  for  a  more  or  less  considerable 
period,  or  there  may  be  several  following  each  other  at  longer  or  shorter 
intervals.  Lafitte  saw  a  Bitch  which  had  given  birth  to  two  Puppies, 
two  days  previously,  and  which  it  was  suckling ;  it  had  an  attack  of 
eclampsia  that  continued  for  a  day,  another  of  shorter  duration  on  the 
following  day,  and  a  last  and  slight  one  the  next  day.  The  Bitch  re- 
covered, but' some  days  afterwards  the  Puppies  had  a  similar  convulsive 
seizure,  less  intense,  and  shorter  in  duration.  One  had  three  attacks 
on  the  first  and  second  days,  and  died ;  the  other  had  only  two  in  one 
day,  and  survived. 

The  same  authority  mentions  a  Bitch  that,  four  days  after  parturition, 
had  clonic  convulsions  of  all  the  muscles,  especially  those  of  the  jaws ; 
there  was  much  salivation,  respiration  was  ditticult,  etc.  There  were 
no  convulsions  during  the  night,  but  on  the  following  morning  another 
attack  set  in,  which  continued  until  the  evening,  when  the  animal  died. 

In  some  cases,  as  nmny  as  six  attacks  have  been  noted  in  the  course 
of  a  day. 

With  regard  to  the  Sow,  there  is  some  doubt  whether  the  disease 
described  as  puerperal  collapse  is  not  eclampsia.  Certainly  there  are 
indications  which  belong  to  both  diseases,  but  the  probabilities  are  that 
it  is  the  latter  ;  though  it  has  been  classed  by  Franck  with  the  first- 
named,  which  he  also  erroneously  designated  eclampsia.  It  has  been 
observed  and  reported  upon  by  EUenberger,  Wostendorf  and  Seiler  in 
North  Germany. 

In  the  cases  EUenberger^  had  an  opportunity  of  seeing,  the  animals 
were  attacked  from  three  to  five  days  after  easy  parturition.  The 
appetite  was  partially  or  totally  lost,  the  young  were  neglected,  and  the 
animal  seldom  moved  about  ;  soon  it  persisted  in  lying,  and  there  was 
suppression  of  fteces  and  urine,  with  diminution  or  cessation  of  milk 
secretion.  The  animal  lay  on  its  side,  the  eyes  closed,  and  the  body 
temperature  low  ;  at  times  there  were  feeble  convulsions.  The  respira- 
tion was  irregular,  deep-drawn,  and  moaning  ;  the  pulse  80  to  90  per 
minute  ;  and  there  was  great  loss  of  sensibility.  Nothing  was  observed 
about  the  generative  organs.  After  twenty-four  to  thirty-six  hours 
improvement  took  place,  ficces  were  voided,  and  the  animal  began  to 
pay  attention  to  surrounding  objects  ;  the  temperature  rose;  the  pulse 
and  breathing  became  normal;  the  appetite  and  milk  secretion  returned; 
and  in  from  three  to  five  days  recovery  was  complete.  All  the  Sows 
survived  the  attack.  In  one  case  reported  by  Seiler,-  the  symptoms 
were  more  of  a  convulsive  or  epileptic  nature. 

Etiology  and  rathology. 

With  regard  to  the  etiology  of  the  affection  in  woman,  opinions  differ 

widely,  and  they  are  not  less  conflicting  with  regard  to  animals.     The 

points  of  similarity  in  the  disease  affecting  woman  and  the  animals 

enumerated  will  have  been  noticed.     It  occurs  in  the  Cow  and  Bitch 

'  Maijaiin  for  Thkrheilktinile  und  I'iehzucht,  1860. 
-  Canstatt's  Jahreshtricht,  1862,  p.  48. 


666  PATHOLOGY  OF  PARTURITION. 

during  pregnancy  and  within  a  variable  period  after  parturition,  and  in 
primiparae  as  well  as  in  pluriparse.  The  symptoms  are  very  analogous, 
though  consciousness  does  not  appear  to  be  so  often  in  abeyance  in 
animals  as  in  woman.  Albuminuria  certainly  would  appear  to  mark  a 
distinction,  but  this  condition  also  has  been  noted  in  some  animals, 
while  it  is  not  a  constant  symptom  in  woman  ;  besides,  the  urine  of 
affected  animals  ha«  only  been  casually  tested,  and  the  presence  of 
albumin  in  it  may  be  as  frequent  in  them  as  in  the  human  female. 
The  difference  in  symptoms  may  be  due  more  to  the  higher  organisa- 
tion of  woman  and  the  circumstances  in  which  she  is  placed,  than  to 
any  divergence  in  the  pathology  of  the  malady,  in  the  three  or  four 
species  in  which  it  manifests  itself. 

Scanzoni,  Dubois,  and  some  others,  believed  the  disease  to  be  a 
neurosis  due  to  reflex  irritation  of  the  spinal  nervous  system.  Playfair^ 
quotes  a  number  of  medical  authorities  to  show  that  its  etiology  in 
woman  is  very  doubtful,  though  the  coincident  existence  of  albuminuria 
seems  to  prove  its  dependence  on  the  retention  of  the  elements  of  urine 
in  the  blood.  But  this  theory  has  been  controverted  by  the  fact  that  a 
large  proportion  of  women  had  albuminuria  before  and  during  pregnancy, 
and  yet  had  no  eclampsia  ;  and  also  that  albuminuria  followed  the  con- 
vulsions and  did  not  precede  them,  rendering  it  probable  that  this  was 
induced  by  the  same  cause  that  gave  rise  to  the  nervous  symptoms. 

Traube  and  Eosenstein  ascribed  the  occurrence  of  eclampsia  to  acute 
cerebral  anaemia,  due  to  changes  occurring  in  the  blood  during 
pregnancy. 

Another  authority  (McDonald)  imagined  it  is  caused  by  irritation 
of  the  vaso- motor  centre,  as  the  result  of  an  anaemic  condition  of  the  blood 
produced  by  the  retention  of  effete  matters  which  the  kidneys  had  failed 
to  remove  ;  and  Haultain-  considered  it  to  be  due  primarily  to  renal 
insufficiency ;  this  gives  rise  to  fits,  from  a  poisoned  state  of  the  blood 
causing  general  extreme  arterial  tension  through  contraction  of  the 
peripheral  arterioles. 

With  regard  to  the  etiology  and  pathology  of  the  disorder  in  animals, 
Hertwig,  speaking  of  the  Bitch,  thought  the  disease  might  be  caused 
by  chills,  the  loss  of  offspring,  and  consequent  stagnation  of  milk,  and 
mental  emotion.  Zundel  asserted  that  it  only  occurred  in  Bitches 
while  suckling,  and  only  in  those  of  the  smaller  breeds  had  he  observed 
it,  these  having  been  well  fed  and  being  rather  plethoric.  Mauri  also,  and 
others,  think  plethora  a  favourable  condition  for  the  development  of 
eclampsia,  as  they  never  observed  it  in  lean  animals  ;  but  in  Cows  those 
in  poor  condition  appear  to  be  as  liable  to  it  as  highly-fed  ones.  Clark 
firmly  believes  that  the  primary  cause,  especially  in  post  partum  cases, 
is  reflex  irritation  of  the  uterine  nerve-centres,  basing  this  belief  on  his 
observation  that  the  attacks  in  the  Cow  occur  most  frequently  from  the 
eighth  to  the  twelfth  day  after  calving,  this  being  the  period  at  which 
the  "  second  cleansing  "  appears.  In  all  his  cases  the  weather  was  un- 
favourable, being  cold  and  stormy,  with  east  and  north-east  winds  ;  and 
this,  in  his  estimation,  was  a  potent  factoi' — causing  chill,  which,  acting 
directly  on  the  nerve-centres  of  the  uterus,  produces  reflex  irritation  of 
the  spinal  system,  which  again  induces  albuminuria. 

In  the  only  case  I  met  with  in  the  Bitch,  I  was  inchned  to  attribute 
the  attack  to  excessive  lactation,  the  progeny  being  too  numerous. 

^  Srkvce  of  Midwifery. 

-  Edtnburijh  Afali.idl  Jonnia/. 


ECLA.VI'SfA.  667 

As  in  parturient  collapse,  the  changes  found  after  death  are  far  from 
being  constant  in  the  human  female.  Dupaul  found  cerebral  congestion 
in  very  many  of  the  women  wlio  had  died  suddenly  from  an  attack,  and 
Stoltz  states  he  noted  this  condition  in  all  his  autopsies ;  but  McDonald 
discovered  only  congestion  of  the  meninges,  extreme  anajmia  of  the 
cerebro-spinal  centres,  and  no  evidence  of  oedema. 

Diag)iosis. 

After  the  description  given  of  the  symptoms,  a  diagnosis  of  the  malady 
should  not  be  ditlicult.  The  history  of  the  case,  and  the  pregnant  or 
parturient  condition  of  the  animal,  should  be  of  service  in  distinguishing 
the  malady  from  epilepsy.  Eclampsia  in  Cows  might  be  mistaken  for 
parturient  collapse,  but  it  should  be  remembered  that  the  latter  generally 
occurs  at  and  after  the  third  calving,  rarely  indeed  during  pregnancy, 
and  usually  within  two  days  after  parturition ;  that  it  is  most  common 
in  fat  or  plethoric  animals  ;  that  the  animal  always  falls  down  ;  that 
though  there  may  be  excitement  and  struggling,  there  are  no  convulsions, 
and  coma  rapidly  ensues. 

Prognosis. 

According  to  some  authorities,  eclampsia  in  animals  is  a  veiy  benig- 
nant disease,  but  others  assert  that  when  treatment  is  not  adopted — 
in  the  case  of  Bitches  at  least — death  is  the  ordinary  termination. 
With  the  Cow  it  is  not  a  serious  malady.  Saint-Cyr  gives  three  deaths 
in  eleven  cases,  some  of  which  had  not  been  medically  treated.  Clark 
had  only  two  fatal  cases  during  twenty-five  years'  practice,  and  these 
were  not  treated.  So  that  the  prognosis  should  not  be  unfavourable  if 
proper  treatment  is  timeously  adopted.  There  do  not  appear  to  be  any 
notable  sequela?,  as  a  rule,  though  Clark  mentions  a  case  in  which  the 
animal,  a  Cow,  lay  for  a  month  after  the  convulsions  disappeared,  and 
became  permanently  blind. 

Treat7nc7it. 

Hertwig  reconnnends  the  abstraction  of  blood  from  the  jugular,  the 
quantity  varying  with  the  size  and  condition  of  the  animals  ;  and  he 
asserts  that  frequently  all  the  symptoms  diminish  considerably,  or  even 
disappear,  while  the  blood  is  flowing.  After  the  bleeding,  he  administers 
a  spoonful  of  tea  every  four  or  six  hours,  with  small  doses  of  nitrate  of 
potass.  If  the  bowels  are  constipated,  an  enema  is  to  be  given.  Zundel 
has  been  particularly  successful  with  the  syrup  of  chloroform,  which,  in 
small  and  frequent  doses,  keeps  the  animal  in  a  state  of  semi-anuisthesia ; 
the  cure  being  terminated  by  a  dose  of  laxative  medicine  and  one  or  two 
enemas.  The  syrup  of  ether  produces  the  same  effect  as  the  chloroform, 
though  less  quickly  and  surely. 

Bromide  of  camphor  has  been  favourably  spoken  of,  as  has  chloral 
given  by  the  mouth  and  in  enema.  Clark  lauds  belladonna  as  almost  a 
specific,  in  doses  of  from  two  to  three  drachms,  repeated  in  two  or  three 
hours,  if  necessary  ;  he  finds  the  glycerol  of  belladonna  (equal  parts  of 
glycerine  and  belladonna)  a  most  convenient  preparation,  as  it  is  easily 
dispensed  and  readily  miscible  with  water.  He  believes  bleeding  may 
be  of  service  in  the  more  urgent  cases  when  belladonna  fails  to  arrest 
the  attack,  though  he  is  not  much  in  favour  of  it. 


668  PATHOLOGY  OF  PARTURITION. 

CHAPTEE  VII. 
Epilepsia  Uterina.— Mania  Puerperalis. 

A  PECULIAR  nervous  affection,  to  which  the  designation  of  "  Epilepsia 
Uterina  ''  has  been  given  by  Storrar,^  might  be  classed  with  the  disease 
which,  in  the  previous  chapter,  has  been  named  "Eclampsia,"  did  it 
not  differ  somewhat  from  it,  and  rather  resemble  epilepsy,  or  what 
Harms  has  called  "  Mania  puerperalis."  Until  its  exact  pathology 
is  better  defined,  it  will  be  convenient  to  retain  Storrar's  designation. 

?iym]}toms. 

The  disease  appears  to  affect  the  Cow  only,"  and  is  marked  by  great 
agitation,  sometimes  fury.  We  cannot  do  better  than  give  the  symptoms 
in  two  cases,  and  then  refer  to  Storrar's  and  Harms'  evidence. 

Rolls-  was  sent  for  in  great  haste  to  see  a  Cow,  five  years  old,  which  had  calved  a 
fortniijht  previously,  and  had  eaten  the  placenta.  For  two  days  before  he  was  called  in 
the  animal  had  not  been  well,  and  its  Calf  had  been  removed  the  previous  night.  It  had 
a  wild,  excited  expression  ;  eyes  staring  ;  ears  warm  ;  pulse  full,  rather  strong  and 
quick  ;  jaws  continually  moving,  as  if  in  the  act  of  biting  ;  foaming  at  the  mouth  ;  the 
under  part  of  the  tongue  purple  and  livid-looking.  The  movement  of  the  jaws  could 
not  be  stopped  by  holding  them  together,  and  when  the  animal  was  left  to  itself  it  was 
continually  biting  at  its  fore-legs,  though  without  making  a  wound  ;  when  interrupted 
it  gnawed  the  manger,  woodwork  of  the  ttall,  or  anything  presented  to  it.  If  hay  was 
offered  it  would  seize  it,  masticate  it  with  the  continuous  and  violent  movement  referred 
to,  and  swallow  it.  It  took  some  bran  mash  and  chilled  water,  and  though  it  partook  of 
nothing  else,  it  looked  full,  and  there  was  the  peculiar  sour  odour  often  met  with  in  Cows 
suffering  gastric  derangement,  and  especially  when  it  occurs  soon  after  parturition. 
Blood  was  abstracted,  and  belladonna  and  linseed-oil  administered.  In  about  three  hours 
afterwards,  the  convulsive  movements  ceased  and  the  Cow  appeared  to  be  much  better. 
Next  day  the  excited  expression  was  still  apparent.  Under  further  treatment  it 
recovered. 

Thirteen  months  afterwards  it  calved  again,  and  when  a  fortnight  old  the  Calf  was 
removed  from  it.  Next  morning  it  was  found  to  be  suffering  from  a  similar  attack, 
the  jaws  moving  in  the  same  convulsive  manner,  but  not  so  violently.  Rolls  noted 
that  the  Cow  looked  wild  and  excited  ;  the  pupils  of  the  eyes  were  normal ;  ears  warm  ; 
pulse  eighty  per  minute,  and  full  and  strong  ;  foaming  at  the  mouth  ;  under  part  of 
tongue  livid  ;  grinding  the  teeth  occasionally  ;  the  fore-legs  were  wet  and  covered  with 
saliva,  from  gnawing  them.  The  animal  was  again  bled  and  had  opiates,  and  recovery 
soon  took  place. 

Robellet'*  gives  a  similar  instance,  in  which  the  symptoms  closely  resembled  those  of 
rabies.  The  Cow — four  years  old — calved  four  days  previously,  parturition  being  normal. 
On  the  day  on  which  Robellet  was  sent  for,  it  had  refused  to  eat  at  pasture,  left  its  com- 
panions, and  constantly  licked  its  fore-legs.  In  the  evening  it  was  restless,  and  bit 
everj'thing  about  it.  Robellet  found  that  it  had  bitten  the  manger,  rack,  and  food, 
allowing  the  latter  to  fall  from  its  mouth  without  masticating  it  ;  it  also  seized  its  breast 
and  forelegs,  but  without  breaking  the  skin.  The  pulse  was  full  and  sixty  per  minute  ; 
the  eyes,  unnaturally  open,  were  red,  fixed,  and  haggard,  and  the  pupils  dilated  ;  the 
buccal  mucous  membrane  was  slightly  inflamed,  and  a  frothy  saliva  surrounded  the 
borders  of  the  lips  ;  the  respiration  was  normal.  At  times  the  Cow  stretched  out  its 
fore-limbs,  bellowed,  pawed  the  ground  with  the  fore-feet,  and  seemed  to  defy  an  in- 
visible enemy.  The  handle  of  a  stable-fork  being  presented,  the  animal  seized  it  in  a 
frantic  manner  and  bit  it,  shaking  the  head  violently. 

These  s3'mptoms  gave  rise  to  the  suspicion  of  rabies  ;  but  no  evidence  as  to  inocula- 
tion could  be  obtained.  The  Cow  was  separated  from  the  others,  secured  by  a  double 
chain,  and  an  ounce  and  a  half  of  chloral  administered  in  two  doses  in  tea — a  quarter 
of  an  hour  between  each  dose.  Several  minutes  after  the  second  dose,  the  Cow,  which 
had  continued  to  show  the  same  symptoms,  hung  its  head,  and,  without  staggering,  fell 

^   Veterinary  Journal,  vol.  iv.,  p.  53. 

^  Ibid.,  vol.  ii.,  p.  17. 

*  Recueil  de  Medecine  Vtterinaire,  187-1. 


KI'ILKI'SIA   UTKUIXA.  669 

like  an  inert  mass  on  the  tiround,  then  rose  at  once  of  itx  own  accorii.  Ten  ininuteH 
afterwiinU  the  eanie  (K;currence  was  again  noted  —  the  Cow  once  more  falling  and  jumping 
up  ;  it  remained  in  the  excited  condition  already  desciibed.  Next  day  all  the  alarming 
syniptoms  had  subsided  ;  there  was  no  fever  or  excitement — nothing  except  slight  weak- 
ness and  prostration.  It  had  fallen  a  third  time  on  the  previous  day,  then  became 
drowsy,  and  remaintd  lying  for  about  three  hours  ;  after  which  it  arose,  apparently  (piite 
well. 

liobellet's  father  had  seen  two  similar  cases. 

Storrar  relates  tliat,  in  one  of  his  cases,  so  savagely  did  the  Cow  bite 
the  timber  forming  the  front  of  its  stall,  that  with  one  desperate  effort 
it  broke  all  the  incisor  teeth  except  one,  entirely  out  of  its  jaw,  and 
fractured  the  alveolar  processes.  Another  Cow,  some  years  before,  so 
severely  injured  the  lower  jaw  that  the  incisors  could  not  be  employed 
for  some  time ;  though  the  molars  could  be  used  when  the  food  was 
placed  in  the  mouth. 

Giinther'  and  Landel-  have  observed  similar  cases.  They  describe 
the  animals  as  extremely  excited  and  violent,  biting  everything  around 
them — even  people — climbing  into  the  manger,  running  against  the 
wall,  roused  to  fits  of  fury  at  the  slightest  noise,  foaming  at  the  mouth, 
and  sometimes  tossing  the  head  and  bellowing.  The  pulse  is  hard  and 
quick,  but  the  heart's  action  is  weak. 

Cause. 

Rolls  thought  that,  in  the  case  he  describes,  depriving  the  animal  of 
its  Calf  was  the  cause  of  the  attack  ;  Harms  ascribes  the  symptoms  to 
chills,  which  produce  brain  congestion  ;  while  Storrar  looks  upon  the 
malady  as  epileptic,  dyspeptic,  and  uterine.  "The  animal  affected  has 
calved  some  few  days  previously — say  from  four  to  fourteen,  or  even 
more  days ;  she  has  been  heartily  eating  iier  food  ;  giving  milk  very 
largely,  or,  more  correctly,  her  milk  has  been  remarkably  rich,  and 
throwing  up,  when  left  for  a  time,  a  very  heavy  layer  of  cream  ;  and  the 
usual  uterine  lochial  discharge  has  been  suppressed.  Or  the  case  might 
be  thus  stated  :  An  excessive  drain  upon  the  system  by  the  mammary 
glands,  causing,  perhaps,  the  suppression  of  the  uterine  cleansing,  with 
the  peculiar  smell  about  the  animal,  and  more  marked  in  her  milk, 
which  is  referred  to  by  Mr.  Rolls,  followed  by  a  more  or  less  severely 
developed  attack  of  indigestion.  These  causes  act  upon  the  nervous 
centres,  so  as  to  produce  the  extraordinary  excitement  which  has  been 
described.  The  dyspeptic  signs  are  the  more  prominently  shown  ^such 
as  a  desire  to  eat  anything  unclean  in  jjreference  to  good  food,  or  coarse 
straw  in  preference  to  roots  or  hay.  The  bowels  beconie  torpid,  and 
the  supply  of  milk  nearly  ceases." 

It  is  scarcely  possible  to  believe  that  this  condition  is  due  to  psychical 
inrtuences,  and  it  might  more  correctly  be  attributed  to  cerebral  irrita- 
tion from  some  physical  cause^either  indigestion,  constipation,  or 
deranged  circulation  in  the  brain,  and  related  to  the  parturient  state. 

Treatment. 

If  indigestion  or  constipation  is  present,  purgatives  should  be  admini- 
stered, with  stimulant  or  tonic  medicines,  according  to  the  indications. 
When  there  is  much  fury  or  excitement,  narcotics  in  large  doses  may 
be  given — the  best,  perhaps,  being  chloral  hydrate.  Belladonna  might 
also  be  very  serviceable.     Great  attention  must  be  paid  to  the  diet. 

'   Gthurlxhiilje,  p.  H.t. 

-  Reptrtorlnm  dtr  Thitrheilkumlt,  vol.  viii. 


670  PATHOLOGY  OF  PARTURITION. 

Giinther  abstracted  blood  in  large  quantity,  and  gave  extract  of  stramo- 
nium. He  also,  on  the  supposition  that  the  brain  was  congested, 
applied  strong  stimulants  to  the  back  of  the  head  and  to  the  spine. 


CHAPTEE  YIII. 

Parturient  Laminitis. 

With  the  Mare,^  a  few  days  after  foaling  or  abortion,  there  has  been 
sometimes  observed  an  attack  of  congestion  or  inflammation  of  the  feet, 
which  closely  simulated  the  painful  and  serious  malady  known  as 
"  Laminitis,"  and  appeared  to  be  related  to  the  parturient  state.  The 
disease  does  not  seem  to  be  very  common ;  though  Obich-  asserts  that 
it  and  metritis  are  the  most  frequent  sequelae  of  parturition  in  the  Mare. 
It  appears  to  have  been  first  described  by  Tisserant^  in  1846  ;  since  then 
it  has  been  alluded  to  by  Gloag  and  Smith^  in  England;  Fabry,  Guilmot, 
Lecouturier,  Windelinck,  and  Deneubourg  ^  in  Belgium;  Obich'^  in 
Germany ;  and  Ayrault"  and  others  in  France.  It  has  been  observed 
also  as  a  complication  of  ruptured  vagina. 

Symptoms. 

The  symptoms  of  the  disease  are  those  of  laminitis  occurring  under 
ordinary  conditions.  They  are  suddenly  manifested  on  the  second  or 
third  day  after  foaling  or  abortion,  more  rarely  on  the  fourth  day,  and 
very  seldom  later.  In  a  small  number  of  cases,  inflammation  of  the 
feet  has  been  noticed  either  during  or  immediately  after  parturition. 
Exceptionally,  it  has  taken  place  within  twenty-four  hours  after  the 
contents  of  the  uterus  have  been  expelled.  As  a  rule,  there  has  been 
nothing  remarkable  in  the  case — birth  having  taken  place  naturally ; 
sometimes,  however,  parturition  may  have  been  difficult. 

The  attack  is  either  sudden,  or  only  very  indefinite  premonitory  indi- 
cations are  present.     The  animal  becomes  unusually  restless,  and  moves 

'  It  would  appear  that  Bovine  animals  are  liable  to  a  foot  inflammation  after  parturi- 
tion, as  well  as  Glares.  Roloff  {]\Iittheiiu»gen  aus  de7-  Thierai'ztUclien  Praais  in  Preus- 
zischen  Staate,  I860,  1866,  p.  154)  observed  a  peculiar  inflammation  of  the  feet  of  Cow.«, 
supervening  on  parturition.  Some  days  after  that  event,  the  skin  between  the  claws 
was  observed  to  be  reddened,  swollen,  and  moist,  and  gradually  the  inflammation 
extended  to  the  coronet  and  heels  (Ballen)  ;  the  skin  became  more  tumefied  and  dense, 
and  immediately  above  the  claws  was  uniformly  thick  and  red.  In  some  cases  absce.sses 
formed  at  the  coronet,  the  horn  became  separated,  and  finally  the  whole  claw  was  shed. 
The  inflammation  extended  to  above  and  behind  the  fetlock,  and  the  pain  was  so  great 
that  the  animals  ate  but  little,  and  consequently  they  soon  lost  condition.  The  hind- 
limbs  were  most  frequently  attacked,  first  one,  then  the  other,  one  being  always  more 
affected  than  the  other.  The  Cows  had  onl}'  calved  a  short  time  previously.  Roloff 
supposed  that  the  disease  was  due  to  contact  of  the  skin  about  the  hind-feet,  with  some 
substance  which  had  escaptd  from  the  vulva  after  calving.  He  therefore  insisted  on 
the  utmost  cleanliness  being  observed  ;  had  the  stalls  cleaned  out  and  sprinkled  with 
chloride  of  lime  every  daj',  the  hind-feet  damped  with  chlorine  water,  particularly 
between  the  claws,  and  afterwards  sit  eared  with  oil.  By  these  measures  the  extension 
of  the  disease  was  at  once  checked. 

-    Wochtnschrift  fiir  Thitrheilknnde,  1869,  p.  105. 

^  Journal  des  Veterinairex  du  Midi,  vol.  ix.,  p.  347. 

■*    Veterinarian,  1851,  pp.  14,  258. 

5  Annahs  de  Medecine  Veterinaire,  1860,  1861,  1868. 

''  Op.  cit. 

"  liecueil  de  Midecine  Veterinaire,  1866. 


I'AirrrniHXT  lamimtis.  67i 

its  limbs — the  fore  ones  especially — continually,  wliile  it  exhibits  si^'ns  of 
sutYering.  There  is  fever,  quick  and  hard  pulse,  hurried  respiration,  and 
all  the  other  signs  of  this  most  distressing  foot-inflammation,  the  most 
marked  of  which  at  this  time  is  the  disregard  of  the  progeny.  In  other 
cases  the  attack  is  more  gradual  ;  there  is  loss  of  appetite,  great  thirst, 
depression,  hurried  respiration,  full,  hard,  and  quick  i)ulse,  constipation, 
etc. — premonitory  symptoms  which  may  continue  for  two,  three,  or  four 
days.  The  fore  or  hind  feet  may  be  affected.  Tisserant  and  Guilmot 
say  the  former,  Deneubourg  the  latter  ;  though  in  some  instances  all  the 
feet  may  be  involved.  The  position  of  the  animal,  if  standing,  indicates 
the  feet  affected,  and  they  are  found  to  be  extremely  hot,  the  plantar 
arteries  throbbing,  and  percussion  of  the  hoof  causes  intense  pain. 
During  the  inflanmiatitm  the  Mare  evinces  the  greatest  agony.  If  all 
the  feet  are  implicated,  standing  may  be  impossible;  the  expression  is 
anxious  and  pinched  ;  the  respiration  is  hurried,  jerking,  and  plaintive, 
and  the  nostrils  widely  dilated  ;  the  skin  is  usually  covered  with  per- 
spiration, and  the  production  of  milk  is  completely  checked.  Indeed, 
the  rapid  disappearance  of  this  secretion  has  attracted  the  attention  of 
nearly  every  observer.  In  the  evening  perhaps,  there  will  be  an  abun- 
dant supply  of  milk,  and  in  the  morning  mulsion  or  suction  will  only 
obtain  a  few  drops  of  a  transparent  or  reddish  tluid,  though  the  mamma3 
may  look  as  full  and  as  well  developed  as  usual.  This  suppression  of  its 
supply  of  food  is  soon  testified  to  by  the  Foal,  which  betrays  its  sensa- 
tions of  hunger  by  becoming  less  timid,  and  making  itself  familiar  with 
those  around  it. 

The  duration  of  the  disease  is  from  four  to  eight  days;  Franck  says 
from  eight  to  fourteen  days.  The  symptoms  are  certainly  most  intense 
between  the  fourth  and  eighth  day.  The  termination  is  generally 
recovery,  if  proper  treatment  has  been  adopted ;  though  in  some  cases 
the  malady  assumes  a  chronic  form,  with  the  accompanying  deformity 
and  disorganisation  of  the  feet.  In  rare  instances,  death  may  ensue 
from  nervous  exhaustion  caused  by  the  excessive  pain;  or  the  intlamma- 
tiun  may  run  on  to  suppuration,  and  a  fatal  result  arise  from  pyjcmia, 
with  purulent  deposits  in  the  lungs,  brain,  or  other  organs. 

A  favourable  or  unfavourable  prognosis  may,  according  to  Guilmot, 
be  gained  from  the  lacteal  secretion.  If  this  returns  in  tlie  course  of  a 
few  days,  it  is  a  good  sign. 

Causes. 

The  cause  or  causes  of  parturient  laminitis  ai-e  imperfectly  known. 
The  prcdisposinij  cause  is  generally  recognised  to  be  the  parturient  state, 
though  there  is  a  wide  divergence  of  opinion  as  to  the  way  in  which  the 
disease  originates.  Tisserant  believed  that  it  is  due  to  a  disturbance  in 
the  functional  equilibrium  existing  between  the  various  organs.  After 
parturition,  and  particularly  after  abortion,  there  is  manifestly  a  dis- 
turbance of  this  kind  ;  there  is,  as  Kainard  correctly  states,  a  general 
superabundance  of  blood,  and  consequently  a  tendency  to  disease  until 
the  equilibrium  between  production  and  consumption  is  restored. 
Guilmot  thinks  that  the  space  left  by  the  fcctus  must  necessarily  bring 
about  a  series  of  exceptional  phenomena,  whose  point  of  departure  is 
perhaps  the  superfluous  supply  of  blood  thrown  into  the  circulation 
after  parturition.  Deneubourg  sees  in  this  disease  and  parturient 
collapse  of  the  Cow,  two  different  "  modes  of  expression  "  of  the  same 
disease  ;  and  while  recognising  the  justness  of  the  expression  employed 
by  the  old  hippiatrists,  that  "  the  fever  has  fallen  into  the  feet,"  he  is 


672  PATHOLOGY  OF  PAETUEITIOX. 

inclined  to  think  that  the  morbid  localisation  is  due  to  sudden  suppres- 
sion of  the  lochia.  "  The  larger  animals,"  he  writes,  "are  not  exempt 
after  parturition  from  the  depuratory  process  which  takes  place  on  the 
internal  surface  of  the  woman's  uterus  after  delivery,  and  known  as  the 
lochia ;  and  its  abrupt  suppression  gives  rise  to  a  disturbance — a  fever, 
which  physicians  designate  '  puerperal  fever,'  and  veterinary  surgeons 
'  vitulary  fever.'  The  disease  proper  to  the  Cow  is,  in  our  opinion, 
simple  vitulary  fever,  which,  in  concentrating  itself  on  the  tendinous, 
articular,  and  perhaps  muscular  tissues,  may  become  a  rheumatismal 
vitulary  fever.  That  of  the  Mare,  until  now  unrecognised,  is  evidently 
due  to  the  same  cause ;  we  cannot  deny  it  a  certain  analogy  with  the 
vitulary  fevers  which  are  witnessed  m  the  -Cow,  and  we  propose  to 
designate  it  by  the  name  of  vitulary  laviinitis,  to  distinguish  it  from 
essential  laminitis." 

Bouley  was  of  opinion  that  parturient  laminitis  may  be  allied  to  that 
other  form  which  so  commonly  succeeds  intestinal  congestions  from 
accidental  causes,  or  from  drastic  purgatives  ;  and  that  both  varieties 
may  well  be  the  result  of  a  momentary  paralysis  of  the  vaso-motor 
nerves  of  the  keratogenous  apparatus  of  the  foot,  under  the  influence  of 
a  profoundly  depressing  action. 

The  occasional  causes  are  quite  as  obscure.  Tisserant  asserts  that 
none  of  the  ordinary  causes  of  laminitis  are  special  in  their  operation 
here  ;  while  Deneubourg  adds  that  it  attacks  INIares  without  distinction 
as  to  age,  constitution,  condition,  or  hygienic  circumstances.  Guilmot, 
however,  remarks  that  Mares  which  are  submitted  to  moderate  work, 
and  which  receive  an  allowance  of  food  in  proportion  thereto,  are  not 
attacked ;  while  those  which  are  fed  on  oats  have  always  been  the 
subjects  affected,  so  far  as  he  has  been  able  to  observe. 

There  is  the  same  diversity  of  opinion  with  regard  to  the  influence  of 
parturition  in  the  production  of  parturient  laminitis.  Tisserant  has 
noticed  it  occurring,  in  the  great  majority  of  cases,  in  Mares  which  had 
aborted  at  a  somewhat  advanced  period  of  gestation,  or  whose  delivery 
had  been  laborious  or  very  difficult,  from  the  wrong  position  of  the 
foetus  or  from  some  maternal  obstacle.  Deneubourg,  on  the  contrary, 
has  observed  it  following  parturition  effected  in  the  most  favourable 
conditions,  as  well  as  after  abortion  or  difficult  labour ;  with  Mares 
which  had  expelled  the  foetal  membranes,  as  well  as  with  those  which 
retained  them  ;  but  never  after  a  laborious  parturition  which  required 
manoeuvres  more  or  less  protracted  and  painful ;  though  he  adds  that 
his  brother  had  witnessed  a  case  following  laborious  and  artificial 
delivery.  It  may  be  noted  that  Gloag^  gives  an  instance  in  which  it 
followed  an  abortion  at  three  months. 

Obich  attributes  the  disease  to  the  action  of  cold  upon  the  skin. 

Treatment. 

In  the  treatment  of  this  disease,  the  rules  observed  in  the  ordinary 
attacks  of  laminitis  are  usually  applicable.  In  the  majority  of  cases 
the  treatment  need  not,  and  should  not,  be  heroic.  If  the  fever  runs 
high,  sedatives — as  the  tincture  of  aconite — should  be  given  ;  and  it 
may  even  be  necessary  to  administer  narcotics — as  chloral  or  opium — 
if  the  pain  is  very  great.  Some  authorities  recommend  the  abstraction 
of  blood,  either  generally  or  locally ;  but  many  are  averse  to  this 
treatment. 

••   Veterinarian,  1851,  p.  14. 


I'ARrrniKXT  lamlxitis.  firs 

The  inflamed  feet  should  he  treated  with  the  greatest  care,  and  for 
subduing'  the  inflainination  nothing'  can  equal  cold  applications — either 
cold  water,  cold  poultices,  or  even  ice.  Continuous  irri'^ation  is  to  be 
preferred,  the  water  being  applied  by  means  of  india-rubber  tubing, 
wliich  carries  the  fluid  direct  from  the  water-tap  to  the  foot.  The  latter 
is  thickly  covered  with  pieces  of  thick  flannel  or  tow,  so  as  to  diffuse 
the  water  around  it.  The  shoes  should  be  previously  removed,  and  the 
wall  of  the  hoof  lowered,  so  as  to  allow  the  sole  and  frog  to  sustain  as 
much  of  the  weight  as  possible.  It  is  a  good  plan  to  litter  the  animal 
on  saw-dust  or  peat-moss. 

Warm  applications  should  never,  on  any  account,  be  employed  for 
the  feet. 

When  suppuration  is  apprehended  or  has  set  in,  or  even  when  the 
eftusion  or  exudation  is  serious,  an  outlet  may  be  made  between  the 
sole  and  the  wall,  towards  the  toe  of  the  hoof,  for  the  escape  of  the 
fluid.  Astringent  and  antiseptic  lotions  or  foot-baths  may  be  useful. 
.\t  the  commencement  of  the  disease,  and  sometimes  at  a  later  period, 
when  it  threatens  to  become  chronic,  stimulating  applications — even 
blisters  —  may  be  applied  with  advantage  to  the  limbs  above  the 
fetlocks. 

The  diet  should  be  light,  and  limited  to  mashes,  grass,  a  small  quantity 
of  good  hay,  and  nitrated  water  or  gruel  as  drink.  The  body  should  be 
comfortably,  if  not  warmly,  clothed,  and  friction  to  the  skin  is  often 
beneficial. 

The  Foal  should  be  allowed  to  remain  with  the  Mare,  as  its  frequent 
sucking  is  likely  to  hasten  the  return  of  the  milk,  which  is,  as  has  been 
already  remarked,  a  most  favourable  sign. 

If  constipation  is  present,  laxatives  should  be  administered,  and 
emollient  enemas  are  then,  as  well  as  at  other  times,  most  useful. 


CH.VPTER    TX 
Mammitis  or  Mastitis. 

In  treating  of  pregnancy,  allusion  was  made  to  the  function  of  the 
mamma>,  and  it  was  pointed  out  that  this  function — except  in  rare 
cases,  when  it  may  be  independent  of  pregnancy  or  the  parturient 
period,  and  even  manifest  itself  in  the  male  sex — is,  in  manunals,  peculiar 
to  the  period  of  parturition  and  rearing  of  the  young.  Some  time  before 
the  progeny  is  born,  the  mamma;  begin  to  enlarge  ;  they  become 
pendulous  and  their  density  increases,  while  they  are  more  vascular;  if 
not  marked  bv  dark  pigment,  their  colour  is  observed  to  have  changed, 
and  the  teats  are  considerably  developed.  So  that  at  parturition  the 
glands  have  attained  dimensions  and  ofTer  appearances  very  dift'erent  to 
those  exhibited  a  short  time  previously;  while  the  fluid— the  milk — 
provided  by  Nature  for  the  sustenance  of  the  young  creature  after  birth, 
is  secreted  in  more  or  less  considerable  quantity — generally  in  propor- 
tion to  the  development  of  the  mamma\ 

With  the  exception  of  some  species — such  as  the  Cow  and  Goat, 
sometimes  the  Ewe  and  Ass  (and  also  the  Mare  among  the  Khirgiz),  in 
which  the  secretion  is  maintained  artificially  for  some  time  beyond  its 
natural  duration,  and,  with  the  former  animal  especially,  almost  per- 
manentlv — the  function  is  essentiallv  intermittent :  being  most  active 

43 


674  PATHOLOGY  OF  PARTURITION. 

during  the  parturient  or  puerperal  period,  and  ceasing  when  the  progeny 
no  longer  requires  milk.  It  is  during  this  period  that  the  activity  of  the 
mammae  exercises  so  much  influence  on  the  health  of  parent  and  off- 
spring, and  it  is  also  at  this  time  that  these  glands  are  most  liable  to 
derangements  which  are  more  or  less  serious.  Even  their  normal 
physiological  development,  when  it  occurs  rapidly  and  considerably 
under  certain  conditions,  often  occasions  uneasiness  and  pain.  Their 
temperature  is  increased,  and  they  are  much  more  sensitive  than  usual. 
But  this  disturbance  is  usually  ephemeral,  and  rarely  continues  for  more 
than  a  day  or  two.  It  may  be  relieved  by  "stripping"  the  teats — the 
importance  of  which,  as  a  preventive  of  parturient  collapse  in  deep- 
milkers  and  plethoric  Cows,  has  been  pointed  out — rubbing  the  udder 
with  olive-oil,  or  fomenting  it  with  decoction  of  marsh-mallows.  This 
might  be  termed  the  normal  or  'physiological  engorgement  of  the  mammae ; 
but  there  is  also  a  ijatliological  engorgement  to  which  attention  has 
been  drawn  by  various  writers,  and  particularly  by  Zundel,  and  to  this 
reference  will  now  be  made,  as  it  is  often  the  commencement  of  inflam- 
mation of  these  glands. 

Pathological  Congestion  of  the  Mamm^. 

Hyperaemia  or  congestion  of  the  mammae  is  not  very  uncommon,  and 
all  female  animals  are  liable  to  it ;  though  it  is  most  frequently  observed 
in  the  Cow,  Mare,  Ewe,  and  Bitch,  in  degrees  varying  rather  with  the 
causes  which  determine  than  the  phenomena  that  accompany  it. 

Causes. 

Congestion  of  the  mammae  is  due  to  various  causes :  among  which 
may  be  cited  injuries,  exposure  to  cold  air  or  water,  or  over-repletion — 
the  stings  of  insects  have  also  been  blamed.  There  is  generally  a 
sympathetic  excitement  existing  at  this  time,  either  from  the  animal 
having  been  immediately  or  recently  delivered,  or  even  when  it  is  in 
oestrum.  Most  frequently,  however,  it  occurs  either  when  the  progeny 
cannot  empty  the  glands,  when  it  has  been  removed  from  the  parent,  or 
when  the  latter  has  not  been  milked  at  the  proper  time.  The  tendency 
of  the  mammae  to  become  engorged  when  the  lacteal  secretion  is  not 
removed,  is  often  made  available  with  a  fraudulent  motive  when  dis- 
posing of  Cows  for  milking  purposes.  The  milk  is  not  withdrawn  for 
some  time,  the  glands  become  greatly  distended  and  assume  an  excessive 
development  ("overstocking"),  which  may  impose  upon  the  unwary, 
and  give  rise  to  the  belief  that  the  animal  possesses  extraordinary 
lactiferous  properties.  Franck  is  of  opinion  that  this  congestion  may 
be  due  to  obstruction  of  the  circulation  in  the  posterior  vena  cava, 
towards  the  end  of  pregnancy.  It  may  also  arise  from  obstruction  in 
the  milk-ducts. 

Symptoms. 
When  the  congestion  is  due  to  accumulation  of  milk,  the  symptoms 
are,  of  course,  only  gradually  developed  ;  but  if  arising  from  injury,  then 
they  may  appear  suddenly,  a  certain  part  becoming  all  at  once  swollen, 
hard,  and  tense,  but  without  altogether  losing  its  softness  and  elasticity. 
There  is  neither  redness  nor  great  sensibility ;  the  swelling  is  not 
oedematous,  and  does  not  "pit";  there  is  but  little  fever,  and  the  appe- 
tite is  not  much  affected. 


MA  MM  IT  IS  on  MASTITIS.  675 

An  important  consideration  in  these  affections  of  the  mammtr,  is  that 
relating  to  their  anatomy.  As  was  shown  at  pp.  32-3o,  in  the  Mare, 
Ewe,  and  Goat,  they  are  formed  of  two  perfectly  distinct  glands  placed 
together  in  the  inguinal  region  ;  while  in  the  Cow  they  are  composed  of 
at  least  four  glands  or  "quarters"  in  close  contact,  and  apparently  form- 
ing one  mass  in  the  prepubic  region  ;  and  in  the  Sow,  13itch,  and  Cat, 
they  are  numerous  and  distinct  from  each  other,  and  extend  from  the 
inguinal  to  tlie  thoracic  region.  When  we  know  that  all  the  glands 
may  become  congested  or  inflamed,  or  only  one — or  even  only  a  certain 
number  of  acini  in  each  gland — we  see  at  once  that  morbid  conditions 
may  give  rise  to  very  diverse  symptoms,  due  to  these  anatomical 
peculiarities. 

With  the  Cow,  congestion  may  therefore  be  limited  to  one  gland  or 
"  quarter ";  though  at  the  commencement  the  whole  udder  may  be 
swollen,  and  localisation  only  occur  at  a  later  period.  The  same  is 
obsen-ed  with  the  Bitch  and  all  the  other  animals  with  numerous 
mammye  :  there  is  always  at  first  general  engorgement,  before  it  is 
finally  localised.  The  tumefaction  partakes  somewhat  of  oedema,  from 
its  readiness  to  pit  on  pressure,  and  there  is  often  a  doughy  swelling 
around  the  udder,  which,  in  some  instances,  extends  to  the  other  parts 
of  the  abdomen.  The  latter  symptom  is  most  noticeable  in  Mares,  in 
which,  in  the  course  of  a  few  days,  the  mammary  swelling  altogether 
disappears,  leaving  only  an  cedematous  tumour  towards  the  umbilicus. 

The  secretion  of  milk  is  diminished  ;  at  first  it  may  be  normal  in  con- 
sistence, and  exceptionally  it  may  offer  streaks  of  blood,  which  give  it 
more  or  less  of  a  rose  tint.  When  this  condition  continues,  however, 
its  degree  of  fluidity  is  changed,  and  it  becomes  lumpy  and  clotted, 
being  partially  coagulated  in  the  lactiferous  sinuses  and  canals,  and  the 
coagula  of  casein  are  evacuated  at  the  same  time  as  the  other  portions 
of  the  milk,  which  is  sometimes  nothing  but  pure  viscid,  yellowish 
serum,  having  a  sweet  taste;  sometimes  these  coagula — round  or 
cylindrical  masses — obstruct  the  canals,  and  prevent  the  escape  of  the 
milk.  Fiirstenberg  states  that  he  has  sometimes  found  casts  of  epithe- 
lial cells  in  them,  and  that  about  the  third  or  fourth  day  tlicre  are 
globules  of  colostrum.  This  alteration  in  the  milk  may  be  limited  to 
that  from  the  affected  gland  or  quarter ;  in  the  others  the  secretion  may 
be  healthy,  though  less  abundant. 

This  condition  most  frequently  terminates  by  resolution,  and  very 
often  without  treatment — the  tumefaction  disappearing  in  a  very  brief 
time,  or  in  the  course  of  four  to  eight  days  ;  though  the  milk  may 
remain  less  plentiful  for  some  time,  and  up  to  the  eighth  or  twelfth  day 
may  still  contain  colostrum  corpuscles.  In  other  cases,  the  quantity  of 
milk  remains  less  than  usual ;  and  when  relief  is  not  afforded,  we  may 
have  inflammation  supervening,  and  the  formation  of  one  or  more 
abscesses. 

In  the  great  majority  of  cases,  it  is  probable  that  this  condition 
commences  in,  or  is  limited  to,  the  parenchyma  of  the  gland,  which 
receives  an  inordinate  supply  of  blood.  This  leads  to  a  congested  con- 
dition, and  consequent  diminished  lacteal  secretion,  with  serous  infiltra- 
tion into  the  interlobular  connective  tissue.  According  to  Fiirstenberg,^ 
the  milk  contains  more  particularly  the  solid  elements  of  this  fluid,  and 
also  the  epithelium  yet  undergoing  that  change  which  should  be  com- 
pleted in  the  acini. 

'  Milchdriisen  der  Kiihe. 


676  PATHOLOGY  OF  FAETURITIOK. 

This  condition  has  often  been  confounded  with  inflammation  of  the 
udder,  though  it  must  be  admitted  that  it  sometimes  constitutes  the 
initial  stage  of  mammitis.  It  may  be  distinguished  from  the  latter  by 
the  non-existence  of  general  symptoms,  and  also  locally  by  the  absence 
of  the  peculiar  density  or  hardness,  and  the  extreme  painfulness  and 
sensibility,  which  mark  the  presence  of  the  latter. 

According  to  Franck,  this  mammary  oedema  (or  Floss)  is  peculiar  to 
many  parts  of  the  Bavarian  Alps,  and  he  appears  to  consider  it  as 
inflammation  of  the  skin  and  connective  tissue  of  the  gl&nd  (Entzilndung 
der  Ueberzilge  des  Enters  und  des  Zellgeicehes).  It  always  appears 
some  days,  on  occasions  some  weeks,  before  parturition,  and  the  whole 
udder  is  involved ;  though  one  side  may  be  more  affected  than  the 
other.  The  swelling  sometimes  extends  as  high  as  the  vulva,  and  even 
beyond  it.  Sometimes  the  skin  is  reddened,  tense,  and  shining  {Erythema 
mammilarum)  ;  in  other  instances  it  is  normal.  The  health  is  seldom 
unaffected,  and  this  is  a  characteristic  feature  of  the  disease ;  there  is  also 
rarely  any  pain,  or  alteration  in  the  secretion — colostrum  or  ordinary 
milk  flowing  from  the  teat.  When,  however,  the  connective  tissue  is 
involved,  there  is  swelling  and  "pitting"  on  pressure,  the  skin  is 
reddened,  and  the  finger  indentations  last  for  some  time ;  there  is  also 
more  pain.  This  latter  condition  has  sometimes  been  designated  the 
"  erysipelatous  "  form  of  mastitis;  though  it  must  be  observed  that  the 
secretion  of  milk  is  unaltered  to  any  extent.  It  continues  for  about 
eight  days. 

When  the  skin  is  much  inflamed,  as  in  the  erysipelatous  form,  Franck 
thinks  it  probable  that  a  special  cause — a  kind  of  infection  of  the  skin 
— is  in  operation. 

Treatment. 

This  malady,  in  the  greater  number  of  cases,  does  not  require  any 
special  treatment.  If  the  animal  eats  well  and  is  not  much  incon- 
venienced, the  mammae  should  be  relieved  of  their  contents  either  by 
allowing  the  offspring  to  suck,  milking  by  hand  every  two  hours,  or 
draining  off'  the  fluid  by  the  teat-syphon.  When  the  swelling  is  great 
and  the  skin  tense,  smearing  with  lard,  butter,  or  olive-oil  will  often 
give  relief,  and  aid  in  dispersing  the  tumefaction. 

When  mammitis  is  apprehended,  Ziindel  highly  recommends  in- 
unction with  camphorated  pomade,  which,  he  asserts,  is  almost  specific 
in  its  deobstruent  action.  At  the  same  time  salines,  and  particularly 
bicarbonate  of  soda,  are  to  be  administered  internally  ;  while  a  moderate 
quantity  of  easily-digested  food  is  to  be  given. 

When  the  redness  or  inflammation  of  the  skin  has  a  tendency  to 
become  erysipelatous,  Franck  prescribes  an  ointment  composed  of 
sulphate  of  iron  (one  part)  and  lard  (eight  parts) ;  or  a  hniment  of 
carbolic  acid  (one  part)  and  olive-oil  (thirty  to  forty  parts). 

Inflammation  of  the  Mamm^. 

All  the  domestic  animals  are  liable  to  inflammation  of  the  mammae; 
and  it  is  somewhat  frequent  after  parturition,  though  it  also  appears 
after  abortion.  The  Cow  is  oftenest  attacked,  and  from  the  importance 
of  the  lacteal  secretion  in  this  animal  it  is  always  more  or  less  serious, 
especially  as  it  may  continue  during  the  whole  period  of  lactation  ;  it 
generally  affects  the  best  milk-producers.     It  is  not  so  common  in  the 


MAMMITIS  on  MA  a  Tins.  67^ 

Goat  and  Sheep,  and  is  still  more  rare  in  the  Mare.  It  is  seldom 
witnessed  in  the  Bitch,  Sow,  or  Cat ;  though  when  it  does  occur  in  the 
foinner,  it  is  liable  to  lead  to  the  formation  of  neoplasms  of  different 
characters  in  the  glands. 

Various  kinds  of  inriamniation  of  the  mammary  glands  have  been 
described — such  as  superficial  or  subcutaneous,  and  deej) ;  acute  and 
chronic,  acticc  and  ^^tiisa-c  or  latent,  and  a  rheumatisiiial  form  ;  while 
Saiut-Cyr  gives  a  catarrhal,  a  i)}ilc(jmonous,  and  a  parcnchijmatous 
mamniitis. 

The  catarrJial  form  is — so  far  as  its  symptoms  are  concerned — allied 
to  that  which  we  have  described  as  due  to  congestion,  and  consists  in 
an  inflammation  of  the  mucous  membrane  lining  the  teats  and  lactiferous 
sinuses.  This  inflammation  is  generally  caused  by  the  retention  of 
millc  in  the  gland  ;  this  fluid  becomes  altered  and  coagulated,  and  the 
clots  irritate  tlie  membrane  and  inflame  it,  the  inflammation  extending 
to  the  acini  after  a  time.  In  the  Cow  the  inflammation  usually  com- 
mences in  one  quarter  or  gland,  and  may  remain  limited  to  it ;  or  it 
may  extend  to  the  other  quarter  of  the  same  side,  and  even  to  one  or 
both  of  the  opposite  side — though  this  is  rare — by  an  extension  of  the 
morbid  process  from  the  acini  to  the  interstitial  and  interglandular 
connective  tissue.  When  more  than  one  quarter  is  involved,  then  the 
disease  in  each  varies  in  intensity. 

When  limited  to  the  mucous  membrane,  the  inflammation  induces  a 
kind  of  catarrh  or  special  galactorrhcea  which,  according  to  Gerlach,  is 
not  at  all  uncommon,  and  accounts  for  the  serous  or  watery  milk  some- 
times given  by  Cows  ;  and  the  same  agency  may  lead  to  the  spontaneous 
coagulation  of  the  milk,  without  any  acidity  being  present. 

Sijmjjtonis. 

The  animal  does  not  at  first  appear  to  be  much  affected,  and  the 
swollen  gland  or  glands  are  evidently  not  very  painful,  the  pain  being 
probably  of  a  dull  character.  The  skin  is  tense  and  shining,  though 
perhaps  not  reddened  ;  the  teat  is  greatly  enlarged,  hard,  and  some- 
what sensitive  to  manipulation.  The  swelling  is  rather  ^edematous 
superficially,  but  when  deeper  the  tissue  of  the  gland  is  found  to  be 
somewhat  harder,  and  towards  the  teat  rather  lumpy,  from  the  presence 
of  coagula  of  casein. 

By  mulsion,  a  rose  or  i-ed-tinted  fluid  is  obtained,  which  looks  like 
decomposed  clotted  milk. 

Witli  careful  and  frequent  milking,  and  attention  to  diet  and  hygiene, 
complete  resolution  may  take  place  within  three  or  four  days ;  the 
secretion  gradually  becomes  normal  in  quantity  and  quality,  though  for 
more  days  it  may  contain  numerous  colostrum  and  pus  globules.  If 
neglected,  however,  or  mismanaged  in  treatment,  the  inflammation  may 
become  more  serious,  and  attack  the  milk  vesicles  and  their  parenchyma 
— the  real  glandular  tissues — giving  rise  to  parenchymatous  mammitis; 
or  it  may  remain  localised,  though  increasing  in  intensity.  Then  the 
secretion  of  milk  is  greatly  diminished  in  the  gland,  and  what  is  with- 
drawn by  mulsion  is  altered — containing,  as  it  does,  mucus,  pus,  and 
clots,  all  emitting  a  highly  ammoniacal  odour. 

This  catarrhal  condition  may  continue  for  a  considerable  time,  and  it 
may  happen  that  the  matter  contained  in  the  sinuses  and  ducts,  be- 
coming inspissated,  escapes  from  the  teat  with  difiiculty,  or  not  at  all ; 
so  that,  in  accmnulating  in  these  cavities,  it  forms  deposits — half  milk, 


678  PATHOLOGY  OF  PARTURITION. 

half  pus — which  are  oftentimes  considerable.  "When  they  have  acquired 
a  certain  volume,  these  deposits  break  up  and  escape,  either  through 
the  teats,  or  by  ulceration  of  the  walls  of  the  duct.  When  opened  by 
means  of  the  lancet,  these  "lacteal  abscesses"  discharge  a  large  quantity 
of  foetid  mattei".  Then  the  general  phenomena  disappear,  the  tumefac- 
tion and  sensibility  diminish,  the  suppuration — though  it  may  persist 
for  some  time — gradually  decreases,  and  the  normal  secretion  of  milk  is 
finally  established.  In  other  instances,  all  the  symptoms  disappear 
except  the  clotted  character  of  the  milk,  and  the  tendency  of  this  fluid 
to  coagulate  in  the  ducts  and  sinuses.  There  it  may  form  solid  masses 
or  concretions  of  variable  size — from  a  pea  to  that  of  a  nut — which 
become  dense  as  dried  cheese,  or  hard  almost  as  a  stone.  Tbey  are 
sometimes  cylindrical  in  shape,  at  other  times  elongated,  being  moulded 
by  the  part  in  which  they  are  formed  ;  they  are  usually  movable,  and 
maybe  displaced  in  the  operation  of  milking;  but  they  always  constitute 
a  more  or  less  serious  obstacle  to  the  flow  of  milk.  When  situated  at 
the  lower  end  of  the  teat,  they  almost  entirely  obstruct  the  canal ; 
higher,  they  render  the  flow  of  milk  more  or  less  difficult,  and  in  all 
cases  they  may  give  rise  to  extreme  distention  of  the  gland,  and  lead  to 
the  formation  of  abscesses  or  parenchymatous  inflammation. 

An  infectious  or  contagious  form  of  catarrhal  mammitis  which  has 
been  observed  in  recent  years,  has  been  carefully  studied  by  Nocard.^ 
In  from  fifteen  days  to  a  month  after  a  Cow  has  been  located  in  a  stable 
where  the  disease  prevails,  a  quarter  of  the  udder  is  discovered  to  have 
a  hard  lump  or  induration  in  its  centre.  The  milk  is  as  yet  unaltered 
in  appearance,  but  it  is  diminished  in  quantity,  and  coagulates  so 
rapidly  that  it  cannot  be  kept ;  finally,  it  becomes  serous,  flaky,  of  a 
yellowish  tint,  with  sometimes  an  unpleasant  odour  which  necessitates 
its  being  thrown  away.  If  mixed  with  good  milk  it  rapidly  coagulates 
it.  It  has  an  acid  reaction,  and  contains  a  special  bacillus.  The 
inflammation  is  at  first  limited  to  the  mucous  membrane  of  one  teat, 
but  it  gradually  extends  to  the  interstitial  connective  tissue,  which 
becomes  so  hypertrophied  and  indurated  as  ultimately  to  cause  atrophy 
of  the  adjoining  glandular  acini. 

The  general  health  of  the  animal  does  not  seem  to  be  afl'ected,  though 
it  appears  to  be  more  difficult  to  fatten.  So  long  as  the  disease  is 
limited  to  one  quarter  of  the  udder,  the  Cow  is  still  useful  as  a  milk- 
producer,  though  the  quantity  is  of  course  less  ;  but  when  two  quarters 
are  involved,  then  the  animal  is  not  worth  keeping,  and  should  be  sent 
to  the  butcher. 

The  'plilecjmonous  ma^nmitis  described  by  Saint-Cyr,  is  always  more 
serious  than  the  catarrhal  form.  It  commences  with  several  generally 
very  well-marked  febrile  symptoms  :  the  animal  is  dull,  loses  its  appe- 
tite, and  ceases  to  ruminate  ;  the  temperature  is  elevated,  the  pulse 
becomes  frequent  and  quick,  etc.  These  symptoms  of  general  disturb- 
ance, according  to  some  authorities,  may  manifest  themselves  three  or 
four  days  before  the  local  disorder,  and  occasionally  diminish  consider- 
ably when  the  latter  appears  ;  this  rule,  however,  has  numerous  excep- 
tions. What  is  certain  is,  that  there  are  rigors  and  unmistakable 
indications  of  general  febrile  reaction  at  the  very  commencement  of 
phlegmonous  mammitis. 

In  a  very  brief  period  the  udder  acquires  a  considerable,  sometimes  a 
great  volume — in  the  Cow,  often  reacliing  as  low  as  the  hocks,  or  even 
^  Archives  Vtttrinaire,  1884. 


MAM  Mir  IS  on  MASTITIS.  679 

lower;  the  swelling  is  a?deniatous,  "  pitting"  deeply  on  pressure;  but 
it  is  hot,  intlammatory,  very  painful,  and  extends  beyond  the  gland — 
at  times  towards  the  vulva  and  umbilicus  or  sternum  with  the  Mare 
and  Ewe.  Beneath  the  ojdematory  tumefaction  the  gland  texture  can 
be  felt  hard,  dense,  and  nodulated  in  places  ;  while  the  skin  is  red, 
tense  and  shining,  and  extremely  painful  to  the  touch.  This  painfulness 
causes  the  animal,  at  other  times  quiet  and  docile,  to  be  irritable  and 
fidgety,  and  averse  to  have  the  part  touched,  either  for  examination  or 
milking.  Progression,  or  even  standing,  is  painful,  the  animal  being 
evidently  afraid  of  the  hind-hmbs  coming  in  contact  with  the  gland  ;  so 
that  it  either  stands  or  walks  with  them  wide  apart,  especially  on  the 
affected  side  of  the  gland.  The  creature,  for  the  same  x-eason,  seldom 
if  ever  lies  down  ;  when  it  does  so,  it  is  on  the  side  on  which  the  gland 
is  least  affected.  There  is  often  much  restlessness  and  anxiety,  and 
the  Mare  may  show  symptoms  of  colic.  The  seci-etion  of  milk  suddenly 
ceases,  and  pressure  on  the  teat  only  causes  a  small  quantity  of 
reddish-coloured  grumous  fluid  to  How. 

All  these  symptoms  may  become  aggravated  in  four,  six,  or  eight 
days,  when  the  malady  may  terminate  by  resolution,  suppuration,  gan- 
grene, or  induration,  according  to  circumstances. 

Parenchi/inatoits  via77nnitis,  or  inflammation  of  the  proper  glandular 
and  connective-tissue  structures  of  the  udder,  is  not,  as  a  rule,  so  acute 
in  its  manifestations  as  the  preceding,  nor  yet  does  it  differ  materially 
from  it,  so  far  as  the  general  symptoms  are  concerned.  The  appetite  is 
diminished,  but  not  altogether  suspended  ;  there  is  much  thirst,  and 
rumination  is  irregular  ;  the  physiognomy  betrays  suffering,  though  not 
of  a  very  acute  kind  ;  the  pulse  is  full  and  quick,  respiration  short  and 
hurried,  and  constipation  is  frequently  present,  while  the  urine  is  less 
abundant  and  dark  ;  the  temperature  of  the  body  surface  is  variable, 
and  the  mutHe  hot  and  dry  ;  there  are  rigors,  and  muscular  twitchings 
or  tremblings,  particularly  towards  the  shoulders  and  Hanks.  The 
conjunctivae  are  injected,  the  skin  more  sensitive  than  usual,  and  the 
Cow  manifests  pain  when  the  loins  are  pressed  upon  ;  with  the  Mare 
the  loins  appear  to  be  stiff  and  sore.  There  also  appears  to  be  lame- 
ness of  the  hind-limb  of  tlie  affected  side,  due  to  the  cause  before  men- 
tioned ;  and  when  more  than  one  quarter  is  attacked,  the  Cow  seldom 
lies  down. 

The  swelling  of  the  gland  is  very  hard  and  hot,  but  not  ctdematous, 
as  in  the  other  forms,  while  the  skin  preserves  somewhat  of  its  natural 
hue,  and  is  not  thickened  ;  the  subcutaneous  veins  are  much  distended 
over  the  whole  surface  of  the  gland.  The  intense  hardness  of  the  in- 
flamed mass  is  very  characteristic,  and  is  noted  throughout  the  whole 
mannnio  ;  though  it  is  always  greater  on  one  side  than  another,  and 
sometimes  only  in  one  quarter — most  frequently  a  posterior  one  in  the 
Cow,  both  mammo!  in  the  Mare.  When  the  inflammation  is  intense, 
and  has  commenced  in  a  particular  part  of  the  gland,  it  generally 
spreads  rapidly  until  the  whole  quarter,  frequently  the  whole  of  the 
udder,  is  involved. 

From  the  commencement  the  secretion  of  milk  is  almost,  if  not  quite 
suspended  in  the  diseased  gland,  and  much  dimmished  in  the  others, 
mulsion  only  yielding  a  very  small  quantity  of  a  red  clotted  fluid,  mixed 
with  blood  ;  in  very  acute  cases  almost  blood  alone  may  escape.  In 
other  cases  the  fluid  is  composed  of  transuded  serum,  and  small  pieces 
of  coagulated  casein.     In  a  short  time  this  fluid  becomes  of  a  purulent 


•680  PATHOLOGY  OF  PARTURITION. 

character  ;  at  other  times  it  is  putrescent  and  foetid.  Microscopically, 
it  is  found  to  be  composed  of  particles  of  solidified  casein,  a  few  fat 
globules,  epithelium  from  the  milk  vesicles  and  ducts,  but  more  espe- 
cially pus  and  red  blood-corpuscles  ;  sometimes  bacteria  and  micrococci 
are  noticed  in  considerable  numbers.  When  abscess  forms  and  ulcera- 
tion takes  place,  bundles  of  fibres  of  elastic  tissue  are  often  discovered 
in  this  fluid.  Chemically,  it  contains  little  casein,  milk,  sugar,  or  fat, 
but  much  v^ater  and  albumin. 

The  progress  of  the  disease  is  very  rapid — more  so  than  in  either  of 
the  other  forms  ;  in  twenty-four,  thirty-six,  or  forty-eight  hours — some- 
times even  in  less  than  the  first-named  period — the  disease  has  reached 
its  greatest  intensity.  The  attack  is  generally  very  sudden — the  animal 
being  apparently  quite  well  when  left  for  the  night,  and  perhaps  pre- 
senting all  the  symptoms  described  when  seen  again  next  morning. 
When  it  has  reached  its  culminating  point,  it  may  remain  stationary 
for  two,  three,  or  four  days  before  passing  to  one  of  its  ordinary  termi- 
nations. Towards  the  third  or  fourth  day  the  vicinity  of  the  gland 
becomes  oedematous,  and  this  oedema  may  extend  to  beneath  the  chest 
and  as  high  as  the  vulva — in  the  Mare,  to  the  inside  of  the  thighs  and 
•down  the  hind-legs. 

Course  and  Terminations. 

The  course  and  terminations  of  mammitis  are  matters  of  much  im- 
portance. It  rapidly  passes  through  its  different  phases  until  the 
fourth,  rarely  until  the  sixth  day,  when  it  terminates  either  by  resolu- 
tion— which  seldom  indeed  occurs  without  prompt  treatment ;  atrophy  ; 
induration ;  snpijuration  ;  gangrene;  or  even  the  death  of  the  animal. 

Eesolution  is,  of  course,  by  far  the  most  favourable  termination.  In 
the  parenchymatous  form  it  can  rarely  be  rendered  complete,  even  by 
the  most  rational  and  vigorous  treatment,  after  the  second  or  third 
day  ;  in  the  phlegmonous  form  it  may  occur  so  late  as  the  fourth  to  the 
sixth  day,  but  seldom  after  the  eighth.  It  is  marked  by  a  gradual 
diminution  in  the  intensity  of  the  symptoms — general  and  local,  and 
particularly  in  the  pain,  which  first  disappears,  then  the  tumefaction 
and  induration. 

Saint- Cyr  lays  much  stress  on  the  decrease  in  density,  with  regard 
to  prognosis.  If  it  persists  beyond  the  time  stated  above — if  after 
forty-eight  hours  in  parenchymatous  mammitis,  or  six  days  in  the 
phlegmonous  form,  the  gland  has  not,  to  any  marked  extent,  lost  some- 
thing of  its  woody  hardness,  there  is  great  reason  to  fear  that  resolution 
will  not  be  complete,  and  that  some  portions  will  remain  indurated,  or 
that  the  mass  will  become  either  partially  or  totally  atrophied. 

Though  the  subsidence  of  the  fever  and  decrease  of  the  swelling  are 
in  themselves  favourable  signs,  yet  they  may  be  deceptive  with  regard 
to  thorough  resolution  ;  and  it  must  be  recognised  as  more  favourable 
when  the  tissue  of  the  gland  resumes  its  softness  and  suppleness,  rather 
than  when  the  swelling  subsides  rapidly  and  the  hardness  remains  but 
little  altered. 

It  is  scarcely  necessary  to  mention  that  the  return  of  the  normal 
secretion  to  the  affected  gland  is  a  most  favourable  sign,  though  this 
does  not  occur  very  rapidly.  For  several  days^ — from  ten  to  twenty,  or 
even  more — the  fluid  obtained  from  the  teat  of  the  affected  quarter  re- 
mains watery,  or  rather  serous  and  curdled  ;  it  contains  numerous  colo- 
strum cells,  and  is  more  albuminous  than  caseous — coagulating  readily 


MA  MM  IT  IS  nil  MASTITIS.  681 

by  heat,  and  having  little  cream  or  sugar.  But  it  gradually  recovers 
its  usual  composition  and  increases  in  quantity,  imtil  at  last,  in  amount 
and  quality,  it  does  not  differ  from  that  furnished  by  the  other  quarters 
of  the  mamniic.  It  sometimes  happens,  however,  that  with  regard  to 
the  lacteal  secretion,  though  the  gland  regains  its  normal  si/e  and  soft- 
ness, it  does  not  acquire  its  full  functional  activity  until  the  next 
pregnancy  and  tiie  next  period  of  lactation.  Complete  recovery  appears 
to  take  place  during  the  period  when  the  Cow  is  "  dry." 

With  the  Cow,  it  generally  requires  four  to  five  weeks  before  resolu- 
tion is  complete  ;  with  the  Goat  the  period  is  less,  and  it  is  still  less 
with  the  Mare. 

Atrophji  of  the  gland  occurs  generally  when  resolution  is  not  com- 
plete. All  the  indications  of  that  change  are  present,  though  they  take 
place  more  slowly  ;  but  the  lacteal  secretion  does  not  return — recovery 
is  not  perfect. 

The  glandular  acini,  obliterated  by  the  proliferation  of  the  interstitial 
connective  tissue  or  the  inflammatory  exudation  which  took  place  in 
their  interior,  are  no  longer  capable  of  performing  their  function ;  and  in 
proportion  as  these  products  of  inflammation  are  absorbed  after  its  sub- 
sidence, so  does  the  diseased  gland  diminish  in  volume,  and  the  mammic 
become  deformed  and  asymmetrical ;  the  teat  retracts  and  assumes  an 
abnormal  direction,  and  little,  if  any,  milk  can  be  obtained  from  it. 
On  manipulation,  instead  of  the  gland  structure,  nothing  can  be  felt 
but  a  very  firm,  dense  mass,  which  feels  like  indurated  connective 
tissue,  having  in  its  texture  some  isolated  nodules  that  appear  to  be, 
and  really  are,  lobules  of  the  gland  which  have  remained  intact,  and 
yet  secrete  the  little  milk  that  is  yielded.  The  loss  of  a  quarter  of  the 
mammic  in  Milch  Cows  is,  of  course,  a  somewhat  serious  termination, 
so  far  as  the  yield  of  milk  is  concerned,  as  this  is  materially  diminished. 
Nevertheless,  the  other  quarters  sometimes  partially  compensate,  by 
their  increased  activity,  for  the  injury,  and  the  animal  is  otherwise  in 
good  health. 

Induration  is  not  at  all  an  uncommon  termination  of  mammitis, 
especially  in  the  Cow  and  Bitch,  and  is  often  the  point  of  departure,  in 
the  latter  animal,  of  various  and  serious  degenerations  of  the  gland 
tissue. 

This  termination  is  to  be  apprehended,  in  the  Cow,  when  the  inflam- 
mation persists  in  a  somewhat  acute  manner  beyond  the  sixth  or  eighth 
day.  Then  the  general  symptoms  diminish,  the  animal  suffers  less 
pain,  the  appetite  returns,  as  well  as  rumination,  if  any  oedema  was 
present  it  has  disappeared,  but  yet  the  gland  does  not  regain  its 
healthy  character.  The  inflammation  has  gone,  the  morbid  products 
are  partly  absorbed,  but  in  different  parts  of  the  substance  of  the 
gland  there  are  more  or  less  voluminous,  well-de6ned,  and  rounded 
masses  which  have  an  almost  stony  hardness,  and  are  apparently 
adherent  to  the  surrounding  tissues.  These  are  evidently  indurated 
lobules  which  have  not  undergone  resolution,  and  their  secretory 
power  is  therefore  lost. 

In  other  instances  in  which  the  inflammation  has  been  very  in- 
tense, recovery  does  not  even  proceed  so  far.  The  febrile  symptoms 
disappear,  and  the  pain  in  the  udder  to  some  extent  diminishes,  as 
well  as  the  swelling ;  though  for  a  long  time  the  local  temperatiire 
is  higher  than  usual,  and  the  animal  evinces  uneasiness  when  it  lies 
down.     The  induration  of  the  swollen  gland,  often  visible  externally, 


682  PATHOLOGY  OF  PARTURITION.       . 

instead  of  diminishing,  appears  to  increase,  owing  to  the  progressive 
organisation  of  the  inflammatory  products,  and  from  the  teat  there 
can  only  be  obtained  a  small  quantity  of  yellowish  turbid  serum,  with 
perhaps  a  few  coagula  of  casein,  epithelium  casts,  and  sometimes  even 
veritable  diphtheritic  false  membranes.  In  such  a  case,  all  the  parts 
of  the  gland  so  altered  are  irrevocably  destroyed,  so  far  as  the  lacteal 
secretion  is  concerned. 

It  is  from  this  indurated  condition  that  those  degenerations  and 
neoplasms  arise  which  are  met  with  in  the  mammse  of  animals,  but 
especially  the  Bitch.  These  are  the  adenomatous,  sarcomatous,  carci- 
nomatous, enchondromatous,  and  fibromatous  growths  which  have 
been  described  so  often  as  found  in  the  mammae  of  this  animal,  but  a 
consideration  of  which  cannot  be  entered  upon  here. 

Supintration — by  which  is  meant  the  formation  of  abscess — is  a 
rather  frequent  termination  of  mammitis,  and  particularly  of  the 
phlegmonous  form.  The  abscesses  may  be  single  or  multiple,  and  vary 
in  size  as  well  as  situation.  Sometimes  they  appear  immediately  be- 
neath the  skin,  and  between  it  and  the  tunic  of  yellow  fibrous  tissue 
covering  the  gland  ;  in  other  cases  they  are  formed  in  the  interstitial 
connective  tissue  separating  the  glands,  or  even  in  the  interlobular 
tissue ;  while,  though  rarely,  they  may  be  found  in  the  connective 
tissue  between  the  mammae  and  the  abdominal  wall 

Suppuration  generally  sets  in  from  the  eighth  to  the  twelfth  day,  and 
is  marked  by  an  increase,  instead  of  a  diminution,  in  the  symptoms — 
augmentation  of  the  fever,  swelling,  and  pain.  If  the  abscess  in  pro- 
cess of  formation  is  superficial,  the  pain  and  redness  appear  to  be 
greatest  at  a  certain  point ;  there  the  skin  is  at  first  of  a  bright  red, 
but  changes  to  a  violet  hue,  and  at  the  same  time  this  part  becomes 
more  prominent  and  circumscribed.  Soon  there  is  fluctuation  and 
the  other  indication  of  abscess,  and  if  not  artificially  opened  this 
takes  place  spontaneously,  and  the  contained  pus  escapes.  Then  the 
febrile  symptoms  diminish,  and  the  general  condition  improves  ;  the 
swelling  in  the  gland  subsides,  along  with  the  pain ;  pus  escapes 
from  the  opening  for  two  or  three  weeks,  and  finally  ceases,  the 
wound  becoming  cicatrised.  Recovery  is  now  complete,  and  nothing 
remains  save  perhaps  a  small  mass  of  indurated  gland  where  the 
abscess  has  been.  This  subcutaneous  or  superficial  abscess  is  not 
generally  very  injurious  or  serious. 

It  is  not  so,  however,  when  the  abscess  is  developed  in  the  inter- 
glandular  connective  tissue,  or  in  that  between  the  mammae  and  the 
abdomen.  Here  the  pus  is  deep-seated,  and  it  burrows  or  spreads 
wherever  the  resistance  is  least  ;  in  this  way  it  leads  to  the  forma- 
tion of  sinuses,  sloughing  of  the  skin  over  a  wide  surface,  isolates 
masses  of  the  glands — thus  destroying  their  relations  with  neighbour- 
ing parts,  and  causing  their  mortification  and  total  destruction.  This 
mammary  suppuration  is  always  serious,  as  under  the  most  favourable 
circumstances  it  generally  ends  in  the  animal  losing  a  large  portion 
of  the  gland ;  while  in  some  cases  it  may  cause  death  from  the 
violence  of  the  inflammation  and  intensity  of  the  pain,  or  through 
exhaustion  from  the  long-continued  aud  profuse  suppuration. 

When  the  abscess  is  situated  in  the  interstitial  or  lobular  connective 
tissue,  the  case  is  no  better,  but  perhaps  worse.  Owing  to  the  nature 
and  disposition  of  the  tissues,  which  resist  distention,  the  pain  pro- 
duced by  the  inflammation  is  most  acute  and  distracting;  while  the 


MAMMITIS  OR  MASTITIS.  683 

process  of  suppuration  destroys  a  greater  or  less  number  of  the  acini, 
and  the  pus — deep-seated  — is  long  before  it  reaches  the  surface  of  the 
gland,  causing  great  havoc  in  doing  so.  Sometimes  the  interstitial 
abscess  opens  into  a  milk  sinus,  and  partly  escapes  by  the  teat  during 
milking.  The  pus  is  then  mixed  with  the  serum  of  the  milk,  and  perhaps 
there  are  clots  of  casein  and  shreds  of  glandular  tissue,  the  fluid  having 
a  highly  amraoniacal  odour.  The  pain  is  less,  but  docs  not  cease, 
and  it  is  generally  necessary  to  make  an  external  opening  for  the 
readier  and  more  complete  evacuation  of  the  matter.  There  is 
generally  much  destruction  of  tissue,  and  cicatrisation  is  diflicult  and 
tedious,  particularly  when  there  are  lacteal  fistulae.  Not  infrequently 
the  abscesses  are  multiple,  and  in  some  instances  there  are  as  many 
as  there  are  intlamed  lobules.  In  other  cases  one  abscess  succeeds 
another,  owing  to  the  presence  of  dead  tissue  in  the  mass  of  the  gland. 

Even  when  the  abscess  opens  externally,  and  the  other  quarters 
yield  milk,  the  pus  is,  of  course,  liable  to  pass  into  that  lluid,  and  to 
render  it  most  objectionable  as  food.  So  that  during  the  whole  of  the 
suppurative  period,  tlie  services  of  the  Cow  as  a  producer  of  milk 
are  lost.  Such  milk  has  usually  a  greyish  tint,  and  often  a  peculiar 
odour — something  similar  to  that  of  pus. 

Filrstenberg  has  drawn  attention  to  a  cold  abscess,  often  observed  in 
the  udder  of  Cows  more  particularly,  and  due  to  the  spontaneous 
softening  of  a  chronic  tumour  or  induration — the  softening  being  the 
result  of  fatty  degeneration.  The  tumour  loses  its  hardness,  and  the 
softening  process  gradually  extends  ;  the  skin  covering  the  mass  be- 
comes pulpy  and  thin,  and  often  the  tumour  opens  spontaneously  and 
externally,  a  thick,  yellowish  kind  of  pus  escaping  ;  or  it  may  evacuate 
its  contents  into  one  of  the  milk  sinuses. 

The  secretory  function  of  one  or  more  quarters  of  the  mammae 
may  be  quite  destroyed — a  serious  result  witli  valuable  Milch  Cows. 

(jaii-jrcnc  of  the  whole  or  a  portion  of  the  udder,  is  not  an  un- 
usual termination  of  mammitis,  and  is,  of  course,  tlie  most  serious 
one,  except  the  death  of  the  annual.  It  may  be  limited  or  ditTused. 
The  first  frecjuently  succeeds  phlegmonous  mammitis,  and  particularly 
when  suppuration  and  diffuse  or  deep-seated  abscess  exists.  In  such  a 
case  the  suppurative  process  has  isolated  a  large  portion — say  a 
quarter — of  the  mammii;  by  the  pus  burrowing  around  it,  and  thus 
cutting  off  its  nutrition — the  bloodvessels  being  the  last  to  give  way 
to  ulceration.  The  dead  gland  is  encapsuled  by  its  fibrous  covering, 
and  there  it  may  remain  for  some  time  unless  removed  by  a  large 
opening — though  sometimes  the  capsule  gives  way,  and  the  mortified 
mass  is  found  lying  on  the  ground  among  the  feet  of  the  animal. 
In  this  way  Nature  gets  rid  of  tlie  diseased  portion,  and  recovery  be- 
comes possible.  The  gangrene  is  generally  limited  by  a  dense  band 
of  fibrous  tissue.  In  many  cases  surgical  interference  is  necessary 
when  the  mammae  mortify;  and  when  this  is  judicious,  and  the 
animal  is  not  too  weak  or  exhausted,  success  is  complete  ;  though,  of 
course,  the  lacteal  apparatus  is  mutilated  and  greatly  damaged. 

When  diffuse,  gangrene  of  the  mamma;  is  generally  fatal.  All  the 
domestic  animals  appear  to  be  liable  to  gangrenous  mammitis,  but 
more  especially  the  Cow,  Mare,  and  Sheep,  the  latter  being  oftenest 
attacked. 

The  symptoms  are  described  as  extraordinarily  intense  from  the  very 
commencement.     There  is  great  depression  of  strength,  and  the  animal 


684  PATHOLOGY  OF  PARTURITION. 

looks  prostrated  ;  the  appetite  is  lost,  rumination  ceases,  the  heart  beats 
loud  and  frequently,  and  there  is  grinding  of  the  teeth  and  convulsive 
tremors.  At  the  same  time  the  udder  swells  enormously,  the  tumefac- 
tion extending  along  the  abdomen  and  up  the  perinasum.  At  first 
oedematous,  hot,  and  extremely  painful,  the  swelling  soon  becomes 
emphysematous,  cold,  and  insensible ;  the  skin,  which  was  previously 
intensely  red,  assumes  a  violet,  then  a  grey,  leaden,  or  dark  hue,  and 
is  cold  and  clammy — vesicles  containing  a  limpid  or  reddish  serosity 
appearing  on  its  surface ;  the  mammary  gland  can  now  be  readily 
enucleated  by  making  an  incision  through  the  skin. 

The  general  symptoms  become  more  grave  ;  the  animal  appears  to  be 
completely  exhausted,  trembles  continually,  and  the  pulse  becomes  im- 
perceptible ;  at  last  the  creature  falls  extended  on  the  ground  and  dies 
— sometimes  within  ten  or  twelve  hours,  rarely  longer  than  a  few  days, 
after  the  commencement  of  the  attack. 

Death  sometimes  occurs  in  phlegmonous  and  interstitial  suppuration. 
Then  the  intense  pain  continues,  or  becomes  still  more  excruciating ; 
the  animal  is  continually  moaning,  lying  down  and  getting  up  again,  as 
the  recumbent  posture  increases  the  agony,  by  making  pressure  on  the 
mammte;  the  temperature  is  elevated;  attempts  to  milk,  which  cause  the 
utmost  distress,  only  result  in  obtaining  a  few  drops  of  reddish  or  semi- 
purulent  fluid  from  the  teat.  All  food  and  drink  are  refused;  emaciation 
sets  in  rapidly  ;  the  animal  is  indifferent  to  everything  around  it ;  the 
expression  is  haggard  and  anxious  ;  the  conjunctivae  are  livid  ;  the 
respiration  is  quickened  and  often  noisy ;  the  muffle  is  dry  and  some- 
times cracked  ;  the  pulse  is  thready  or  imperceptible,  and  there  are 
constant  tremblings  ;  the  prostration  is  soon  so  extreme  that  the  animal 
falls,  perhaps  turns  its  head  towards  its  shoulder,  and  dies  without  a 
struggle. 

Ewes  are  very  liable  to  mammitis  during  the  "yeaning"  or  lambing 
period,  and  in  very  many  instances  it  assumes  an  almost  epizootic 
prevalence,  and  the  fatal  gangrenous  form.  This  is  more  particularly 
observed  in  large  flocks,  where  gangrenous  mastitis  may  be  said  to  be 
the  rule.  Of  this  there  are  many  instances  to  be  found  in  veterinary 
literature,  and  particularly  those  given  by  Toggia,  Yvart,  D'Arboval, 
Eoche-Lubin,  Lafosse,  Nocard,  and  others.  That  recorded  by  Yvart,  as 
occurring  in  the  Alfort  flock  in  1833,  is  interesting.  Kotelmanni  gives 
a  very  good  description  of  the  disease,  as  he  observed  it.  In  the 
majority  of  cases  he  saw  only  one  half  of  the  udder  affected,  and  gener- 
ally first  around  the  teat,  extending  thence  in  every  direction.  The 
seat  of  the  inflammation  was  in  the  substance  of  the  udder — the  gland 
parenchyma,  the  swelling  being  hard,  and  the  skin  covering  it  light  red; 
the  pain  was  very  great.  Before  the  inflammation  had  reached  its 
culminating  point,  a  thin  serous  fluid  {milcliicasser)  dropped  from  the 
teat,  and  when  the  latter  was  squeezed  curdled  milk,  or  milk  in  firm 
clots  about  the  size  of  a  jpea,  was  obtained.  The  affected  Ewe  kept 
apart  from  its  companions,  did  not  eat,  looked  very  dull,  head  and  ears 
drooping,  back  arched,  hind-limbs  widely  separated,  and  movement 
difficult,  the  hind-leg  tow^ards  the  inflamed  side  of  the  udder  being  most 
slowly  and  cautiously  extended,  as  if  lame  ;  when  both  mammae  were 
afiected,  the  gait  was  markedly  straggling,  and  the  steps  short.  When 
the  Lamb  attempted  to  suck,  the  Ewe  sank  to  the  ground  from  pain,  and 
could  not  rise  again  without  assistance.  Sometimes  in  the  evening  the 
1  ZeitschriJ't  fiir  die  P.  Thierheilkunde  von  Nehd  und  Vix,  1836,  p.  423. 


MAMMITIS  on  MASTITIS.  685 

quarter  yielded  good  milk,  and  in  the  morning  blood  or  reddish-coloured 
serum  would  be  found  dropping  from  the  teat.  In  twenty-four  hours 
from  the  commencement  of  the  disease,  death  not  unfrequently  ensued. 
If,  in  the  first  twelve  hours,  the  malady  did  not  yield  to  antiphlogistic 
treatment,  the  skin  covering  the  part  and  tlie  hard  gland,  hitherto  hot, 
became  cold,  painless  to  the  touch,  and  assumed  a  dark-blue,  glazed 
appearance.  Then  an  u'dematous  swelling  showed  itself  in  front  of  the 
udder,  and  which  soon  extended  to  the  umbilicus  and  sternum,  along 
the  side  of  the  body,  and  down  the  thigh  to  the  hocks.  The  develop- 
ment of  this  a^dema  was  a  sure  sign  that  gangrene  had  commenced  in 
the  mass  of  the  diseased  gland,  and  the  sanious  Huid  which  could  be 
drawn  fron;  the  now  insensitive  teat  was  a  further  proof  of  this  condi- 
tion. When  this  change  took  place,  the  animal  seemed  to  be  much 
easier  ;  it  looked  livelier,  began  to  graze  and  eat,  and  even  to  ruminate. 
But  the  dark-blue  colour  of  the  udder,  and  the  oedema  extending  tliere- 
from,  were  unmistakable  signs  of  approaching  death,  which  usually 
occurred  in  thirty-six  hours,  when  operations  on  the  udder  and  scarifi 
cation  of  the  swelling  did  not  avail. 

This  form  of  mammitis  attacked  young  and  old,  good  and  bad,  among 
the  Ewes,  but  more  particularly  those  of  the  improved  foreign  breeds 
— the  Ewes  that  reared  weakly  Lambs  which  could  not  sutliciently 
empty  the  udder,  and  which  were  well  fed. 

Kotelmann  believed  that  this  insufficient  evacuation  of  the  manmia?, 
mechanical  injury  to  the  teat,  etc.,  was  the  cause. 

Pathological  Anatomi/. 

In  the  majority  of  instances,  the  interlobular  connective  tissue  is  the 
principal  seat  of  the  inflammation,  particularly  when  the  disease  has 
been  neglected.  The  layers  of  this  tissue  enveloping  the  lobules  and 
acini  are  swollen  and  infiltrated,  and  compress,  or  even  efface,  the 
proper  substance  of  the  gland,  as  well  as  the  vessels  of  the  part.  It  is 
this  swelling  and  infiltration  which  cause  tumefaction  of  the  marania^  ; 
though  the  inflammation  of  the  proper  gland-tissue  will  bring  about 
the  same  results.  Retention  of  the  milk  is  caused  by  the  inflam- 
matory infiltration  of  the  connective  tissue  surrounding  the  milk  ducts 
and  canals.  When  inflammation  has  gone  on  to  suppuration,  we  find, 
on  section  of  the  affected  part,  the  gland  tissue  more  or  less  occupied  by 
large  and  small  abscesses,  adjoining  healthy  connective  tissue ;  these 
abscesses  may  be  isolated,  or  communicate  with  each  other  and  form 
one  large  irregular  cavity.  Sometimes  there  is  necrosis  of  the  liga- 
mentous bands  which  form  the  principal  septa  between  the  glands,  and 
in  this  way  are  produced  fistula)  or  secondary  abscesses,  which  may 
open  externally  or  into  the  milk  sinuses.  These  latter  are  generally 
lined  by  a  large  quantity  of  cylindrical  epithelium  :  in  severe  cases 
their  walls  are  thickened  and  of  a  dark  colour ;  their  cavity,  as  well 
as  that  of  the  teat,  being  dilated  with  the  altered  fluid.  The  matter 
in  the  abscesses  varies  exceedingly  in  its  composition.  Along  with 
cylindrical  epithelium  are  blood-corpuscles,  fat-crystals,  fragments  of 
yellow  elastic  tissue,  colostrum  corpuscles,  and  an  extraordinary  quan- 
tity of  micrococci  of  various  shapes. 

The  interlobular  connective  tissue  is  thickened,  dense,  and  like  tendon 
or  cartilage  (sclerosis).  The  gland  tissue  itself  has,  instead  of  a  yellow 
tint,  a  marbled  aspect ;  in  chronic  cases  calcareous  salts  may  even  be 
found  in  the  textures.     So  that  parenchymatous  mammitis  is  not  only 


686  PATHOLOGY  OF  FARTURITIOX. 

an  inflammation  of  the  acini,  but  also  of  the  intervening  connective 
tissue,  involving  the  lymphatic  system  ;  consequently,  there  is  reason  to 
suspect  the  disease  to  be  infectious. 

When  circumscribed  gangrene  has  occurred,  and  elimination  of  the 
diseased  part  is  accomplished,  the  dead  mass  may  weigh  as  much  as 
five  or  six  pounds  in  the  Cow  ;  it  is  somewhat  regularly  oval,  but 
rather  flattened  and  discoid  in  the  Mare  ;  the  colour  is  a  light  or  pale 
yellow,  and  in  consistence  it  is  pulpy  but  not  elastic,  and  the  finger 
cannot  be  easily  passed  into  its  substance  ;  traces  of  its  lobulated 
structure  can  still  be  perceived,  and  if  a  section  be  made  of  it,  all  the 
characters  of  the  mammary  gland  can  be  made  out  in  its  interior. 

In  diffused  gangrene,  however,  the  glandular  tissue  is  deep-red  in 
colour,  softened,  and  filled  with  pulpy  cavities  ;  the  ducts  and  sinuses 
are  distended  or  choked  with  coagulated  milk,  pus  and  serum,  the 
whole  forming  a  diversely-coloured  fluid.  In  the  veins  are  sometimes 
blood-clots,  variable  in  colour  and  consistency  ;  gas  and  foetid  fluids 
escape  from  the  tissue  on  section ;  and  the  oedema  is  found  to  be  due 
to  infiltrations  of  yellow  serum  in  which  are  brown  and  greenish  streaks. 
This  fluid,  examined  microscopically,  has  much  the  appearance  of  that 
found  in  animals  which  have  died  from  septicaemia.  Shreds  of  necrotic 
tissue  are  also  met  with. 

Causes. 

Mammitis  appears  to  be  due  to  the  most  diverse  causes.  Among  the 
principal  predisposing  causes,  the  first  is  lactation — the  disease  appear- 
ing immediately  before  or  soon  after  parturition  ;  and  the  animals  whose 
mammae  are  most  active  at  this  period,  are  those  most  frequently 
attacked.  In  the  great  majority  of  cases  in  the  Cow — in  which  animal 
it  is  most  serious — it  follows  within  a  month  after  parturition.  It  is 
true  that,  in  certain  maladies— as  foot-and-mouth  disease,  cow-pox, 
sheep-pox,  etc. — the  udder  may  be  afi'ected  at  any  time  ;  yet  the  lacta- 
tion period — that  when  the  mammse  are  at  the  height  of  their  function,  is 
the  time  when  this  inflammation  is  generally  met  with.  With  those 
animals  whose  milk  is  only  utilised  to  rear  their  progeny,  sudden 
separation  from  their  young  without  any  precautions  is  often  noted  as 
an  exciting  or  predisposing  cause.  The  great  activity  of  these  glands 
in  the  Cow,  and  the  long  time  during  which  this  activity  is  maintained, 
is,  there  can  be  no  doubt,  one  of  the  chief  reasons  why  this  animal 
so  often  suffers  from  this  affection. 

Mechanical  causes  may  produce  this  inflammation — such  as  con- 
tusions, wounds,^  injuries  in  milking-  or  sucking,  blows  from  the  head 
of  the  young  creature,  etc.  Parenchymatous  inflammation  of  the  gland 
may  also  be  due,  according  to  Franck,  to  a  deep  purulent  wound  in 

^  Gotze  (Sachs.  Jahreshericht,  1867,  p.  92),  quoted  by  Franck,  mentions  an  instance  in 
which  the  posterior  part  of  the  udder  of  a  Cow  became  inflamed,  and  soon  there  was  a 
severe  attack  of  mammitis.  When  the  animal  was  killed,  a  large  abscess  was  found  in 
the  gland,  and  in  it  were  two  common  pins  which  Gotze  thought  might  have  ptnetrated 
there  from  the  rumen. 

-  In  those  countries  where  the  milk  of  Ewes  is  utilised,  like  that  of  Cows,  in  the  pro- 
duction of  cheese — as  at  Roquefort,  where  cheese  bearing  this  name  is  largelj*  manufac- 
tured— mammitis  appears  to  be  very  frequent,  and  has  been  attributed  very  often  to  the 
rough  handling  the  teats  and  udder  receive  in  milking. 

Rnche-Lubin  says  that  he  has  often  witnessed  shepherds  acting  so  violently  in  milking, 
that  the  Ewes  could  scarcely  breathe,  staggered  in  their  hind-limbs,  and  sometimes  fell 
from  the  pain  and  shock. 


MAMMITIS  on  MASTITIS.  (587 

the  canal  of  the  teat,  especially  that  produced  in  dilating  this  channel, 
or  in  the  removal  of  papillomatous  tumours  from  this  part.' 

In  these  cases  infection  may  occur  from  the  wound  itself,  or  through 
micro-organisms  passing  into  the  canals  from  without.  In  support  of 
the  latter  view,  wliich  will  be  referred  to  again,  we  may  mention  that 
Viseur  has  attributed  catarrh  of  the  membrane  lining  the  milk-ducts 
and  sinuses  to  the  too  frequent  employnient  of  the  teat-tube  or  syphon  ; 
this  more  or  less  paralyses  the  sphincter  of  the  teat,  and  through  the 
relaxed  aperture  the  air,  charged  with  germs,  irritates  and  inflames  the 
membrane. 

"  Overstocking  "  of  the  udder  with  milk  has  generally  been  considered 
a  very  likely  cause  in  the  production  of  inflammation.  The  sudden 
removal  of  the  young,  imperfect  milking,  etc.,  have  also  been  blamed. 
Franck,  however,  appears  to  doubt  the  influence  of  mammary  disten- 
tion, and  some  observations  and  experiments  would  tend  to  prove  that 
this  does  not  always  cause  inflammation.  For  instance,  Cows  which 
had  suff^ered  from  mammitis,  and  had  temporarily  lost  the  function  of 
one  or  two  quarters  of  the  mammui,  were  found  at  the  next  lactation 
period  to  have  recovered  the  secretory  power  of  these  glands,  but  the 
excretory  canal  in  the  teat  was  obliterated.  Consequently,  great  dis- 
tention occurred,  and  this  was  not  relieved  by  an  artificial  opening. 
Nevertheless,  no  inflammation  ensued  ;  after  the  third  day  there  was 
a  marked  diminution  in  the  turgescence  of  the  quarters,  and  in  about 
eight  days  they  had  resumed  their  normal  volume.  And  Kehrer  has 
experimentally  shown  that  extreme  distention  may  not  cause  inflamma- 
tion, by  closing  two  teats  of  a  pregnant  Bitch  with  collodion,  and  so 
securely  that  at  birth  the  Puppies  could  not  remove  it.  The  corre- 
sponding glands  were  much  distended  with  milk,  but  no  inflammatory 
action  was  set  up. 

The  influence  of  cold  and  wet,  and  especially  the  former — particularly 
when  animals  rest  with  the  udder  on  the  ground — has  also  been  ascribed 
as  a  cause  of  mammary  inflammation,  but  probably  there  is  some 
exaggeration  in  this  ;  as  Cows  which  are  seldom  housed  sufTer  less, 
perhaps,  from  this  malady  than  those  kept  in  warm  cowsheds.  Cold 
winds  or  draughts  in  cowsheds  have  been  especially  alluded  to  as 
operating  powerfully  in  its  production  ;  and  though  these  and  lying  on 
cold  ground  do  not  produce  the  disorder  so  frequently  as  is  imagined, 
yet  there  can  be  no  doubt  that  while  the  udder  is  very  active,  and  it  is  in 
a  state  of  almost  constant  hypera?mia,  it  will  be  more  susceptil)le  to 
alternations  of  temperature,  particularly  if  the  animal  is  rendered  deli- 
cate by  high  feeding  and  an  artificial  existence. 

Certain  atmospherical  conditions — as  electrical  storms — have  been 
supposed  to  exert  some  influence  also  ;  and  extensive  outbreaks  of 
mammitis  have  certainly  been  observed  to  coincide  with  these  disturb- 
ances— the  udder  being  attacked  with  a  kind  of  phlegmonous  erysipelas. 

'  Noquet  (Recueil  lie  M^il.  Vittrhiaire,  IS.'d)  ftllndos  to  a  Cow  in  which,  in  conBe- 
qnence  of  mainmitJ!*,  for  six  months  the  two  j.)o»torior  quarters  of  the  iKidnr  lost  their 
p<)wer  of  secretin^  milk.  It  afterwards  c  ilved,  and  the  siniineH  of  these  <|iiarterR  were 
tilled  with  milk,  but  none  could  escaj^x.',  owing  to  the  teat  canals  l)eing  closed.  By  means 
of  a  knittini;-needle,  artificial  pasiaces  were  made,  but  these  became  deep  purulent 
fissures.  When  Noquet  first  saw  the  Cow,  three  quarters  of  the  mammte  were  enormously 
swollen  and  gangrenous.  Deep  scarifications  were  made,  and  repeated  dressings  ap[>lied  ; 
while  camphorated  draughts  wtre  administered  internallj-.  The  three  quarters  were 
destroyed,  leaving  only  the  left  anterior  quarter.  Half  a  year  afterwards  all  had  cica- 
trised, and  there  remained  only  a  fistula.  The  animal  waa  in  good  condition,  and  was 
therefore  slaughtered. 


688  PATHOLOGY  OF  rARTURITION. 

Faulty  hygiene  has  been  looked  upon  as  aiding  in  the  development  of 
mammitis  ;  filthy  and  badly  ventilated  dwellings  being  greatly  blamed 
as  tending  to  generate  a  miasma,  which  exerts  a  special  influence  on  the 
udder. 

Plethora  has  been  imagined  to  be,  if  not  an  exciting,  at  least  a  pre- 
disposing cause,  and  so  has  hot  weather.  Bardy  gives  a  description  of 
an  epizooty  of  mammitis  which  was  said  to  be  due  to  the  Cows  con- 
suming ranunculaceous  plants,  which  were  very  abundant  in  the  fields 
where  the  animals  grazed.  The  people  in  the  locality  assured  him 
that  this  always  occurred  when  these  plants  were  most  plentiful  in 
certain  years. 

Mammitis  sometimes  complicates  or  accompanies  vaginitis,  metritis, 
peritonitis,  etc.,  according  to  some  authorities. 

There  is  much  reason  to  believe  that  a  particular  form  of  mammitis 
is  due  to  a  putrid  or  septic  infection,  and  Franck  is  one  of  the  strongest 
supporters  of  this  view.  Indeed,  he  asserts  that  the  majority  of  cases 
of  mammitis  are  of  septic  origin  ;  and  he  has  experimentally  proved  the 
correctness  of  his  statement.  For  instance,  he  has  repeatedly  injected 
into  the  teats  of  healthy  Cows,  pus  from  the  udder  of  those  affected 
with  mammitis,  or  fluid  from  putrid  flesh,  as  well  as  putrid  blood,  and 
within  twenty-four  hours  an  acute  inflammation  of  the  corresponding 
quarters  has  been  observed.  This  inflammation  occurred  in  Cows  whose 
udder  was  in  active  function,  as  well  as  those  which  were  "  dry."  The 
uninjured  epithelium  of  the  milk  sinuses  and  vesicles  is,  therefore,  not 
protective  of  the  gland  like  the  pavement  epithelium  of  the  vagina  ;  for 
it  has  been  shown  that  when  putrid  flesh  or  blood-fluid  was  injected 
into  the  uninjured  vagina  of  Ewes  and  Cows,  no  inflammation  was 
set  up.i 

'  One  of  Franck's  experiments  is  instructive.  A  Cow  which  gave  only  a  small  quantity 
of  milk,  had,  on  February  26,  1875,  a  quantity  of  fresh  pus  from  the" udder  of  another 
Cow  suffering  from  mammitis,  and  diluted  with  ten  times  its  bulk  of  water,  injected 
into  the  te*t  of  the  left  anterior  quarter.  Next  day  this  quarter  had  all  the  appearance 
of  being  affected  with  parenchymatous  inflammation.  The  other  three  quarters  were 
generally  intact.  The  secretion  from  the  diseased  quarter  was  yellow,  creamy,  and  pus- 
like. It  only  contained  pus-globules  in  great  quantity,  and  these  weie  studded  with 
micrococci  ;  there  were  also  some  epithelial  cells,  milk  globules  and  small  masses  of 
coagulated  casein.  On  February  28,  the  inflammation  had  extended  to  the  left  posterior 
quarter. 

In  another  experiment  he  injected  some  putrid  flesh-fluid  into  the  milk-duct  of  a  teat. 
Next  day  this  quarter  of  the  udder  was  affected  with  acute  parenchymatous  inflamma- 
tion ;  the  milk  was  curdled,  purulent,  and  contained  large  numbers  of  pu3  corpuscles  and 
micrococci.     In  a  few  days  the  adjoining  quarter  was  likewise  involved. 

In  the  veterinary  journal  of  the  University  of  Pisa  {Giornale  di  Anatomia,  etc.,  degli 
Anbnali,  1875),  Professor  Rivolta  describes  a  form  of  mammitis  prevailing  among  Sheep 
in  the  neighbourhood  of  Pisa,  towards  the  end  of  winter  and  commencement  of  spring, 
and  to  which  he  has  prefixed  the  designation  of  "  septic."  He  gives  it  this  designation 
because,  when  it  begins  at  a  certain  part  of  the  mammary  gland,  there  is  noted  a  kind 
of  putrefaction  of  the  juices  of  the  skin,  as  well  as  of  the  gland  itself  ;  and  besides,  in 
the  sero-sanguinolent  fluid  in  the  connective  tissue  of  the  gland  are  remarked  a  very 
active  element  in  the  process  of  putrefaction,  in  the  presence  of  micrococci  and  bacteria. 

The  disease  appears  to  be  perfectly  distinct  from  the  gangrenous  mammitis,  and  the 
gangrenous  or  anthracoid  erysipelas,  described  by  various  writers.  It  is  a  local  malady 
which  usually  invades  the  gland,  extending  at  a  certain  rate  of  progress,  and  most 
frequently  proving  fatal.  It  ordinarily  commences  in  the  neighbourhood  of,  or  in  one  of 
the  teats  ;  if  the  latter,  it  offers  a  circumscribed  ojderaatous  tumefaction,  while  the 
surface  of  the  skin  thereon  is  intensely  red.  This  red  patch  rapidly  assumes  a  grey 
colour,  and  finally  becomes  almost  black.  Sometimes  blood  escapes  from  the  affected 
teat.  This  oedematous  swelling  and  discoloration  gradually  extend,  and  in  a  more  or 
less  brief  period  of  time  have  invaded  one-third  or  one-half  of  the  udder — not  even  sparing 
the  tissue  of  the  gland.     The  whole  of  the  affected  part  is  then  tumefied,  doughy,  some- 


.1/./.1/.W77.S'  OR  MASTITIS.  689 

The  structure  of  the  teat  and  arran^'einent  of  the  inilk- sinuses  and 
ducts  in  the  Mare,  Ruminants,  and  Swine,  are,  in  the  opinion  of  Franck, 
favourable  for  the  reception  of  infection  ;  and  this  accounts  for  the 
readiness  with  which  parenchymatous  inflammation  of  the  udder  occurs 
very  early  in  foot-and-mouth  disease,  the  virus  of  this  specific  malady 
finding  its  way  from  the  surface  of  the  gland  into  the  teat.  The  wider 
prevalence  of  mammitis  in  close  sultry  weather  during  summer,  than  in 
cold  winter  weather,  may  be  accounted  for  by  the  readiness  with  which 
organic  matters  putrefy.  By  the  way  of  infection,  those  extensive  out- 
breaks of  mammitis  which  occur  among  flocks  of  sheep  may  also 
be  explained.  Those  cases  of  the  disease  which  follow  abortion,  or 
accompany  metritis  or  vaginitis,  may  also  be  attributed  to  auto-infection, 
instead  of  metastasis;  indeed,  in  Franck's  view  those  maladies  which 
lead  to  the  formation  of  putrid  or  septic  matter — such  as  parturient 
fever,  omphalitis  in  the  progeny,  retention  and  putrefaction  of  the  after- 
birth, etc. — may  all  be  productive  of  mammitis  in  this  way.  Disease  of 
the  progeny  may  also  give  rise  to  it,  the  infection  being  conveyed  to  the 
teat  by  the  young  in  the  act  of  sucking.  The  hands  of  milkers  or  others, 
or  soiled  litter  or  gi'ound  on  which  the  animal  lies,  may  also  be  the 
means  of  conveying  the  infection.  Franck  believes  that  the  column  of 
milk  in  the  sinuses  and  ducts  is  first  tainted,  and  that  this  is  effected 
through  the  milk  at  the  end  of  the  teat — a  drop  or  two  of  which  may 
be  suspended  therefrom.  A  chemical  change  is  thereby  brought  about 
in  the  milk,  and  this  altered  secretion  leads  to  the  inflammation,  wliich 
is  secondary.  An  alteration  in  the  character  of  the  milk  is,  it  will  be 
remembered,  one  of  the  first  symptoms — if  not  the  first — of  mammitis. 
Consequently,  "dry"'  Cows,  or  those  to  which  the  infection  cannot 
obtain  access,  are  not  attacked  by  the  malady  ;  and  "  dry "  Cows 
suffering  from  foot-and-mouth  disease  never  have  parenchymatous 
mammitis. 

In  1SS4,  Nocard  bad  an  opportunity  of  confirming  Franck's  views 
while  investigating  an  enzooty  of  mammitis  that  had  prevailed  among  a 
number  of  Cows  for  six  years.  In  milk  from  the  affected  udders,  he 
constantlj'  found  a  special  micro-organism  which  could  be  readily  culti- 
vated in  milk  and  other  fluids  ;  when  the  twelfth  culture  of  this  germ 
was  injected  into  the  teat  of  a  Cow  or  Goat  the  milk  become  acid  and 
clotted,  and  the  tissue  of  the  gland  after  a  time  was  denser  than  in 
health.     This  injection  had  no  effect  on  the  Bitch. 

what  consistt^nt,  slightly  f)r  not  at  bII  sensitive,  .ind  dark  or  blftck  in  \\\\v.  Tlie  line  oi 
demarcation  between  the  healthy  and  diseaoed  portion  in  perfectly  defined  ;  the  former 
being  of  a  ro'v  colotir,  and  normal  in  nizn  and  consistency.  The  diseased  condition 
spread.**  l>eyond  the  tidder  to  beneath  the  alnlonien,  and  when  an  ulcer  apfiears  on  the 
^land.  di<chart;ini,'  a  f<itid  sanguinolent  fluid,  the  animal  then  becomes  depressed  and 
le\eri^h,  debility  and  emaciation  set  in,  and  the  cr'ature  succumbs  to  an  attack  rif 
septika'mia. 

The  numerous  necroscopical  examinations  made  by  Kivulta  confinn,  in  his  opinion,  the 
distinction  he  has  establi."he<l  lH;tween  this  special  malady  and  erysipelatous  mammitis. 
With  reijard  to  the  causeo,  the  shepherds  affirm  that  the  malady  attacks  those  sheep 
which  are  kept  for  a  long  time  "n  a  thick  bed  of  litter  ;  others,  again,  .i.Hsert  that  it 
appears  when  they  .tre  allowed  to  pasture  in  the  oj>en  air,  and  are  not  confined.  The 
same  uncertainty  prevail-  with  regard  to  its  contagiousne«s.  The  shej>herds  carefully 
isolate  the  affecte<l  animals  :  and  it  would  seem  that,  by  their  doing  so,  the  disease  is 
limited  to  those  first  attacked. 

Rivelta  is  of  opinion  that  this  form  of  mammitis  is  produced  and  maintained  by 
special  micrococci  and  bacteria,  which  penetrate  by  the  teats,  or  at  some  part  of  the  skin 
covering  the  gland. 

44 


690  PATHOLOGY  OF  PARTURITION. 

Several  Italian  authorities,  and  among  them  Brusasco,  Oreste, 
Metaxa,  and  Provizano,  have  drawn  attention  to  a  peculiar  disease  of 
Goats  and  Sheep,  accompanied  by  the  gradual  loss  of  milk.  Often 
lameness  is  observed,  and  within  fourteen  days  the  secretion  of  milk  is 
reduced  to  one-fifth  of  the  usual  quantity.  This  fluid  soon  becomes 
sour.  The  disease  appears  to  be  contagious,  for  it  could  be  produced  by 
injecting  the  milk  from  affected  Sheep  into  the  teats  of  healthy  Sheep 
and  Goats.  All  the  animals  so  experimented  upon  became  affected,  the 
period  of  incubation  being  six,  twelve,  fifteen,  or  twenty  days.  The 
secretion  of  milk  ceases  in  from  eighteen  to  thirty  days. 

In  the  gangrenous  mammitis  of  Sheep  which  Nocard  investigated, 
and  which  w^as  due  to  a  micro-organism,  it  was  found  that  five  drops  of 
the  altered  milk  from  a  diseased  gland,  when  injected  into  the  teat  of  a 
healthy  Sheep,  produced  the  disease  and  caused  death  in  forty-two  hours. 

Tuberculosis  of  the  udder  is  sometimes  a  cause  of  mammitis,  and  in 
all  cases,  when  severe,  it  diminishes  the  secretion  of  milk.  The  mammae 
are  greatly  enlarged,  hard,  and  nodulated,  and  softening  of  the  tubercular 
masses  may  give  rise  to  isolated  or  diffused  abscesses. 

Cojnjjlications. 

With  Euminants,  the  digestive  organs  are  generally  involved  in  the 
disturbance,  and  require  attention.  Inflammation  of  the  joints  (arthritis) 
is  a  frequent  complication  of  mammitis  ;  any  of  the  articulations  may 
become  affected,  but  the  patellar  and  tarsal  aj^pear  to  be  the  most  pre- 
disposed. Septic  infection  and  pyaemia  are  grave  complications,  and 
appear  when  gangrene  or  extensive  suppuration  is  present.  There  are 
also  the  degenerations  and  new  formations  in  the  mammae  which  com- 
plicate the  malady  when  chronic,  or  subsequently. 

Prog7iosis. 

The  prognosis  of  mammitis  is  generally  unfavourable,  unless  the 
inflammation  is  superficial  and  limited,  not  severe,  and  treatment  is 
adopted  early. 

When  the  inflammation,  and  particularly  in  the  Cow,  attacks  the 
whole  of  the  mammas,  it  is  then  most  serious,  and  rarely  indeed  can  a 
favourable  result  be  prognosticated.  When  the  inflammation  is  local- 
ised and  not  likely  to  extend,  and  particularly  when  the  suppuration  is 
superficial,  the  results  may  be  trifling — provided  always  that  judicious 
treatment  is  early  adopted  and  energetically  carried  out.  With  cattle 
and  sheep  at  pasture,  mammitis  is  often  a  most  serious  disease,  from 
the  fact  that  its  existence  is  generally  not  perceived  in  time  to  check  it, 
and  the  causes  which  produced  it  are  perhaps  still  in  operation.  The 
permanent  induration  or  sloughing  away  of  one  or  more  quarters  of  the 
mammae,  is  always  to  be  apprehended  w^hen  the  inflammation  is  inter- 
glandular  or  interstitial,  and  especially  when  it  is  acute.  Gangrene, 
and  even  death,  may  result ;  indeed,  the  gangrenous  termination  of 
mammitis  is  fatal  in  nearly  every  case. 

Treatment. 
_  However  slight  the  attack  or  mild  the  form  of  mammitis  may  be,  in 
view  of  the  serious  consequences  which  it  may  entail,  treatment  should 
be  prompt  and  judicious ;  as  in  two  or  three  days  alterations  may  be 
produced  in  the  secretory  apparatus  of  the  gland  which  medical  skill 
may  be  unable  to  amend. 


M.IMMITIS  on  MASTITIS  691 

When  the  udder  or  quarter  is  simply  engorged  witli  milk,  nothing 
more  has  to  be  done  than  to  thoroughly  remove  this  lluid.  This,  of 
course,  cannot  be  accomplished  at  once,  and  it  may  be  necessary  to 
milk  tlie  animal  several  times  during  the  day — five  or  six  times,  or  even 
every  one  or  two  hours.  When  this  causes  pain,  the  milking  should  be 
gently  performed  ;  and  if  pressure  on  the  teat  causes  so  much  dis- 
turbance that  the  Huid  cannot  be  withdrawn  by  hand,  then  the  teat- 
syphon  (Fig.  221),  well  oiled  should  be  passed  into  the  milk-duct;  should 
it  be  necessary  to  retain  it  there,  then  the  ring-syphon  (Fig.  222)  may  be 
employed,  its  retention  being  effected  by  a  cord  or  tape  passed  through 
the  rings  and  tied  over  the  animal's  loins.  In  all  cases  in  whicli  hand- 
milking  causes  pain,  and  is  likely  to  increase  the  evil  it  is  intended  to 


Fig.  221. 
Tk.vt  svphon. 

avert,  the  teat-syphon  should  be  resorted  to.^  It  may  be  necessary  to 
remove  the  progeny  for  a  day  or  two,  or  allow  it  access  only  to  the 
healthy  quarters,  if  the  animal  is  suckling  ;  and  should  it  be  required  to 
lessen  the  secretion  of  milk  until  the  gland  has  recovered  its  normal 
condition,  this  may  be  effected  by  a  suitable  diet,  and  perhaps  a  dose  of 
laxative  or  purgative  medicine.  Application  of  vinegar  to  the  gland  has 
been  recommended  ;  painting  it  over  several  times  with  a  solution  of 
cocaine  might  be  useful. 

When  the  pain  has  diminished  it  is  generally  advisable  to  allow  the 
progeny  to  withdraw  the  milk. 

Should  the  gland  remain  hard,  tense,  and  painful,  and  the  superficial 


mT    MLLtKS   »(' 


Q 


U 


Fig.  22'-'. 

RlX«  TE.\T-SYrHON. 


veins  be  gorged  witli  blood,  nmch  relief  will  be  afforded  by  bleeding 
from  the  corresponding  mammary  or  "  milk  "  vein,  if  a  Cow. 

The  animal  should  not  be  exposed  to  cold  or  draughts,  and  it  may  be 
advisable  to  cover  the  body  with  a  large  blanket.  If  fever  is  appre- 
hended, enemas  may  be  administered,  in  addition  to  the  exhibition  of 
nitrated  gruel. 

Should  coagula  or  solid  caseous  concretions  have  formed,  they  must 
be  removed.  This  may  be  accomplished  by  moving  the  masses  up  and 
down,  when  possible,  by  careful  and  gentle  pressure.  When  they  can 
be  easily  displaced,  they  may  then  be  pushed  d'own  to  the  end  of  the 

'  Franck  very  properly  drew  attention  to  the  necesK-ity  for  thoroughly  cleansing  these 
syphons  in  boilini,'  water  or  carbolic  »cid  .solntion.  The  danger  of  conveying  infection  Ut 
other  quarters  of  the  mammse,  or  to  the  udder  of  healthy  animal.^,  is  obvious  unless  this 
precaution  is  adopted. 


692  PATHOLOGY  OF  PARTURITION. 

teat,  and  pressed  through.  A  coagulum  or  concretion  as  large  as  a 
nut  has  been  extracted  in  this  manner.  When  it  is  too  voluminous, 
however,  it  may  be  necessary  to  introduce  a  sound  carefully  into  the 
canal,  in  order  to  break  it  up  ;  or  it  may  even  be  required  to  incise  the 
teat,  when  the  mass  is  too  large  and  dense  to  be  got  rid  of  in  this 
way. 

Eetention  of  the  milk  is  sometimes  due  to  atresia  or  obliteration  of 
the  milk  canal  in  the  teat,  and  will  then  demand  an  operation  which 
will  be  referred  to  presently. 

When  phlegmonous  or  parenchymatous  mamraitis  is  present,  the 
treatment  must  be  energetic  and  adopted  early,  in  order  to  prevent 
those  serious  alterations  in  the  gland  which  take  place  so  rapidly. 

In  the  Cow,  bleeding  from  the  corresponding  mammary  vein  has 
been  recommended  by  many  excellent  authorities,  from  the  speedy 
relief  it  gives  to  the  congested  gland  ;  in  the  Mare,  if  bleeding  is  neces- 
sary, the  blood  must  be  abstracted  from  the  jugular,  though  this  can 
rarely  be  productive  of  much  benefit.  Leeches  may  be  most  usefully 
employed,  locally,  for  the  smaller  animals,  and  Bouley  has  even  had 
recourse  to  them  with  great  advantage  in  the  Cow. 

In  inflammation  of  the  gland,  emptying  it  of  its  secretion,  or  removing 
from  it  the  products  of  the  inflammation,  must  be  scrupulously  observed. 
Milking  by  hand  must  be  persisted  in  for  brief  but  frequent  periods, 
even  though  only  a  few  drops  of  serum  be  withdi'awn  each  time.  The 
teat-syphon  may  sometimes  be  usefully  introduced  ;  but  its  employment 
requires  much  circumspection  when  the  inflammation  is  acute.  With 
the  smaller  animals,  as  the  Bitch,  milking  is  not  so  urgent. 

The  general  treatment  must  depend  upon  the  condition  of  the  animal 
and  the  nature  and  degree  of  the  disturbance,  and  must  be,  in  principle, 
that  of  all  inflammation.  The  local  treatment  is  a  matter  of  much 
importance,  and  here  we  find  the  most  diverse  recommendations. 

Zundel,  Baumeister  and  Euefi',  Gillibert,  and  others,  have  lauded  the 
advantages  to  be  obtained  from  the  application  of  collodion,  particularly 
with  small  animals.  With  the  larger  animals,  as  Mares  and  Heifers,  it 
has  been  most  successfully  employed  by  Zundel,  who  adds  a  few  drops 
of  castor-oil  to  the  collodion,  which  is  applied  either  over  the  whole 
gland  or  the  inflamed  quarter  or  quartei's,  commencing  at  the  teat,  the 
orifice  of  which  must  not  be  covered ;  a  second  or  a  third  application 
may  be  made.  The  evaporation  of  the  ether  produces  a  salutary  degree 
of  cold,  while  the  continuous  layer  of  cotton,  closely  adhering  to  the 
surface  of  the  skin,  affords  equable  compression  and  support  by  its  con- 
traction when  the  ether  evaporates. 

Astringent  and  refrigerant  applications  have  always  held  a  high  place 
in  the  treatment  of  mammitis,  and  every  authority  has  his  own  favourite 
application.  In  this  way  we  have  cold  water,  either  alone  or  with  the 
addition  of  ice,  acetate  of  lead,  or  Goulard's  extract ;  clay  tempered 
with  vinegar  or  salt  water  ;  evaporating  lotions  of  various  kinds,  etc. 
These  applications  may  be  usefully  and  safely  employed  when  there  is 
merely  congestion,  or  at  the  commencement  of  slight  inflammation; 
but  when  the  inflammation  has  become  fairly  established,  and  there  is 
exudation,  they  increase  the  tension,  and,  without  allaying  the  pain, 
promote  induration.  So  that,  as  a  rule,  they  are  to  be  avoided  until 
the  inflammation  has  been  greatly  subdued,  when  they  may  be  resorted 
to  with  some  advantage. 

Emollient    applications,    and   especially   when    warm,    afford    more 


MA  MM  IT  IS  on  MASTITIS.  693 

satisfactory  results.  In  this  direction  warm  fomentations  and  poultices 
appear  to  be  most  grateful  to  the  animal,  and  to  dissipate  the  inllainma- 
tion  most  readily.  They  must  not  be  too  hot,  astlie  skin  of  the  udder 
is  so  thin  that  it  is  easily  injured  by  inordinate  heat.  Poultices  of 
linseed-meal,  oatmeal,  marsh-mallows,  dough,  etc.,  covered  witli  olive- 
oil,  laudanum,  opium,  or  extract  of  belladonna,  are  especially  to  be 
reeonunended,  in  preference  to  fomentations  which  retjuire  much  time; 
and  as  they  cannot  be  applied  continually,  the  udder  often  sulVers  from 
the  reaction — the  change  from  heat  to  cold,  though  this  may  to  some 
extent  be  obviated  by  drying  the  parts  well,  and  smearing  them  with 
lard.  An  excellent  poultice  is  furnished  by  spongio  piline,  which,  if 
covered  externally  by  oiled  silk,  and  holes  made  in  it  for  the  teats  to 
pass  through,  makes  an  excellent  and  clean  cataplasm  when  steeped  in 
warm  water  and  applied  to  the  udder.  Williams  recommends  "  spent" 
hops,  which  are  very  light,  contain  much  moisture,  are  soothing,  and  do 
not  irritate  when  they  become  dry.  The  drying  of  a  poultice  can  be 
averted  by  placing  it  in  a  piece  of  waterproof  material  or  oiled  silk. 
Poultices  and  other  applications  of  this  kind  are  best  retained  by  a  wide- 
tailed  bandage,  in  which  are  holes  for  the  teats,  and  which,  passing 
upwards  on  each  side  at  the  flank,  and  back  between  the  thighs,  is 
secured  over  the  loins  and  croup.  This  bandage  is  at  all  times  bene- 
ficial in  relieving  the  pain  and  congestion,  by  the  support  it  affords  the 
swollen  organ.     It  should  therefore  be  adopted  early. 

Lotions  of  belladonna,  opium,  tincture  of  camphor,  poppy-heads,  etc., 
are  convenient  applications,  and  if  warm  do  good  ;  but  to  prove  eflica- 
cious  they  umst  be  applied  frequently,  and  at  the  commencement  of 
the  disease.  A  sponge,  or  rubbing  in  with  the  hand,  is  the  best  means  of 
applying  them.  Fiirstenberg  recommends  continuous  tepid  alkaline 
lotions  a})plied  by  the  hand  for  twenty-four  to  thirty-six  hours  ;  and 
Schaack  asserts  that,  employed  at  the  commencement,  they  have  a 
remarkable  effect — often  arresting  the  inflannnation  in  that  interval,  the 
swelling  disappearing  in  one  or  two  days. 

Kychner  states  that  nothing  can  equal  the  success  resulting  from  the 
employment  of  alkaline  lotions.  The  owners  of  cattle  in  Switzerland 
are  well  aware  of  this,  and  as  soon  as  they  observe  the  slightest  altera- 
tion in  the  milk  of  a  Cow,  they  take  a  handful  of  wood-ashes,  which 
they  moisten  with  milk,  and  making  a  lotion  of  tiie  mixture  rub 
it  on  the  udder.  Rychner  is  of  opinion  that  the  potash  in  the  ashes 
prevents  the  coagulation  of  the  milk  in  the  udder — this  coagulation 
being,  according  to  him,  the  point  of  departure  or  initial  phenomenon  of 
mastitis.  For  this  reason  he  gives  the  following  recipe,  which  lias 
obtained  more  success  than  any  other,  when  applied  before  the 
inflammation  had  attained  its  greatest  intensity  : 

Potass 1  part. 

Water    -         -         -         -         -         -         -  2  parts. 

Olive-oil -^      M 

These  are  to  be  well  mixed,  and  then  four  or  five  parts  more  water 
are  to  be  added.  Often,  after  five  or  six  hours,  during  which  nothing 
could  be  drawn  from  the  teat  except  a  small  quantity  of  thin  curdled 
milk,  there  is  obtained  a  whitish-yellow  fluid,  more  like  pus  than  milk, 
which  is  a  very  favourable  sign. 

Ointments  and  embrocations  of  various  kinds  are  also  employed — as 
those   of   belladonna,    henbane,   moi-phia,    camphor,    laurel,   etc.      In 


694  PATHOLOGY  OF  PARTURITION. 

England,  the  extract  of  belladonna  is  much  used  as  an  application  to  the 
inflamed  gland.  Eychner  recommends  an  ointment  made  with  soft 
soap  and  this  extract ;  Hertwig  gives  his  testimony  in  favour  of  cam- 
phorated pomade  ;  while  some  prefer  simple  lard.  Strong  mercurial 
ointment  has  been  greatly  extolled  as  an  anodyne  and  emollient,  and 
justly  so.  Its  constitutional  effects  should  be  watched,  and  care  must 
be  taken  that  the  progeny  is  not  allowed  to  suck  the  teat. 

Stimulating  applications  should  not  be  employed,  unless  the  disease 
is  in  a  chronic  form,  and  then  their  effect  must  be  noted. 

When  suppuration  appears  to  be  inevitable,  this  process  should  be 
expedited  by  every  means,  so  as  to  concentrate  the  pus  at  one  point,  if 
possible.  The  warm  poultice  or  fomentations  should  be  continued,  and 
it  may  even  be  advantageous  to  apply  mercurial  ointment,  ammoniacal 
liniments,  and  such  other  "  maturatives  "  as  blisters.  The  abscess  is  to 
be  treated  according  to  general  principles  ;  it  should  be  opened  as  soon 
as  fluctuation  can  be  detected,  and  for  this  purpose  the  bistoury  or 
lancet  may  be  employed  ;  though  some  practitioners  prefer  the  actual 
cautery,  which,  they  believe,  does  not  entail  so  much  risk  of  haemorrhage, 
favours  the  exit  of  indurated  parts,  affords  a  better  means  for  the  escape 
of  pus,  and  the  resulting  wound  heals  up  more  readily.  When  opened, 
the  wound  demands  only  ordinary  treatment — cleanliness,  detersive  or 
stimulant  dressings,  carbolic  oil  or  lotion,  etc.  To  prevent  the  opening 
closing  too  early — which  it  may  do  when  the  abscess  has  been  opened 
by  the  bistoury,  it  will  be  necessary  to  introduce  a  small  tent  of  lint  or 
fine  tow. 

Sometimes  several  abscesses  are  developed  simultaneously  or  succes- 
sively in  the  tumour,  and  are  separated  from  each  other  by  thin  septa. 
In  such  a  case,  having  opened  the  largest  abscess,  it  often  happens  that 
the  pus  from  the  others  drains  through  the  opening,  converting  it  into 
a  fistula.  In  such  circumstances,  a  counter-opening  must  be  made ; 
and  if  there  is  any  necrotic  tissue  to  be  found,  it  should  be  removed.  In 
all  operations  on  the  mannnary  glands,  the  incisions  should  be  carefully 
made,  and  no  larger  than  is  absolutely  necessary. 

When  the  abscesses  are  deep-seated  in  the  texture  of  the  gland  or  the 
connective  tissue,  it  frequently  happens  that,  in  opening  them,  one  or 
perhaps  more  of  the  milk-ducts  are  wounded,  and  then  we  may  have 
"  lacteal  fistuUe."  From  these  the  milk  escapes,  and  this  renders  their 
cicatrisation  difficult  and  tedious,  if  the  gland  is  active.  The  treatment 
must  chiefly  consist  in  the  application  of  caustics  to  the  walls  of  the 
fistulae,  in  order  to  hasten  granulation — the  nitrate  of  silver,  chloride  of 
zinc,  tincture  of  iodine,  or  even  the  actual  cautery,  being  generally 
resorted  to.  Sometimes  a  cure  cannot  be  effected  until  the  gland  has 
become  "  dry."  In  some  cases  a  pitch  plaster  or  one  of  marine  glue  is 
useful,  or  the  pressure  of  a  broad  elastic  band  when  the  fistula  is  situ- 
ated at  the  base  of  the  teat. 

The  occurrence  of  gangrene  is  always  serious,  though  of  course  it  is 
not  so  grave  when  limited  as  when  diffuse.  It  generally  leads  to  the 
loss  of  one  or  more  quarters,  or  even  to  the  death  of  the  animal  from 
icorrhaemia  or  septiksemia.  When  limited,  little  can  be  done,  and  in 
some  cases  it  is  best  to  wait  for  the  spontaneous  elimination  of  the  dead 
portion  :  waiting  and  watching  the  process,  supporting  the  strength  of 
the  animal,  accelerating  the  separation  of  the  dead  from  the  living 
tissues,  favouring  the  free  escape  of  pus  and  putrid  matters,  so  as  to 
hinder  their  absorption,  making  counter-openings,  and  applying  anti- 


MAMMITIS  on  MASTITIS.  095 

septic    dressings — as  chloride  of   zinc,  carbolic  acid,  permanganate  of 
potash. 

In  other  cases,  it  may  be  necessary  to  expedite  recovery  by  excision 
of  the  mortified  mass.  In  order  to  do  this,  it  is  sometimes,  but  not 
always,  requisite  to  cast  the  animal,  and  to  fix  it  as  for  castration.  The 
opening  by  which  the  pus  escapes  is  enlarged,  and  the  tissues  still 
adhering  to  the  living  parts  of  the  gland  are  separated  from  it  by  the 
lingers,  keeping  clear  as  nmch  as  possible  of  the  arteries,  which  should 
be  ligatured,  if  injured.  When  the  separation  is  complete,  ligatures  may 
be  placed  round  the  principal  vessels — the  ligature  being  a  piece  of 
narrow  tape  or  ribbon,  as  their  walls  are  fragile  and  easily  torn.  If  any 
hanuorrhage  occurs,  the  actual  cautery  or  perchloridc  of  iron  may  be 
employed  to  subdue  it.  The  wound  is  then  to  be  dressed  with  dis- 
infecting and  stimulating  applications,  until  it  ceases  to  give  oil'  a  bad 
odour,  and  is  throwing  out  liealthy  granulations.  The  animal  must  be 
well  fed,  and  its  strength  sustained  by  stimulants  and  tonics  if  neces- 
sary. 

When  gangrene  threatens  to  become  diffuse,  there  must  be  no  hesita- 
tion in  resorting  to  deep  scarifications,  in  order  to  limit  its  ravages ; 
these  allow  the  escape  of  the  septic  fluids,  which  would  impregnate  the 
healthy  tissues  if  permitted  to  remain  ;  and  the  isolation  of  the  diseased 
parts  may  be  still  further  secured  by  plunging  the  actual  cautery  deeply 
into  them,  and  applying  oil  of  turpentine,  carbolic  acid,  perchloride  of 
h-on,  or  tincture  of  camphor  to  them  and  into  the  wounds.  It  is  often 
advisable  to  trace  a  line  around  the  gangrenous  part,  so  as  to  circum- 
scribe it.  When  it  is  surrovyided  by  a  ring  of  inflammation,  then  emol- 
lient poultices  may  be  applied  to  hasten  its  separation ;  indeed,  if  the 
part  is  quite  dead,  it  may  be  judicious  to  cut  into  and  remove  as  much 
of  it  as  can  be  done — cauterising  the  wound  well  with  the  hot  iron  or 
perchloride  of  iron,  and  afterwards  dressing  it  with  chloride  of  lime, 
carbolic  acid,  and  other  antiseptics.  At  the  same  time,  antiseptic 
medicines,  tonics,  and  stiumlants,  should  be  administered  internally. 
It  might  be  well  wortli  trying  the  injection  of  antiseptic  agents — such 
as  carbolic  acid,  tincture  of  iodine,  etc.,  into  the  gangrenous  tissues,  by 
means  of  deep  incisions  and  a  Prava;^  syringe. 

Induration  following  mastitis  can  rarely  be  remedied,  but  it  may  be 
useful  to  continue  the  inunction  of  ointments  which  contain  prepara- 
tions of  mercury — as  the  iodide,  or  iodine  for  a  certain  time.  Armatage 
recommends  the  following  ointment  to  be  applied  once  a  day,  with  smart 
friction  : 

Soft  soap \  lb. 

Mercurial  ointment  -         -         -         -     1  oz. 

Camphor  ointment    -         -         -         -     4   ,, 

Extract  of  belladonna        -         -         -     4  drams. 

Or  the  following  tincture  : 

Tincture  of  iodine      -         -         -         -     G  oz. 
Tincture  of  opium     -         -         -         -     ^   ,, 
Soap  liniment  -         -         -         -         -     4   ,, 

Frequent  and  gentle  milking  may  also  prove  seniceable,  as  well  as 
dry  friction. 

As  a  preventive  measure  when  infection  is  apprehended — as  in  reten- 
tion of  the  placenta,  metritis  or  vaginitis,  etc. — it  is  advisable  to  inject 


696  PATHOLOGY  OF  PARTURITION. 

a  weak  solution  of  carbolic  acid  (2|  per  cent.)  or  alum  (2  per  cent.),  up 
tlae  teat  by  means  of  a  glass  syringe,  always  after  milking  ;  the  fluid 
should  be  at  a  temperature  of  95^  Fahr.  Franck  has  proved  the  value 
of  this  precaution,  and  also  its  utility  as  a  remedial  measure;  indeed, 
Armatage  had  previously  recommended  the  injection  of  weak  solutions 
of  carbonate  of  soda  or  potash  in  mastitis.  Franck  has  employed  a  ten 
per  cent,  emulsion  of  carbolic  acid  as  an  injection  in  artificially-produced 
mastitis  (sixty  grammes  daily),  and  by  this  means  suppressed  the 
development  of  micrococci  and  bacteria  in  the  milk,  as  well  as  prevented 
curdling  of  that  fluid  in  the  ducts  and  sinuses.  Solutions  of  alum — ten 
per  cent.,  100  grammes  injected  daily — appeared  to  be  also  beneficial  in 
this  direction.  And  Nocard  successfully  treated  the  chronic  catarrhal 
form  of  mammitis  in  which  he  found  a  special  bacillus,  by  injecting  up 
the  teat  of  the  affected  quarter  a  four  per  cent,  tepid  solution  of  boric 
acid ;  this  was  done  after  milking  in  the  evening,  at  intervals  of  eight 
days,  two  or  three  repetitions  being  sufficient.  The  induration  of  the 
gland  gradually  diminished,  the  milk  resumed  its  ordinary  characters, 
and  the  bacillus  disappeared  from  it.  In  order  to  prevent  the  spread  of 
the  disease,  the  person  who  milked  the  cattle,  before  doing  so,  washed 
his  hands  and  the  teats  of  the  animals  with  a  three  per  cent,  solution 
of  carbolic  acid,  the  aflected  cow^s  being  the  last  to  receive  his  attention. 
Their  milk  was  kept  apart  and  given  to  pigs. 

Armatage  reconmiends  that  animals  suffering  from  gangrene  of  the 
mammee  should  be  removed  from  those  which  are  pregnant,  "  as  great 
excitement  will  be  produced  by  the  odour  of  decomposition,''  and  abortion 
is  probable. 


CHAPTEE  X. 
Agalactia. 

"  Agalactia,"  or  absence  of  milk  in  the  mammae,  is  not  uncommon  in 
animals,  particularly  the  Mare  and  Cow,  and  more  especially  in  those 
which  have  not  been  bred  from  for  a  long  time,  or  which  have  brought 
forth  their  first  young,  though  themselves  aged.  This  absence  of  secre- 
tion may  occur  even  when  pregnancy  has  been  normal  and  has  reached 
its  full  limit.  The  udder  is  small  and  soft,  and  attempts  at  milking 
only  result  in  the  production  of  some  drops  of  yellowish  matter,  followed 
sometimes  by  a  few  drops  of  white  watery  fluid.  There  appears  to  be  a 
want  of  development  in  the  lacteal  apparatus,  which  various  causes 
concur  in  producing.  The  principal  of  these  causes  are  :  previous  or 
present  chronic  disease  in  the  mammae  ;  atrophy  of  these  glands  ;  ex- 
haustion following  disease  ;  severe  labour  ;  insufficient  food,  either 
during  or  immediately  after  pregnancy ;  natural  debility,  emaciation, 
etc.  In  some  instances  the  milk  gradually  appears  some  time  after 
parturition,  and  a  tolerable  quantity  is  secreted  ;  but  in  the  majority  of 
cases  it  is  either  not  produced  at  all,  or  only  in  very  small  quantity. 
This  condition  is  very  unfortunate  for  the  progeny,  which  will  suffer 
from  hunger  if  not  observed,  and  must  either  be  artificially  reared,  or 
put  to  another  animal  to  be  suckled. 

The  treatment  of  this  condition  frequently  proves  unsuccessful.  It 
must  chiefly  consist  in  giving  good  food,  particularly  of  a  leguminous 
kind,  with  aniseed  and  fennel,  fennel-seeds,  water  fennel,  ilfe«7?i  mutelli- 
num,  antimonials,  and  other  agents  which  are  likely  to  stimulate  the 


IXJrniES  TO  THE  Th'.lTS.  G97 

secretory  function  of  the  inanimoe.  Great  attention  must  be  paid  to 
the  digestive  organs,  and  tlie  teats  should  be  frequently  stripped  and  the 
niamune  rubbed,  either  dry  or  with  some  stimulating  application. 

Macorps'  records  a  case  in  which  the  udder  was  rubbed  with  brandy, 
friction  applied  to  the  abdomen,  and  warm  milk  and  fennel-seeds  ad- 
ministered ;  in  two  days  the  milk  began  to  appear. 

When  the  absence  of  milk  is  due  to  disease  of  the  gland,  this  must  bo 
combated  according  to  the  indications. 


CHAPTER  XL 
Injuries  to  the  Teats. 

FiSSUKES. 

Thk  chief  injuries  to  the  teats  consist  of  wounds,  in  the  form  of  fissures 
or  "  cracks,"  which  are  most  frequently  witnessed  in  the  Cow  a  few  days 
after  parturition  ;  and  though  apparently  unimportant,  they  nevertheless 
may  become  very  troublesome  and  serious  if  neglected,  and  even  lead 
to  mastitis  and  icorrhaimia  or  septicicmia  ;  while  they  render  the  animal 
fidgety  and  averse  to  being  milked  or  suckled — the  latter  being  especially 
inconvenient,  particularly  in  the  case  of  the  Foal. 

Causes. 

These  injuries  are  generally  produced  by  the  powerful  traction  of  the 
young  creature  on  the  teat  while  sucking,  and  mainly  when  the  teat  is 
empty,  the  milk  scanty,  and  the  skin  very  thin  and  line — as  in  primi- 
paru>.  Even  when  the  milk  is  abundant  but  the  skin  thin,  these  fissures 
may  occur.  The  teat  is  alternately  distended  by  milk — when  it  is 
covered  and  softened  by  the  externally  warm  saliva  and  buccal  secre- 
tions of  the  progeny,  in  the  act  of  sucking — then  retracted  and  corrugated 
when  emptied.  At  the  bottom  of  the  folds  the  epidermis  is  rendered 
soft,  and  its  cells  become  loose  and  swollen  ;  these  finally,  instead  of 
forming  a  continuous  layer  capable  of  protecting  the  subjacent  derm, 
give  rise  to  a  whitish  unctuous  pulp,  which  accumulates  at  the  bottom 
of  the  corrugations.  When  this  is  removed  a  sore  is  left,  and  the 
development  of  this  sore  is  hastened  by  cold,  which  still  further  corru- 
gates the  part  ;  as  well  as  by  want  of  cleanliness,  contact  with  dirty 
litter  or  manure,  which  irritates  the  organ  ;  besides  the  act  of  milking  or 
suction,  which  extends  the  sore  in  length  and  depth.  It  may  be  that 
certain  conditions  of  the  saliva  in  the  young  creature  also  lead  to  irrita- 
tion. Cows  with  voluminous  udders  and  long  teats  are  often  the 
subjects  of  this  injury. 

Si/niploms. 

The  sore  appears  as  a  more  or  less  deep,  narrow,  and  sinuous  ulcer, 
running  transversely  around  the  teat,  and  having  indurated,  thickened, 
raised  margins,  greyish  at  the  bottom,  or  very  red  and  erythematous, 
and  containing  a  variable  quantity  of  the  thick  unctuous  matter  just 
mentioned.  The  teat  is  apparently  not  much  deformed — at  least  after 
milking,  when  it  is  retracted  ;  and  the  fissures  might  readily  pass  un- 
perceived.  Then  it  is  necessary  to  pull  the  end  of  the  teat  gently,  in 
order  to  discover  them. 

When  superficial,  they  are  not  so  troublesome  as  when  deep,  irritable, 

'   Canstatt's  Jahi-etberichl,  1S60. 


698  PATHOLOGY  OF  PARTURITION. 

and  bleeding ;  then  they  are  extremely  painful,  and  the  animal  refuses 
to  be  suckled  or  milked,  while  attempts  to  handle  the  teat  cause  the 
creature  to  offer  great  resistance. 

These  fissures  have  an  almost  natural  tendency  to  increase  in  depth, 
so  long  as  the  young  creature  is  suckled.  Sometimes  they  form  at  the 
very  extremity  of  the  teat,  and  the  sinus  and  milk  ducts  become  in- 
flamed, the  viscid  matter  secreted  becomes  firm  and  blocks  up  the  canal, 
which  may  ultimately  be  completely  obliterated,  causing  retention  of 
the  milk,  inflammation  of  the  gland,  and  perhaps  leading  to  a  fatal 
termination. 

Treatment. 

Fissures  in  the  teat  should  not  be  neglected,  however  slight  they  may 
appear  to  be.  They  might  be  prevented  by  cleanliness  and  care,  and 
keeping  the  animal  from  draughts  of  cold  air.  It  is  a  good  plan,  par- 
ticularly with  primiparae,  and  especially  the  finer  bred  Cows,  to  examine 
and  wash  the  teats  for  a  short  time  after  parturition,  and  if  there  is  a 
tendency  to  sores,  to  dress  them  with  some  bland  substance — as  lard, 
glycerine,  or  olive-oil. 

When  fissures  are  present,  and  especially  when  they  are  deep,  an 
essential  condition  for  their  recovery  is  preventing  the  progeny  from 
using  the  affected  teat  or  teats.  By  this  abstention,  and  the  use  of  the 
teat-syphon  (well  disinfected  every  time)  to  empty  the  gland,  recovery 
in  the  most  serious  cases  is  comparatively  rapid,  and  sometimes  even 
spontaneous. 

Emollient  lotions  are  generally  recommended,  and  the  ordinary 
fluid  is  the  milk  drawn  from  the  teat,  which  is  to  be  frequently  applied 
during  the  day,  the  part  being  well  cleaned  with  a  soft  cloth  after  each 
application.  This  and  other  mild  emollients  may  be  useful  when  the 
injuries  are  very  slight  and  superficial ;  but  when  they  are  more  serious, 
or  a  rapid  recovery  is  important,  then  recourse  must  be  had  to  more 
efficient  remedies.  For  this  purpose,  perhaps  nothing  is  better  than 
carbohsed  glycerine  (1  to  20),  or,  in  very  severe  cases,  a  watery  solution 
of  silicate  of  soda.  Dry  dressings — as  iodoform  or  boric  acid — may  be 
employed  in  some  cases  ;  an  ointment  composed  of  tannic  acid  3  parts, 
water  2  parts,  and  lard  25  parts,  has  been  recommended.  It  may 
expedite  recovery  to  touch  the  fissures  lightly  with  nitrate  of  silver,  and 
to  cover  the  teat  with  an  india-rubber  capsule  or  ring. 

Obliteeation  of  the  Galactophokus  Sinus. 
This  may  result  from  fissures,  disease,  or  growths  of  various  kinds,  or 
it  may  be  congenital  (atresia),  and  is  most  frequently  observed  in  the 
Cow.     It  may  be  either  partial  or  complete. 

Symptoms. 
When  due  to  fissures  or  disease,  the  symptoms  are  gradually  developed ; 
but  when  the  occlusion  is  congenital,  they  suddenly  appear  either  imme- 
diately before  or  after  parturition,  when  the  gland  becomes  active. 
Then  the  udder  is  distended,  but  no  milk  issues  from  the  teat  ;  the 
distention  increases,  and  if  relief  is  not  aflbrded  inflammation  and 
suppuration  may  result.  On  examination  of  the  end  of  the  teat  in  con- 
genital atresia,  pressure — as  if  in  milking,  and  if  the  skin  alone  be  the 
obstacle — will  cause  a  slight  prominence  where  the  opening  of  the  sinus 
should  be,  the  milk  being  felt  in  the  sinus.     Should  the  occlusion  extend 


IXJCJilES  TO  THE  TKATS.  699 

higher,  and  the  whole  or  a  portion  of  the  sinus  be  obliterated,  then  this 
prominence  will  not  be  produced,  and  the  obstacle  will  bo  discovered 
towards  the  base  of  the  teat. 

Occlusion  brought  about  by  inflammation,  hypertrophy  of  the  mucous 
membrane  lining  the  sinus,  or  the  development  of  any  growth — as  a 
wart — does  not  occur  suddenly  ;  and  in  milking  it  will  be  observed  that 
the  stream  of  fluid  gradually  becomes  smaller,  until  at  last  it  can  only 
be  drawn  drop  by  drop,  or  its  flow  has  completely  ceased. 

Treatment. 
When  the  occlusion  is  only  due  to  the  skin — which  is  not  uncommon 
in  primipane — a  small  crucial  incision  made  through  it  by  the  bistoury 
or  lancet  is  generally  all  that  is  necessary.  The  sinus  of  the  teat  is 
distended  with  milk  by  pressure  from  the  base,  and  the  prominence  at 
the  end  is  then  incised.  To  prevent  the  wound  closing,  a  small  bougie 
is  introduced  into  the  sinus  for  four  or  five  days  until  the  wound  has 
cicatrised  ;  it  should  only  be  taken  out  at  milking-time.  Fiirstenberg 
states  that  he  has  seen  the  opening  thus  made  remain  permeable  during 
the  whole  period  of  lactation,  but  close  again  when  this  period  expired  ; 
and  a  second  operatiou  had  to  be  performed  at  the  next  calving. 


4^^ 


B. 
Fig.  223. 

LCTHI's   rERKOB.VTING    SoCNn. 

A.    Il.alf  the  Natural  Size.     R.  Natural  Size  and  Section  of  the  Cone. 

When  the  obstacle  is  in  the  sinus  of  the  teat,  at  the  narrow  part  of 
the  canal,  and  immediately  above  the  sphincter,  a  fine  trocar  or  stocking- 
needle,  previously  cleaned  in  boiling  water  and  dipped  in  carbolic  acid 
solution,  must  be  passed  into  it  and  through  the  obstruction,  when  the 
milk  will  flow.  To  prevent  closure,  the  cannula  of  the  trocar  or  a  teat- 
syphon  may  be  inserted  for  some  days,  the  opening  being  closed  by  a 
cork  except  at  milking-time.  Or  a  solid  gutta-peixha  sound  may  be 
employed  until  an  artificial  mucous  membrane  is  formed,  removing  it 
when  milking. 

When  the  canal  is  only  partially  obstructed  and  the  milk  yet  flows, 
the  introduction  of  a  small  feather — pigeon's — or  a  piece  of  thick  catgut, 
will,  with  a  little  patience,  gradually  effect  dilatation.  But  should  it 
not  suffice,  and  particularly  if  a  wart  is  the  cause  of  obstruction,  an 
incision  will  be  necessary.  Various  instruments  have  been  proposed  for 
this  operation,  but  Liithi's  sound  (Fig.  223)  is  perhaps  the  best.  This 
is  an  iron  wire  about  eight  millimetres  long  and  two  in  diameter,  having 
a  ring  at  one  end,  and  at  the  other  a  steel  cone  screwed  on  to  it.  This 
cone  has  a  very  sharp  point,  and  both  sides  have  cutting  edges  at  the 
base  or  widest  part.  It  is  passed  into  the  opening  of  the  teat,  pushed 
through  the  obstacle,  and  then  gently  turned  round  from  side  to  side 
until  no  resistance  is  felt.     Then  it  is  withdrawn,  and  a  bougie  or  teat- 


700  PATHOLOGY  OF  PARTURITION. 

syphon,  or  a  piece  of  thick  carbohsed  catgut,  introduced.  Zundel 
mentions  that  Liithi  and  Strebel  have  been  very  successful  by  this 
method  of  operating. 

In  all  cutting  operations  on  the  teat,  every  precaution  must  be  adopted 
for  the  prevention  of  mastitis ;  and  this  must  chiefly  consist  in  follow- 
ing out  the  antiseptic  method  of  treatment  of  the  incisions  as  closely  as 
possible. 

Fistula  of  the  Teat.    • 

We  have  seen  several  cases  of  fistula  of  the  teat  which  proved  very 
troublesome  to  cure  during  the  period  of  lactation.  From  injury  or 
disease,  an  opening  is  established  between  the  milk  sinus  and  the  side 
of  the  teat ;  so  that  the  milk,  instead  of  passing  through  the  canal  in 
the  extremity,  escapes  in  a  jet  at  the  side,  and  its  flow  is  nearly  con- 
stant. This  is  a  source  of  loss,  and  has  often  an  unpleasant  appearance. 
If  it  is  decided  to  cure  the  fistula  during  the  lactation  period,  and  the 
opening  is  towards  the  middle  of  the  teat,  then  the  ring  teat-syphon 
must  be  kept  in  the  sinus  for  some  time,  and  the  fistula  treated  accord- 
ing to  surgical  principles.  When  the  fistula  is  towards  the  extremity 
of  the  teat,  however,  the  case  is  more  difficult,  and  the  teat-syphon  only 
too  often  renders  it  worse.  Then  it  is  generally  necessary  to  wait  until 
the  Cow  is  "  drj',"  when,  with  a  little  attention,  the  fistula  is  readily 
cured. 


AurHYXJA  OF  THE  XEU'IlOJLX  AMMAL.  701 

BOOK  VI. 

DISEASES  AND  ABNORMALITIES  OF  THE  YOUNG  ANIMAL. 

The  diseases  and  abnormalities  of  the  young  animal,  observed  imme- 
diately after  birth,  are,  many  of  them,  of  the  greatest  importance,  and 
deserve  far  more  attention  than  they  have  yet  received  in  this  country. 
Their  consideration  forms  an  appropriate  complement  to  what  has  been 
said  as  to  the  pathology  of  the  parturient  state  of  the  parent ;  and  a 
notice  of  them,  however  brief  and  imperfect  it  may  be,  is  all  the  more 
necessary,  as  few,  if  any  of  them,  are  referred  to  in  works  on  veterinary 
medicine  or  surgery.  They  will  be  described  in  the  following  order  : — 
(1)  Asphi/xia,  (2)  Umbilical  Hcemorrhage,  (3)  Persistence  of  the  Urachus, 
(4)  Umbilical  Hernia,  (5)  CEdema  of  the  Umbilicus,  (6)  Inflammation  of 
the  Umbilical  Cord,  (7)  Arthritis,  (8)  Indigestion,  (9)  Gastro-intestinal 
Catarrh,  (10)  Dysentery  of  Young  Animals,  (11)  Betention  of  Meconium, 
(12)  Eclampsia  of  Young  Animals,  (13)  Tetanus  Agnorum,  (14)  Cyanosis, 
(lo)  Skin  Dryness,  (16)  Iinperforatc  Anus,  (17)  Imperforate  Vulva  and 
Vagina,  (18)  Imperforate  Prepuce,  (19)  Occlusion  of  the  Eyelids,  (20)  Oc- 
clusion of  the  Auditory  Canal,  (21)  Tongue-tie,  (22)  Cleft  Palate. 

CHAPTEE  L 
Asphyxia  of  the  New-born  Animal. 

At  p.  265,  under  the  head  of  "  Suspended  Animation,"  allusion  was 
made  to  asphyxia  of  the  new-born  animal — a  condition  similar  to  that 
of  the  new-born  child — and  brief  mention  was  made  of  the  measures 
necessaiy  for  restoration.  The  immediate  cause  of  this  condition  was 
also  referred  to.  It  has  been  recognised  that  when  animals  ai-e  sub- 
mitted during  pregnancy  to  insufficient  food,  to  severe  exertion,  have 
sutTered  from  chest  disease,  or  from  colic  a  short  time  before  parturition, 
or  when  labour  has  been  difficult  and  protracted,  the  young  creature  at 
birth  is  often  so  exhausted  that  it  lies  apparently  dead — all  the  tissues 
being  pale  and  flaccid  and  the  body  low  in  temperature,  while  the 
heart's  beats  and  the  respiratory  movements  are  very  feeble  or  quite 
imperceptible. 

There  may  also  be  syncope  or  asphyxia  from  pletliora  or  cyanosis; 
asphyxia  may  likewise  be  due  to  interrupted  circulation  in  the  umbilical 
cord,  and  intra-uterine  respiration. 

Apparent  death,  or  suspended  animation,  must  be  treated  in  the 
manner  indicated  at  p.  265.  The  mouth  and  trachea  should  be 
cleared  of  mucus  and  amniotic  fluid,  if  any  of  the  latter  has  passed 
into  the  air  passages  ;  as  it  may  give  rise  to  pneumonia  should  the 
creature  be  resuscitated  and  live  for  a  short  time.  With  the  Calf  or 
Foal,  it  is  possible  to  pass  an  elastic  tube  or  catheter  thi-ough  the  nostril 
into  the  trachea,  and  by  means  of  a  syringe  to  remove  much  of  the  fluid 
therefrom. 

Aspersion  of  the  skin  with  cold  water,  or  flicking  it  with  a  wet  towel, 
may  also  be  useful  in  stimulating  the  respiratory  nerve-centre,  by  the 
reflex  action  it  induces.  This  is  more  particularly  indicated  when 
asphyxia  is  due  to  an  excess  of  carbonic  acid  in  the  blood.     Stimulation 


702        DISEASES  AND  ABNORMALITIES  OF  THE  YOUNG  ANIMAL. 

of  the  skin  may  also  be  useful  in  this  direction.  Direct  electric  stimu- 
tion  of  the  phrenic  nerve  might  be  attempted.  Artificial  inflation  of 
the  lungs  should  not  be  tried  until  the  mouth  and  fauces  have  been 
cleared  of  mucus;  this  may  be  effected  by  suction,  which  has  a  very 
beneficial  action  otherwise.  Indeed,  some  authorities  prefer  aspiration 
to  inspiration  or  blowing  into  the  mouth  ;  and  Albert^  has  restored  41 
out  of  47  cases  of  apparently  dead  animals  by  aspiration  or  suction. 

Transfusion  of  blood  by  the  umbilical  vein  might  prove  useful ;  between 
one-half  and  a  litre  of  blood  should  be  sufficient  for  a  Foal  or  Calf, 
according  to  Franck.  The  fumes  of  ammonia  or  some  other  powerful 
volatile  irritant  may  be  applied  to  the  nostrils.  A  few  drops  of  brandy 
might  also  be  poured  into  the  nostril. 


CHAPTER  II. 
Umbilical  Haemorrhage. 

HAEMORRHAGE  from  the  umbilical  cord  does  not  appear  to  be  a  very 
common  accident ;  nevertheless,  it  does  sometimes  occur,  and  in  some 
cases  so  copiously  as  to  cause  death.  It  ensues  immediately  afterbirth, 
rarely  after  some  days  ;  and  it  may  continue  for  a  short  or  long  period 
— producing  more  or  less  debility,  or  even  dissolution.  The  haemorrhage 
is  generally  due  to  imprudence  in  cutting  the  umbilical  cord  too  near  the 
abdomen,  or  to  laceration  of  the  vessels  of  which  it  is  composed,  during 
difficult  parturition,  when  violent  traction  tears  it  close  to  the  abdominal 
ring  ;  in  very  rare  instances  it  may  be  due  to  a  varicose  condition  of  the 
vessels.  Zundel  alludes  to  a  predisposition  to  umbilical  haemorrhage — 
a  kind  of  hemophilia.  In  one  or  two  instances  the  bleeding  has  been 
induced  by  either  the  mother,  the  young  creature,  or  its  companions 
sucking  or  pulling  at  the  remains  of  the  cord. 

In  the  Foal  the  haemorrhage  may  take  place  from  the  artery,  as  that 
vessel  is  firmly  attached  to  the  umbilical  ring  ;  with  Euminants  it  takes 
place  from  the  vein,  because  of  the  existence  of  the  ductus  Arantii,  and 
the  retraction  of  the  artery  within  the  abdomen. 

Trcatvient. 

When  the  bleeding  is  trifling  and  not  likely  to  continue  long,  little,  if 
anything,  requires  to  be  done  ;  but  when  it  is  copious  and  continuous, 
active  and  prompt  treatment  must  be  adopted. 

If  the  cord  is  extremely  short,  astringents — as  alum,  tannic  acid,  etc. 
— maybe  tried,  or  such  haemostatic  agents  as  the  sesquichloride  of  iron, 
nitrate  of  silver,  etc.,  or  even  the  actual  cautery  in  a  fine  point.  If, 
however,  the  cord  is  sufficiently  long,  it  is  better  to  apply  a  ligature ; 
this  will  check  the  bleeding,  and  the  cord  will  slough  away  in  four  or 
five  days.  In  applying  the  ligature,  however,  the  operator  must  be 
careful  not  to  include  a  poi-tion  of  intestine  within  it;  and  when  there  is 
much  infiltration  of  the  cord,  as  sometimes  happens,  the  serum  should 
be  got  rid  of,  as  much  as  possible,  by  squeezing  with  the  fingers  or 
scarification,  in  order  that  the  ligature  may  exercise  sufficient  com- 
pression. 

Artificial  respiration  is  sometimes  required  when  syncope  or  asphyxia 
is  present,  and  this  alone  often  causes  the  haemorrhage  to  cease. 

The  transfusion  of  blood  may  be  urgently  demanded  in  extreme  cases. 
1  Renke's  Zeiischri/tfur  Staatsarzneikitnde,  vol.  xxiii,,  p.  279. 


PERSISTEXCE  OF  THE  rUArlll'S.  703 

CHAPTER  III. 
Persistence  of  the  Urachus. 

In  studying  the  development  of  the  foetus  the  urachus  was  described 
(pp.  S2,  94),  and  it  was  pointed  out  that  it  is  a  canal  formed  by  the 
middle  portion  of  the  allantois,  which  passed  throu^'h  the  umbilical 
rin^',  and  durinj^  foetal  life  communicated  with  the  bladder,  from  which 
it  conveyed  the  urine  into  the  allantoid  sac.  After  birth  this  canal  is 
obliterated,  its  walls  become  a  thin  cord,  and  the  bladder  is  retracted 
within  the  pelvic  cavity,  the  urine  tlien  passing  through  the  urethra. 
It  not  unfrequently  happens,  however,  that,  from  accidental  circum- 
stances or  some  malformation,  the  canal  of  the  urachus  is  only  partially, 
or  not  at  all  obliterated  after  birth  ;  consequently,  the  urine  continues 
to  escape  by  drops  or  in  a  thin  stream  from  the  umbilicus  or  umbilical 
cord.  This  condition  is  far  more  frequent  in  Solipeds  than  in  Ruminants, 
owing  to  the  urachus — like  the  umbilical  artery — being  firmly  attached 
to  the  umbilical  ring  in  the  former,  and  therefore  not  at  once  withdrawn 
into  the  abdomen,  as  in  the  latter,  when  the  umbilical  cord  is  divided 
at  birth.  Therefore  it  is  Ihat  escape  of  urine  from  the  navel  is  very 
seldom  noticed  in  the  Calf;  while  in  the  Foal  it  is  often  witnessed, 
particularly  when  the  abdominal  ring  remains  very  open,  or  the  cord  is 
excised  close  to  the  body.  This  condition  has,  however,  been  seen  in 
Calves. 

It  appears  to  be  more  frequent  in  male  than  female  animals,  and  is 
most  serious  in  the  former ;  in  the  latter,  the  discharge  of  urine  by  this 
abnormal  channel  often  ceases  spontaneously,  only  passing  at  first  in 
drops ;  whereas,  in  the  male  it  generally  escapes  in  a  stream,  little  or 
no  urine  being  discharged  from  the  urethra. 

Treatment. 

In  some  cases  scarcely  any  treatment  is  necessary,  the  escape  of 
urine  ceasing  in  a  few  days  after  birth  ;  and  when  interference  is 
demanded,  a  cure  can  generally  be  effected  in  a  short  time  if  the  urethra 
is  pervious.  Benard'  mentions  an  instance  of  this  accident,  in  which 
death  occurred  two  days  after  applying  a  ligature  to  the  urachus  ;  it 
was  then  discovered  that  the  urethra  was  imperforate,  so  that  the  urine 
could  not  be  expelled  at  all.  It  is  therefore  necessary,  before  adopting 
remedial  measures,  to  ascertain  whether  the  urethra  is  patent. 

When  the  urachus  protrudes  sutViciently  from  the  umbilical  ring,  a 
ligature  may  be  fastened  firmly  around  it.  When  it  is  close  to  the 
abdominal  ring,  and  consequently  too  short  to  be  tied  by  the  ordinary 
ligature,  it  must  be  secured  by  a  curved  needle.  The  Foal  is  thrown  on 
its  left  side,  and  the  operator,  holding  the  needle  armed  with  the  thread 
in  his  right  hand,  seizes  the  urachus — which  is  covered  by  the  skin — 
between  the  thumb  and  index-finger  of  the  left  hand,  and  pulls  it  out- 
wards ;  the  needle  is  then  passed  through  behind  the  canal,  including 
as  little  of  the  skin  as  possible,  and  the  ends  tied.  If  there  is  any  doubt 
as  to  the  patency  of  the  urethra,  the  ligature  should  only  be  partially 
tightened  until  the  nature  of  the  obsti-uction  is  ascertained  and  removed. 
When  this  is  done,  then  the  ligature  may  be  firmly  tied,  when  the  urine 
escapes  freely  by  the  natural  channel. 

^  Secue'tl  lie  Midtcine  Viterinairt,  1828. 


704       DISEASES  AXD  ABXOBMALITIES  OF  THE  YOUXG  ANIMAL. 

In  those  cases  in  which  the  urachus  cannot  be  secured  by  this  proce- 
dure, astringents  or  caustics — -such  as  the  sulphate  of  copper — may  be 
successfully  employed.  Beneficial  results  have  been  obtained  by  the 
application  of  a  strong  vesicant  around  the  umbilical  ring,  the  tumefac- 
tion caused  by  it  closing  the  opening.  The  actual  cautery  has  also  been 
most  successfully  employed,  particularly  in  a  fine  point. 


CHAPTEE  IV. 
Umbilical  Hernia. 

ExoMPHALis,  omphalocele,  or  umbilical  or  ncivel  hernia,  is  not  at  all  rare 
in  young  animals,  and  is  perhaps  most  frequently  observed  in  Foals  and 
Puppies  ;  it  does  not  appear  to  be  so  common  in  Calves,  and  in  Pigs 
and  Lambs  it  is  seldom  seen.  It  would  appear  to  be  more  prevalent  in 
some  countries  or  regions  than  in  others.  Marlot  states  that  in  every 
score  of  Foals  or  Mules  bred  in  France,  one  is  so  affected.  The  hernia 
or  rupture  may  appear  at  birth  or  some  time  after,  and  may  continue 
during  the  life  of  the  animal  if  no  measures  are  adopted  to  cure  it ; 
it  may  be  congenital  or  acquired.  The  congenital  form  is  produced 
during  fa^tal  life,  when  a  portion  of  the  digestive  and  biliary  apparatus 
is  contained  in  the  umbilical  cord.  The  embryonic  connective  tissue,  or 
Whartonian  gelatine,  in  which  are  imbedded  the  two  umbilical  arteries 
and  vein  (two  in  the  Calf  and  Pig),  is  very  abundant  at  the  elliptical 
opening  named  the  umbilical  ring — through  which  also  pass  the  urachus, 
the  omphaio-mesenteric  vessels,  and  a  portion  of  intestine.  After  birth 
the  umbilical  cord  shrivels,  and  the  Whartonian  gelatine  becomes  con- 
densed and  organised,  forming  a  fibrous  membrane  that  closes  the 
umbilical  opening  and,  gradually  contracting,  brings  the  two  edges 
together  ;  these  unite,  and  soon  nothing  is  left  to  mark  the  situation  of 
the  opening,  except  a  short  lozenge-shaped  fibrous  cicatrix.  The  intes- 
tine had  previously  been  withdrawn  into  the  abdomen,  the  urachus 
becomes  contracted  after  birth  into  a  thin  ligament,  while  the  blood- 
vessels are  obliterated. 

It  sometimes  happens,  however,  that  the  process  of  cicatrisation  is 
either  prevented,  retarded,  or  interrupted ;  consequently,  the  umbilical 
ring  continues  more  or  less  patent,  and  certain  viscera  either  remain  in 
it,  or  are  pushed  into  it  by  internal  pressure,  and  lodged  in  the  pouch 
formed  externally  by  the  skin.  In  this  congenital  hernia,  the  vein  or 
veins  and  the  arteries  are  separated  by  the  misplaced  viscera,  the  former 
being  usually  in  front,  the  latter  behind. 

The  lesion  may  be  observed  at  the  moment  the  animal  is  born  ;  and 
after  the  cord  is  ruptured  it  may  happen  that  the  abdomen  remains  open 
and  the  viscera  are  exposed ;  the  creature  then  generally  succumbs 
quickly. 

Acquired  or  accidental  umbilical  hernia  usually  appears  soon  after  the 
cord  has  withered,  or  within  a  few  months  after  birth. 

A  true  Sund  false  exomphalus  have  been  described  :  the  first  being  that 
just  mentioned,  in  which  hernia  takes  place  through  the  umbilical  ring; 
while  the  second  is  due  to  an  accidental  opening  in  the  neighbour- 
ing aponeurotic  or  muscular  tunics  of  the  abdomen,  and  is  in  reality 
ventral  hernia — occurring,  as  it  generally  does,  after  birth  and  in  adult 
animals.     Various  kinds  of  umbilical  hernise  have  also  been  alluded  to, 


UMBILICAL  IIEJtXIA.  705 

according  as  the  viscus  is  intestine  or  onientuiu,  or  both  ;  thus  we  have 
entcromphalus,  mcscntcro-  or  cpiploviphalus,  and  entcro-cpiploniphalus. 
The  last  is  most  frequently  observed  in  Carnivorous  animals. 

Causes. 

Wo  have  just  alluded  to  the  cause  of  congenital  hernia.  Acquired  or 
accidental  hernia  may  be  due  to  severe  or  sudden  muscular  exertion  ; 
as  when  the  Foal  or  Calf  runs  or  jumps  very  actively  during  its  gambols, 
or  wiien  pursued,  or  in  falls.  It  is  sometimes  produced  when  the  young 
creature  is  separated  from  its  parent,  and  being  kept  in  an  isolated 
place,  it  rushes  about  and  cries  energetically.  Umbilical  hernia  has 
also  been  known  to  follow  an  attack  of  colic,  and  after  constipation  or 
diarrhcca. 

There  appears  to  be  generally  present,  in  umbilical  hernia,  a  certain 
organic  predisposition,  due  to  the  suppressed  or  imperfect  organization 
of  the  Whartonian  gelatine  ;  and  it  has  been  remarked  that  common- 
bred  animals  are  more  liable  to  it  than  those  of  the  higher  breeds. 
Nevertheless,  in  all  those  in  which  it  manifests  itself— no  matter  what 
the  breed  may  be — there  is  usually  constitutional  debility  present,  due 
in  many  instances  to  the  mother  having  been  ill-fed  and  badly  cared 
for  during  pregnancy.  Zundel  says  that  there  are  years  in  which  the 
accident  is  unusually  frequent,  and  particularly  wlien  much  rain  prevails, 
as  then  the  food  of  Herbivorous  animals  is  more  aqueous  than  at  other 
times.  Low,  wet,  marshy  pastures  are  also  believed  to  predispose  to 
hernia  ;  as  in  them  the  tissues  become  soft  and  relaxed,  and  the 
digestive  organs  inordinately  bulky;  Foals  and  Calves  kept  in  these 
situations  have  the  belly  voluminous,  and  the  extrinsic  pressure  weakens 
the  abdominal  walls.  Bcnard,  Hamon,  Cruzel,  Bouley,  and  others, 
believe  in  heredity  as  a  predisposing  cause.  Mares  which  were  afTected 
with  umbilical  hernia  when  young,  have  produced  foals  which  presented 
this  lesion. 

Patholoijical  Anatomy. 

The  hernial  pouch  or  sac  is  nearly  always  lined  by  peritoneum — the 
peritoneal  investment  being  produced  at  the  same  time  as  the  hernia. 
In  some  instances,  however,  the  peritoneum  gives  way  to  the  pressure 
of  the  viscera,  and  then  the  walls  of  the  sac  are  composed  only  of 
connective  tissue  and  skin.  The  latter  is  frequently  so  much  stretched 
that  it  becomes  thinner,  and  in  Puppies  is  generally  quite  transparent. 

Marlot  says  that  the  sac  is  usually  composed  of  five  layers:  I.  The 
parietal  peritoneum  ;  2,  A  very  fine  fibrous  layer  constituted  by  the 
fascia  transversalis  ;  3.  A  kind  of  dartos  formed  by  the  tunica  abdo- 
minalis  ;  4.  The  panniculus  carnosus  muscle  ;  5.  The  skin — the  whole 
being  connected  by  connective  tissue.  But  this  arrangement  is  far 
from  being  constant.  The  opening  of  the  iiernial  sac  corresponds  to  the 
umbilical  opening,  which  is  elongated,  and  measures  in  the  Foal  from 
\\  to  3.1  inches  in  length,  its  width  being  variable,  but  never  exceeding 
2'inche's.  The  viscera  contamed  in  the  sac  are  usually  the  small 
intestine,  omentum,  free  colon,  and  the  point  of  the  caecum.  Lanclot, 
Bonard,  Delafond,  Ilertwig,  and  others,  have  sometimes  found  tlic 
urachus  in  the  sac,  as  well  as  intestine  ;  but  in  congenital  hernia  the 
\nachu3  can  scarcely  fail  to  be  absent,  and  we  may  also  have  the 
lunbilical  veins.  It  rarely  happens  that  there  is  any  adhesion  between 
th«  hernied  organs  and  the  sac  containing  them,  inflammation  being 

45 


706        LISEASES  AXD  ABNORMALITIES  OF  THE  YOUXG  ANIMAL. 

rare ;  the  sac  seldom  indeed  contains  any  serum,  and  is  therefore  in 
immediate  contact  with  the  misplaced  viscera.  When  ascites  is  present, 
however,  serous  fluid  may  then  be  present,  and  constitute  the  diseased 
condition  termed  "  hydro-enteromphalus." 

Symptoms. 

The  symptoms  of  umbilical  hernia  are,  as  a  rule,  entirelj*  local. 
There  is  a  round  or  pyriform  tumour  situated  in  the  region  of  the 
umbilicus  or  "  navel,"  varying  in  size  in  different  individuals  and  species 
— from  that  of  a  pigeon's  egg  to  a  child's  head,  or  even  larger.  The  size 
also  varies  in  the  same  individual  at  different  times,  according  as  the 
digestive  organs  are  full  or  empty,  the  attitude  standing  or  recumbent, 
at  rest  or  undergoing  active  exertion,  or  the  duration  of  the  hernia — 
the  older  it  is,  the  larger  the  tumour.  It  is  usually  soft,  fluctuating, 
easily  depressed  by  the  finger,  and  as  readily  resuming  its  ordinary  size 
and  shape  ;  when  recent,  however,  it  is  often  tense  and  not  depressible. 
Sometimes  it  has  a  doughy  feel  and  fluctuates  much,  and  at  other  times 
it  is  flaccid,  according  as  the  portion  of  intestine  which  it  contains  is 
empty  or  filled  with  alimentary  matters.  It  is  nearly  always  indolent, 
and  in  the  large  majority  of  cases  can  be  reduced  by  throwing  the 
animal  on  its  back,  by  manipulation  externally,  or  by  taxis  internally. 
The  tumour  soon  returns,  however,  especially  when  the  animal  lies  down 
or  moves  about ;  closing  the  nostrils  or  causing  the  animal  to  cough, 
will  also  produce  its  immediate  appearance. 

"When  the  sac  has  been  emptied  by  pressure  or  taxis,  the  opening  in 
the  abdomen  can  then  be  perceived.  As  a  general  rule,  the  volume  of 
the  tumour  corresponds  to  the  dimensions  of  this  opening,  which  is 
sometimes  elliptical,  at  other  times  nearly  or  completely  circular ;  in 
false  or  accidental  hernia  it  is  usually  irregular  in  outline.  The  borders 
of  the  opening  feel  tense  and  resisting. 

On  applying  the  open  hand  against  the  tumour,  the  vermicular  move- 
ment of  the  intestine  can  be  ascertained ;  careful  taxis  may  lead  to  the 
discovery  of  a  loop  of  intestine  in  the  sac ;  while  auscultation  may 
detect  the  rumbling  of  the  displaced  viscus. 

When  the  tumour  is  not  reducible,  this  is  generally  due  to  the  presence 
of  an  accumulation  of  fscal  matters  or  other  substances  in  the  intestine. 
Inflammation  is  rare,  and  is  usually  due  to  contusions  or  other  external 
influences.     Strangulation  of  the  intestine  is  likewise  far  from  frequent. 

Prognosis. 

Umbilical  hernia  is  not  a  serious  condition  in  young  animals,  except 
in  rare  cases.  Sometimes  spontaneous  recovery  takes  place ;  in  the 
great  majority  of  instances  a  cure  is  easily  effected ;  and  even  when  the 
hernia  persists  there  is  but  little  danger,  health  and  utility  being  seldom 
interfered  with.  When  the  hernial  sac  is  occupied  by  omentum  only, 
and  the  abdominal  opening  is  small,  there  is  much  less  danger  than 
when  the  intestine  is  involved,  while  spontaneous  recovery  is  much 
more  probable.  In  adult  animals  umbilical  hernia  is  often  a  serious 
accident ;  and  its  gravity  generally  depends  on  the  volume  of  the  tumour. 
Complicated  hernia  is  always  dangerous. 

Though  not  at  all  serious  in  itself  when  affecting  young  animals,  yet 
from  their  diminished  value  and  the  expense  of  treatment,  umbilical 
hernia  may  become  a  cause  of  much  loss. 


VMlilUCAL  IIKllXIA.  yoy 

prevalence  in  this  country.         ''°"'=""""-    ^^^  ''"ow  nothing  as  to  its 

Diagnosis. 

cor;fi'':irt,:[.r^^.^irt'htTn"it"irhtf  ;"i;;  J 's  V' ': "- 

.t  may  he  „,istai<eu  for  an  abscess  o°  a   ec^nt'  t'^rnmi^  f.  «den,atous, 
lunWIical  he?:^  a    but  also  whether  ?t  iLf°  t^""°'^  ""=  '^"''''"'^  "' 


Treatment. 


We  have  stated  that  umbilical  hernia  in  youn-  anin.nl^  nffo.    a- 

Piiiifiiilii 

for'2^Foara''d'?L'rai?l^irth:V°r'  ''  generally  .-eco^nised  that. 

and  stron,^er.  am  tss TkX  to  -ff- '^  ''^'^•°'  ""'  ''  ^""'"^^  ''  °^*^'' 
The  methods  of  treatment  CO  nnrirm/       )"  ^^^^"f  ^^^.^^y  operations. 

heJni^?ons^Ts';;L';7airo/l'''T^  '^"^^^^'^  ^^^  '^^  ^"^«  °f  ""^^ilical 
body.  b>  t^rlid  'r^h  ch  the-i  '  ^"-''r'  '5"^''  P^"^«^  ^'•-""^i  'he 
aga.^st\he  umbihearopenin'  a  ild"" tended  t""^  the  tumour,  and 
from  a^ain   descendincr  w  In  Vi      ^      '^tended  to  prevent  the  viscera 


708        DISEASES  AND  ABNORMALITIES  OF  THE  YOUNG  ANIMAL. 

he  claims  solidity,  fixity,  and  elasticity.  This  consists  of  a  kind  of  well- 
stuffed  saddle,  from  the  four  corners  of  which  pass  leather  straps,  which 
are  buckled  to  two  girths — one  of  which  is  of  canvas  webbing,  and  passes 
round  the  chest ;  the  other,  of  india-rubber  webbing,  goes  round  the 
belly,  and  maintains  a  pad  against  the  umbilicus.  This  pad  is  a  wide, 
but  not  very  thick  cushion  stuffed  with  horsehair,  and  which  a  broad 
longitudinal  band  uniting  the  pectoral  and  abdominal  girths  prevents 
from  slipping  backwards.  In  Italy,  the  Massiera  truss  is  employed. 
This  is  also  a  kind  of  small  saddle  with  two  wide  girths  passing  under 
the  chest,  that  presses  against  the  sternum  and  epigastrium  a  plate  of 
iron,  the  posterior  extremity  of  which,  corresponding  to  the  umbilical 
ring,  and  covered  by  a  leather  cushion  stuffed  with  horsehair,  is  applied 
to  the  seat  of  hernia.  In  Germany,  Strauss's  apparatus  is  in  vogue. 
This  likewise  consists  of  girths  disposed  in  a  similar  manner,  with  a 
kind  of  martingale  to  prevent  them  gliding  backwards.  If  a  pad  is  used, 
Lafosse  recommends  that  it  should  not  be  too  convex  or  elevated  in  the 
middle. 


rig.  224. 
Armatage's  Truss  applied  for  Umbilical  Hernia. 

Armatage  advises  the  employment  of  a  similar  arrangement  or  harness, 
which  furnishes  a  compress  at  the  proper  part ;  it  is  merely  a  number  of 
straps,  capable  of  being  shortened  or  lengthened,  as  may  be  necessary 
in  order  to  fit  animals  of  different  sizes  (Fig.  224). 

It  usually  requires  from  one  to  three  months  to  effect  a  cure,  the 
period  depending  chiefly  on  the  size  of  the  hernia.  A  tonic  regime 
hastens  recovery. 

Some  veterinary  surgeons  combine  agglutinative  agents  with  the  use 
of  the  truss — employing,  for  instance,  a  pad  steeped  in  a  mixture  of 
pitch  and  turpentine. 

Before  the  truss  is  applied,  it  is,  of  course,  necessary  to  reduce  the 
hernia,  and  place  the  pad  exactly  over  the  umbilical  opening. 

Trusses  are  chiefly  objectionable  from  the  long  time  thej'^  must  remain 
on  the  animal,  and  the  tightness  with  which  they  must  be  applied  in 
order  to  act  beneficially.  This  inconveniences  and  often  injures  the 
young  creature,  and  not  infrequently  causes  it  to  fret,  impairs  its 
appetite,  and  induces  loss  of  condition  ;  and  though  highly  recom- 
mended by  Ma  riot,  Lafosse,  Perosino,  Schreger,  Strauss,  Ungefrohrn, 


I'MIULIVAL  IllJllXI.t.  709 

and  many  others,  they  are  not  always  to  be  preferred  to  other  methods 
of  treatment. 

2.  Topical  Applications.  —  Topical  applications  have  been  for 
centuries  employed  for  the  cure  of  hernia,  Celsus  having  recommended 
the  use  of  sulphuric  acid,  which  was  resorted  to  at  a  later  period  by  the 
early  hippiatrists ;  and  since  1833,  when  it  was  brought  to  notice  by 
Hertwig.  it  has  been  used  in  Germany,  being  applied  to  the  tumour 
every  two  or  three  days.  The  subcutaneous  serous  inliltration  and  the 
plastic  exudation  in  tbe  hernial  sac,  drive  the  misplaced  viscera  into  the 
al>domen,  and,  in  becoming  absorbed  afterwards,  produce  obliteration 
of  the  cavity  and  its  opening.  Blisters  act  in  the  same  way;  and  appli- 
cations of  alcohol,  creosote  water,  and  other  agents,  have  been  largely 
resorted  to.  But  Girax-d,  D'Arboval,  Benard,  and  Mignon  have  asserted 
that  these  topical  applications  are  very  uncertain,  and  even  dangerous, 
as  the  irritation  produced  readily  causes  adhesion  between  the  wall 
of  the  sac  and  the  organs  it  contained,  and  thus  renders  i^eduction  im- 
possible. 

But  in  1848,  Dayot,  and  more  recently  other  veterinarians,  had  drawn 
attention  to  the  value  of  nitric  acid  cauterisation  in  umbilical  hernia. 
The  acid  is  applied  to  the  skin  covering  the  tumour  until  at  first  an 
eschar  is  formed,  and,  finally,  detachment  of  the  cutaneous  hernial  sac 
is  achieved.  In  order  to  efl'ect  this,  the  hair  is  removed  from  the  skin, 
and  by  means  of  a  spun-glass  brush  or  cotton- wool  fi.xed  on  a  glass  rod, 
nitric  acid  of  commerce  is  applied  around  the  base  of  the  tumour  at 
first ;  then  over  the  other  part  it  is  used  in  sufticient  quantity,  and  with 
friction,  so  as  to  destroy  the  skin  and  ensure  its  speedy  mortification  and 
sloughing.  Experience  has  proved  that  the  more  profound  the  dis- 
organisation the  more  certain  is  the  beneficial  action.  According  to 
Lafosse,  it  requires  from  24  to  32  grammes  of  acid  for  a  hernial  tumour 
the  size  of  a  fist ;  and  the  friction,  which  ought  to  be  as  equable  as 
possible  over  the  whole  surface,  should  be  continued  for  three  to  five 
minutes — supposing  the  animal  to  be  quiet  and  the  rubbing  not  inter- 
rupted. A  smaller  quantity  of  acid  and  less  friction  may  be  employed 
to  herniie  which  are  not  so  considerable  in  volume,  and  are  covered  by 
fine  skin.  When  the  animal  has  to  be  thrown  and  placed  on  its  back, 
the  quantity  of  acid  and  amount  of  friction  must  also  be  diminished. 
Dayot  reconmiends  that  the  application  be  repeated  once  or  twice  in 
the  hour,  according  to  the  thickness  of  the  skin  ;  but  it  has  been  found 
that  one  application  is  generally  sufficient,  fifteen  days  being  allowed  to 
elapse  in  order  to  watch  the  result.  If  at  the  end  of  this  time  the  skin 
is  not  destroyed,  the  application  may  be  repeated. 

The  nitric  acid  produces  a  yellow  eschar,  which,  if  not  dry  on  the  first 
day,  soon  becomes  soft,  unctuous  to  the  touch,  and  easily  destroyed. 
With  the  formation  of  this  eschar  there  is  much  swelling,  either  imme- 
diately on  the  application  of  the  acid,  or  soon  after;  in  some  cases  there 
is  but  little  if  any  swelling.  The  tumefaction  is  due  to  the  action  of  the 
nitric  acid  on  the  subcutaneous  connective  tissue,  which  becomes  infil- 
trated, and  causes  a  uniform  pressure  on  the  hernied  mass  ;  this  leads 
to  the  latter  being  pushed  into  the  abdomen  and  kept  there  as  if  by  a 
truss.  The  oedematous  swelling  established  external  to  the  tumour,  is 
oblong  and  depressed  in  the  centre,  in  consequence  of  the  diminished 
elasticity  of  the  central  portion  of  the  escharified  skin  ;  in  a  few  days  it 
is  gradually  absorbed  and  becomes  more  consistent,  while  the  skin  in 


710        DISEASES  AXD  ABNORMALITIES  OE  THE  YOUNG  AXIMAL. 

the  centre  becomes  dry  and  hard,  like  parchment.  Instead  of  the 
hernia,  there  is  now  only  a  newly-formed  mass  of  fibrous  tissue,  which 
is  gradually  lessened  in  volume,  condensed,  and  partly  absorbed,  like 
cicatricial  tissue.  At  the  same  time  the  cauterised  skin  begins  to  be 
thrown  off  at  the  margin,  the  process  of  separation  extending  to  the 
centre,  where  it  takes  a  long  time  to  be  completed,  because  of  the  re- 
mains of  the  umbilical  cord.  When  completely  detached,  there  is  a 
granulating  healthy-looking  wound  left,  which  may  have  some  fibrous 
masses  in  its  middle.  This  suppurates,  dries,  becomes  covered  with  a 
crust,  and  is  gradually  furnished  with  epithelium'.  In  retracting,  the 
wound  contributes  largely  in  closing  the  hernial  opening,  while  the  in- 
durated skin  which  continues  for  some  time  to  adhere  to  the  abdominal 
walls  through  the  medium  of  the  condensed  connective  tissue,  contri- 
butes its  share.  In  about  a  month  cicatrisation  is  finished  ;  the  cicatrix 
remains  destitute  of  hair,  and  often  of  pigment. 

According  to  the  testimony  of  Zundel  and  others,  this  mode  of  treat- 
ing an  umbilical  hernia  is  prompt  and  speedy.  There  is  generally  no 
occasion  to  throw  the  animal  down,  and  one  assistant  only  is  necessary ; 
it  is  rarely  followed  by  accidents.  These  do  occur,  however,  and  the 
most  serious  and  frequent  is  the  escape  of  the  intestines  through  the 
eschar,  about  eight  days  after  the  nitric  acid  has  been  applied.  This 
unfortunate  result  has  been  attributed  to  excessive  cauterisation  when 
the  skin  is  thin  and  fine,  though  it  may  also  occur  from  the  animal 
rubbing  or  tearing  off  the  sloughing  cuticle  when  the  pain  or  itching  are 
troublesome.  To  obviate  this  accident,  Eey,  Lafosse,  Legoff,  and  others 
recommend  the  employment  of  a  bandage,  and  quietude  after  the  opera- 
tion. Eeynal  has  observed  peritonitis  as  a  consequence  of  nitric  acid 
cauterisation,  and  Lafosse  mentions  a  case  of  tetanus  due  to  this  treat- 
ment. 

When  the  cauterisation  has  not  been  sufficient,  a  relapse  is  likely  to 
occur  ;  Lafosse  has  observed  one  in  twenty  successful  cases.  This  in- 
sufficiency is  generally  noticed  on  the  following  day,  in  the  absence  or 
trifling  amount  of  swelling  ;  but  the  cauterisation  must  not  be  attempted 
again  in  less  than  two  or  three  weeks. 

Hertwig,  as  has  been  mentioned,  recommends  sulphuric  instead  of 
nitric  acid,  and  applies  it  in  lines,  night  and  morning,  for  two  days,  by 
means  of  a  glass  rod.  CEdema  soon  sets  in,  and  it  may  be  increased  by 
rubbing  the  cauterised  surface  with  oil  of  turpentine  and  oil  (one  to 
two).  The  sulphuric  acid,  however,  appears  to  be  less  prompt  than  the 
nitric.  Strong  blistering  ointment  applied  at  intervals  of  three  days  ; 
chromate  of  potass  ointment  (one  to  three)  rubbed  in  once  a  day  for 
five  minutes  at  a  time,  on  two  consecutive  days ;  solution  of  bichloride 
of  mercury,  and  other  topical  irritants,  have  all  been  more  or  less  suc- 
cessfully employed.  Even  the  actual  cautery,  in  lines  and  points,  has 
been  resorted  to  ;  but  the  beneficial  effect  to  be  derived  from  it  is  un- 
certain, and  at  best  it  is  very  painful. 

Boulej^^  draws  attention  to  Luton's  method  of  subcutaneous  injections 
for  the  cure  of  congenital  hernia?  in  infants,  and  believes  it  will  be  found 
more  advantageous  than  any  other  treatment  yet  attempted  for  umbilical 
hernia  in  animals.  Luton's  method  consists  in  the  subcutaneous  injec- 
tion of  a  few  drops  of  common  salt  solution  around  the  hernial  tumour, 
by  means  of  the  ordinary  subcutaneous-injection  syringe.  ITnder  the 
irritating  influence  of  this  injection  oedema  sets  in,  and  this  mechanic- 
'  Bizictil  de  Mtderine  Veterinaire,  1877. 


r.Mim.li-.lL  IIERXIA.  711 

ally  repels  the  contained  viscus,  the  margins  of  the  abdominal  opening 
come  into  apposition,  and,  with  the  connective  tissue,  are  inflamed  and 
soon  unite. 

The  needle  of  the  syringe  must  not  pass  beyond  the  subcutaneous 
connective  tissue. 

3.  CoxsTuicTiON. — Constriction  of  the  hernial  sac  has  been  largely 
reported  to  for  the  cure  of  umbilical  hernia,  with  the  view  of  destroying 
it  by  mortification,  causing  adhesion  above  the  part  where  this  has 
taken  place,  and  including  secondary  cicatrisation  when  the  sac  has 
sloughed  away.  The  constriction  is  produced  by  li(ialurc,  cla)ns,  and 
.suture.  To  apply  these,  the  animal  must,  in  nearly  all  cases,  be  thrown; 
but  before  this  is  attempted,  the  tumour  should  be  well  examined,  in 
order  to  ascertain  if  it  is  reducible,  if  there  are  adhesions,  the  extent  of 
the  abdominal  opening,  and  the  limits  within  which  the  constricting 
iipparatus  should  be  applied. 

The  best  position  for  reduction  and  constriction  is  the  dorsal.  The 
animal,  if  a  Foal,  should  be  cast  on  a  good  bed  of  litter,  and  placed  on 
Its  back.  Very  often  the  change  of  position  reduces  the  hernia  ;  if  not, 
gentle  manipulation  and  pressure  will  effect  this,  and  then  the  empty 
sac  is  pulled  well  away  from  the  body,  and  the  operation  completed. 

The  oldest  procedure  is  ligaturing  the  entire  mass  of  the  hernial  sac 
by  a  piece  of  cord  tied  firmly  round  it,  close  to  the  body.  This  produces 
at  first  a  merely  mechanical  occlusion,  but  subsequently  this  is  physio- 
logical— exudation  and  organisation  of  the  plasma  thrown  out  by  the 
iiiHammatory  process  set  up,  producing  adhesion  of  the  peritoneal 
surfaces.  A  piece  of  whipcord  answers  very  well  for  this  ligature,  but 
it  must  be  drawn  very  tight  around  the  neck  of  the  sac,  in  order  to  pro- 
duce its  immediate  and  consecutive  effects. 

To  keep  the  ligature  in  place,  some  practitioners  pass  one  or  two 
wooden  pegs  through  the  sac  where  it  is  encircled  by  the  ligature;  these 
])revent  the  twine  being  displaced  by  the  swelling  which  quickly  super- 
venes. Sometimes  a  ring  is  employed,  which  is  less  in  diameter  than 
the  umbilical  opening,  and  through  which  the  hernial  sac  is  passed 
before  the  ligature  is  made. 

Some  authorities  prefer  a  double  ligature,  made  by  passing  a  double 
cord  through  the  base  of  the  sac  by  means  of  a  sacking  needle,  and  tying 
each  separately  or  entirely  round  the  sac.  Sometimes  the  ligatures  are 
multiple ;  and  Legoff  has  recommended  the  employment  of  several 
ligatures  passing  through  the  sac  from  apex  to  base,  each  becoming 
tighter  as  the  abdomen  is  neared. 

Ligatures  are  very  simple  and  easily  applied,  but  they  have  their 
drawbacks,  and  these  have  led  to  their  disuse.  .\mong  their  dis- 
advantages are  uncertainty  in  their  action — which  is  sometimes  too 
intense,  at  other  times  insufVicient ;  the  sac  often  sloughs  off  before 
adhesion  has  taken  place  to  such  a  degree  as  to  sustain  the  weight  of 
the  abdominal  viscera  ;  and  it  has  been  pointed  out  that  there  is  risk  of 
including  or  wounding  the  intestine. 

Very  favourable  results  obtained  by  the  elastic  ligature  in  castration 
have  been  reported  by  Guerin  ;*  this  ligature  might  prove  effective  in 
umbilical  hernia. 

The  procedure  by  clains  is  often  resorted  to,  particularly  when  the 
hernia  is  serious.  The  ordinary  wooden  clam  (Fig.  225)  may  be  employed, 
'  Jiccucil  de  Ucdccine  Vttirinaire,  1S77. 


712        DISEASES  AND  ABNORMALITIES  OF  THE  YOUNG  ANIMAL. 

or  one  of  iron,  either  hinged  at  one  end  or  tightened  by  screws.  To 
render  the  coaptation  of  the  two  branches  of  the  clam  more  perfect,  and 
to  prevent  the  instrument  shpping  when  tumefaction  sets  in,  as  well  as 
to  produce  more  prompt  inflammation,  adhesion,  and  gangrene,  various 
contrivances  are  in  use.  Borhauer  has  used  a  clam,  in  the  branches  of 
which  are  a  number  of  holes  placed  opposite  each  other,  through  which 
wooden  or  metal  pins  can  be  passed  when  the  instrument  is  fixed  on  the 
sac.  Other  practitioners  employ  a  clam  with  toothed  branches,  the 
teeth  perforating  the  walls  of  the  sac.     Armatage.  recommends  an  iron 


rig.  225. 
Umbilical  Clam. 

screw  clam,  one  branch  of  which  has  a  long  deep  groove,  and  into  this 
fits  a  narrow  projecting  ridge  on  the  opposite  branch  (Fig.  226).  To 
apply  the  clam,  he  gives  the  following  directions:  "The  animal  is 
secured  and  placed  on  its  back.  The  skin  over  the  rupture  is  drawn 
together  by  the  fingers  in  aflat  fold,  corresponding  w'ith  a  central  longi- 
tudinal line  through  the  abdomen  {linea  alba),  and  elevated  from  the 
parts  beneath,  in  order  to  cause  the  intestines  or  omentum  to  descend. 
The  clam  is  then  put  over  the  skin,  as  close  to  the  abdomen  as  possible, 
and  the  screws  tightened.     The  pressure  must  not  be  too  severe,  or  the 


Fig.  226. 
Armatagk'8  Iron  Umbilical  Clam. 


parts  will  drop  off  too  soon,  and  possibly  the  intestines  may  escape. 
The  operation,  therefore,  requires  to  be  carefully  w^atched." 

Degive^  has  improved  upon  this  method,  by  introducing  two  strong 
steel  needles  through  the  skin  and  margins  of  the  umbilical  opening — 
guiding  their  points  so  as  to  prevent  injury  to  the  intestine,  by  a  finger 
passed  through  a  small  incision  at  the  base  of  the  tumour.  Above  these 
needles,  i.e.,  closer  to  the  body,  the  clam  is  applied;  this  can  be 
tightened  to  the  necessary  degree  by  the  screw  at  each  end.  In  order 
to  prevent  displacement  of  the  clam  when  the  needles  are  withdrawn, 
some  small  steel  pins  are  passed  through  the  skin  immediately  beneath  it. 
^  7'Ae  Ve.ierip.ary  Journal,  1894,  p.  156. 


(EDEMA  OF  THE  r.]f/!fLTCrs.  Tl-'i 

Sutures  are  frequently  employed,  and  there  are  various  ways  of  using 
them.  One  method  is  the  "  twisted "  suture,  which  is  applied  as 
follows  :  The  hernial  sac  is  included  between  two  round  })ieces  of  hard 
wood  or  iron,  which  are  drawn  ti^'htly  together  by  whipcord  passed 
round  their  extremities  before  and  behind  ;  double  sutures  are  then 
passed  through  the  sac,  one  of  which  is  tied  to  the  piece  of  wood  on  one 
side,  and  the  other  to  that  on  the  other  side — so  that  the  sac  is  com- 
pletely invested  between  the  wood  and  ligatures,  which  divide  it  into 
two  portions.  Another  procedure  by  suture  is  to  make  a  thick  longi- 
tudinal fold  of  the  skin  covering  the  hernia,  to  pass  the  suture  needle — 
armed  with  a  waxed  thread  or  cord — as  near  to  the  muscles  as  possible, 
and  about  three  to  four  inches  from  the  ring,  from  before  to  behind,  or 
one  side  to  the  other  ;  the  needle  is  again  passed  through  in  the  con- 
trary direction,  about  half  an  inch  from  the  first  perforation,  and  the 
two  portions  of  suture  firmly  tied,  so  as  to  draw  the  skin  together  like 
the  mouth  of  a  sac.  Sutures  are  then  passed  through  the  sides  of  the 
pedicle  and  tied,  so  as  to  include  the  whole  of  the  skin  in  the  multiple 
loops.  A  cure  by  this  procedure  is  usually  effected  in  al)out  fifteen  days. 
The  only  objection  to  the  operation  appears  to  be  the  danger  of  wound- 
ing the  intestine  by  the  needle.  To  obviate  this,  some  operators,  after 
reducing  the  hernia,  pull  the  empty  sac  well  away  from  the  abdomen, 
and  pass  it  through  a  partially  split  piece  of  lead  which  is  applied  close 
to  the  belly  ;  then  the  needle  can  be  used  without  risk,  as  the  lead — 
which  is  secured  in  situ — forms  a  shield  as  well  as  a  truss,  and  prevents 
the  descent  of  the  intestine  until  adhesion  has  taken  place. 

When  the  hernia  is  irreducible  or  strangulation  has  taken  place,  then 
it  will  be  necessary  to  carefully  open  the  sac.  Should  adhesion  have 
taken  place  between  the  latter  and  the  intestine,  or  between  the  skin 
and  peritoneum,  this  must  be  broken  up  ;  if  the  umbilical  ring  has  to  be 
incised  in  order  to  return  the  viscus,  this  may  be  effected  by  a  probe- 
pointed  bistoury.  The  incision  should  be  no  longer  than  is  absolutely 
requisite. 

The  after-treatment  of  operation  for  hernia  must  be  conducted  on 
surgical  principles,  and  according  to  the  necessities  of  the  case.  Easily 
digested  food,  in  small  quantity  and  frequently,  should  be  given  until 
the  cure  is  effected. 


CHAPTER  V. 
(Edema  of  the  Umbilicus. 

TuMEF.vcTioN,  or  rather  "  u  tlema  "  of  the  umbilical  region,  is  not  at  all 
uncommon.  Often  it  is  simply  due  to  an  effusion  of  serum  in  the 
connective  tissue  of  the  umbilical  cord,  and  sometimes  to  an  infiltration 
of  blood  in  this  pai-t  and  the  surrounding  connective  tissue. 

The  accident  is  usually  produced  by  contusion  and  laceration  during 
birth,  though  at  times  it  may  also  be  caused  by  the  young  creatures, 
when  two  or  more  are  together,  sucking  and  pulling  at  the  remains  of 
the  umbilical  cord.  It  may  also  be  due  to  chronic  inflammation  of  this 
part,  or  the  formation  of  abscess  in  the  umbilical  ring. 

The  accident  is  readily  recognised  ;  the  swelling  is  often  very  con- 
siderable, and  always  cold  to  the  touch.  It  often  persists  a  long  time 
in  Bovine  animals  ;  and  Zundel  says  that  it  then  constitutes  a  grave 


714        DISEASES  AXD  ABNORMALITIES  OF  THE  YOUXG  AXIMAL. 

defect  in  young  Bulls,  which  it  mechanically  prevents  from  copulating. 
When  due  to  sclerosis  of  the  connective  tissue,  it  is  usually  persistent. 

Treatment. 

Cold  applications  and  compresses  have  been  recommended  in  the  way 
of  treatment,  as  well  as  lotions  of  arnica,  camphorated  spirits  of  wine, 
preparations  of  iodine,  mercury,  etc.  These  often  fail,  however,  and  it 
is  generally  better  to  resort  to  scarifications  or  leeches  at  once,  to  be 
succeeded  by  hot  water  fomentations.  When  the  swelling  is  chronic 
and  due  to  a  blood  clot,  which  is  sometimes  the  case,  Baumeister 
recommends  enucleation. 


CHAPTEE  YI. 

Inflammation  of  the  Umbilical  Cord. 

Inflamjiatiox  of  the  umbilicus,  or  omphalitis  (the  so-called  "  navcl-iU" 
of  shepherds),  is  a  serious  accident,  and  often  terminates  fatally.  It 
consists  essentially  in  inflammation  of  the  umbilical  vein,  which  sooner 
or  later  involves  the  adjoining  tissues,  and  is  often  followed  by  suppura- 
tion and  pytemia,  which  causes  the  death  of  the  young  creature.  It  is 
rare  indeed  that  the  inflammation  remains  of  a  simple  kind  throughout 
its  course.  As  a  rule,  it  is  not  merely  an  omphalo-phlebitis,  but  involves 
the  abdominal  portion  of  the  umbilical  vein.  There  is  a  thrombus, 
which  soon  suppurates  ;  a  fistula  appears  at  the  umbilicus,  the  umbilical 
vein  is  inflamed  as  far  as  the  liver,  to  which  the  thrombosis  extends, 
and  the  portal  and  hepatic  veins  may  even  be  affected.  As  a  conse- 
quence, the  most  serious  accidents  may  arise.  Embolic  infarction  of 
the  lungs,  liver,  or  other  organs  is  likely  to  occur,  with  gangrene,  septi- 
caemia or  pyaemia. 

Symj^tojns. 

The  inflammation  commences  soon  after  birth.  The  remains  of  the 
umbilical  cord,  in  the  normal  condition,  quickly  dries  up  and  withers, 
as  it  were,  within  a  few  days  after  the  creature  is  born.  When  inflamed, 
however,  the  part  appears  to  be  moist,  and  projects  from  the  abdomen 
as  an  enlarged,  compact,  and  hard  mass,  from  the  centre  of  which  flows 
a  small  quantity  of  thin,  unhealthy,  purulent-looking  fluid  that  soils  the 
surrounding  skin.  The  peculiar  tap-like  appearance  of  the  umbilical 
cord,  its  density  and  high  temperature,  with  the  discharge  therefrom, 
will  lead  the  careful  observer  to  recognise  the  existence  of  omphalitis. 

A  probe  can  be  readily  passed  into  the  umbilical  vein,  which  remains 
patent  to  a  considerable  extent.  The  local  symptoms  are  often  over- 
looked at  the  commencement,  and  the  first  general  signs  of  omphalitis 
observed  are  usually  dulness,  arched  back,  indifference  to  the  teat  and 
to  surrounding  objects,  persistent  recumbency,  fever,  and  hurried  pant- 
ing respiration  when  general  infection  takes  place,  and  embolism  of  the 
lungs  is  occurring.  As  the  malady  progresses,  great  prostration  is 
manifest ;  there  is  swelling  at  the  umbilicus,  and  intense  pain  on 
manipulation  of  that  region  :  the  eyes  are  dull  and  injected,  the  mouth 
very  hot  and  dry  ;  the  pulse  is  so  small  and  quick  as  to  be  scarcely 
perceptible  ;  the  bowels  may  be  constipated  and  the  faeces  scanty,  or 
obstinate  diarrhoea  may  supervene ;  the  urine  is  greatly  diminished  in 
quantity  ;  the  mucous  membranes  frequently  assume  a  yellowish  tint ; 


IXh'LAMMATloX  "F  THK  I  M i:l IJf.l L  rni;],.  715 

soft,  rtuctuatiii^'  swellings,  containing  a  yellow  gelatinous  iluid,  often 
appear  on  various  parts  of  the  body  ;  the  creature  refuses  to  suck  ; 
indications  of  colic  or  peritonitis  are  sometimes  manifested,  with  enteror- 
rhagia  ;  and  in  the  majority  of  cases  death  rapidly  ensues. 

Not  infrequently  the  phlebitis  is  most  intense  in  the  internal  abdominal 
portion  of  tlie  vein,  and  the  pus,  instead  of  freely  escaping  from  the  ex- 
ternal opening,  accumulates  in  the  canal  to  such  a  degree  as  to  form  a 
large  swelling  at  the  umbilical  ring,  which  might  be  mistaken  at  the  first 
glance  for  a  hernia.  When  this  swelling  has  been  opened,  about  half  a 
[)int  of  pus  escapes  in  some  instances. 

When  a  fatal  termination  does  not  quickly  follow  from  septika'mia,  or 
from  embolism  of  some  important  organs,  through  detached  portions  of 
the  thrombus  being  carried  into  them  by  the  circulation,  we  may  have 
1  ironic  morbid  conditions  of  a  pya^nic  character  set  up,  which  are 
iiaracterised  by  metastatic  inflammation  of  the  serous  membranes  in 
various  parts  of  the  body,  and  particularly  of  the  articulations.  Indeed, 
it  is  now  recognised  by  the  highest  Continental  veterinarians,  that  the 
destructive  arthritis  or  "joint  disease"  of  Foals,  Calves,  and  Lambs  is 
attributable  to  omphalo-phlebitis.  Inflammation  of  the  joints — especi- 
ally of  the  hocks — has  often  been  accidentally  produced  by  tlie  inllam- 
mation  excited  through  ligaturing  the  umbilical  cord. 

Metastasis  to  the  iris,  choroid  coat  of  the  eye,  diarrhoea,  tumefaction 
of  the  lymphatic  glands,  abscesses  in  the  muscles  and  other  parts, 
etc.,  have  been  observed  as  a  result  of  inflammation  of  the  umbilical 
cord. 

Pathological  Anatoviy. 

In  animals  which  have  died  or  been  killed  in  consequence  of  this 
disease,  the  walls  of  the  umbilical  vein  throughout  the  course  of  the 
vessel  are  much  thickened,  and  tlie  communication  with  tlie  portal  vein 
entirely  interrupted  by  a  blood  clot.  The  vessel  is  flUed  by  a  yellow 
pulpy  mass,  foul-smelling  in  some  cases,  odourless  in  others  ;  while  its 
intinia  is  detached,  and  forms  part  of  the  contents.  In  the  abdominal 
cavity  we  may  And  effusion,  exudation,  and  adhesion  of  various  viscera, 
with  peritoneal  ha^norrhagic  spots.  The  portal  and  other  abdominal 
veins  often  contain  matter  similar  to  that  in  the  uml)ilical  vein  ;  the 
liver  is  enlarged,  in  some  cases  atrophied,  clay-coloured,  and  almost 
bloodless.  The  lymphatics  of  the  liver  and  mesentery  are  usually 
nodulated,  swollen,  and  infiltrated.  The  lungs  in  many  instances 
exhibit  intense  httMnorrhagic  infarction,  lobular  pneumonia  and  its  con- 
sequence, and  particularly  purulent  broncho-pneumonia.  In  special 
cases,  to  be  alluded  to  hereafter,  the  joints  are  swollen  and  inflamed, 
and  their  capsules  contain  pus.  When  the  creature  lives  until  it 
becomes  cachectic,  fatty  degeneration  of  tiie  muscles,  with  ecchymoses 
in  various  parts  of  the  body,  is  nearly  always  noted. 

Caitses. 
The  causes  of  omphalitis  are  numerous.  They  may  be  enumerated 
as  follows  :  the  admission  of  air  or  foreign  matters  to  the  interior  of  the 
umbilical  vessels;  bruises  or  injury  to  the  umbilicus,  either  during  birth 
or  afterwards  :  irritation  of  this  part  either  by  the  litter,  manure,  or 
urine  ;  the  habit  which  certain  females  have  of  licking  the  umbilicus  of 
their  progeny,  or  of  young  ci-eatures  to  suck  the  remains  of  the  umbilical 
cord  of  each  other  ;  rupture  of  the  cord  close  to,  or  within  the  abdomen; 


716        DISEASES  AXD  ABKOBMALITIES  OF  THE  YOUNG  ANIMAL. 

improper  food  given  to  the  motlier ;  exposure  to  cold  and  wet ;  and 
infection.  Bollinger  admits  that  in  certain  establishments,  in  conse- 
quence of  over-crowding,  the  omphalitis  of  young  animals  may  become 
erysipelatous,  and  be  due  to  an  analogous  infection  to  that  which  pro- 
duces the  oftentimes  fatal  inflammation  of  the  umbilical  cicati'ix  in  new- 
born children  in  maternity  hospitals.  Eueif  asserts  that  omphalitis  is 
more  frequent  in  some  years  than  others. 

There  can  scarcely  be  any  doubt  that,  as  Franck  remarks,  this 
inflammation  is  due  to  contact  of  the  atmosphere  with  the  umbilical 
wound,  and  to  the  ingress  of  germs  which  excite  zymosis  ;  or  to  contact 
with  filth  or  putrid  matters  containing  these  germs. 

There  can  scarcely  be  a  doubt,  also,  that  the  manner  in  which  the 
umbilical  cord  is  divided  at  birth  has  an  influence  in  the  production  of 
this  inflammation  ;  indeed,  the  separation  or  rupture  of  the  cord  neces- 
sarily produces  a  wound  that  is  readily  absorbent  under  all  circumstances, 
until  the  remaining  portion  attached  to  the  umbilicus  becomes  dry  and 
shrivelled.  The  exposed  umbilical  vein  and  artery  in  the  Foal,  the 
double  vein  in  Euminants,  also  increase  this  readiness  to  receive  infection, 
and  consequent  tendency  to  phlebitis  ;  and  these  vessels  are  occasionally 
laid  quite  bare  when  tlie  cord  is  divided  close  to  the  umbilical  ring,  and 
their  protecting  sheath  is  removed. 

Franck  gives  an  instance  of  this  accident,  which  was  witnessed  in  the 
breeding  sheds  of  the  Munich  Veterinary  School.  A  Cow  brought  forth 
twin  calves,  one  of  which — A — had  the  umbilical  cord  ruptured  in  the 
usual  way,  while  the  other — B — had  it  torn  asunder  in  a  markedly 
abnormal  manner.  Alongside  this  Cow  stood  another  which  had 
recently  calved,  then  was  attacked  with  puerperal  fever,  and  eventually 
succumbed  to  that  disease.  The  after-birth  of  this  animal  was  allowed 
to  lie  behind  the  Cow  which  had  given  birth  to  the  twins  ;  so  that  there 
was  no  lack  of  infection-producing  material — the  floor,  straw,  imple- 
ments, as  well  as  the  hands  of  the  cowmen,  being  impregnated  with  it. 
The  calf — B — which  had  the  umbilical  cord  abnormally  ruptured, 
became  affected  with  omphalitis ;  while  the  other — A — with  the  wound 
better  protected,  escaped  infection  and  remained  in  good  health. 

This  cause  of  omphalitis  must  be  frequently  and  extensively  in  opera- 
tion among  the  Lambs  of  flocks  of  Ewes  when  abortions  occur  among 
these,  or  when  putrid  matters  are  discharged  from  the  vulva,  or  even 
when  gangrenous  or  septic  mammitis  is  present  among  them.  It  is 
often  remarked  that  omphalitis  sometimes  appears  among  a  greater 
number  of  Lambs  on  a  particular  pasture  ;  and  it  is  extremely  probable 
that  careful  investigation  will  lead  to  the  discovery  that  many  of  these 
outbreaks  are  largely,  if  not  entirely,  due  to  septic  infection  of  this  kind. 
Franck  has  observed  such  occurrences  in  extensive  cowsheds,  when 
sometimes  of  ten  to  fifteen  Calves  born  within  a  few  days  of  each  other 
and  kept  together,  half  the  number  have  become  affected  with  this 
inflammation  of  the  navel,  and  the  remainder  has  escaped. 

It  must  be  remembered,  too,  that  the  discharge  from  one  diseased 
umbilicus  may  afford  sufficient  material  to  infect  a  great  many  newly- 
born  animals,  should  circumstances  prove  favourable. 

Not  only  may  contamination  take  place  through  actual  contact  with 
objects  soiled  or  impregnated  by  such  infective  material,  but  the  air 
itself,  or  flies,  may  prove  media  for  its  conveyance  to  the  umbilical 
wound.  There  may  also  be  a  special  infection,  as  a  consequence  of 
overcrowding  in  badly-ventilated    dwellings — something  analogous  to 


IXFLAMMATloX  OF  TIIK  UMBILICAL  CORD.  717 

the  puerperal  infection  observed  in  certain  maternity  and  other 
hospitals. 

A  niali^'nant  and  a  l)eni^'nant  form  of  omphalitis  have  been  described 
by  various  autliorities  ;  but  the  distinction,  if  it  really  exists,  is  of  no 
practical  importance,  and  it  is  perhaps  advisable,  in  so  far  as  treatment 
is  concerned,  to  consider  the  disease  always  as  mali^Miant.  It  would 
appear  to  be  fully  ascertained  that  septic  infection  gives  rise  to  far  more 
serious  and  destructive  intlammation  than  that  due  to  entrance  of  the 
air,  or  an  aerial  ferment,  into  the  wound  or  open  vessels  of  the  cord. 

As  lias  been  remarked,  this  inflammation  of  the  umbilical  cord  is 
more  frequent  in  Calves  and  Lambs  than  in  Foals  ;  and  the  reason  for 
this  is  probably  due  to  the  fact  that  in  the  former  tliere  is  a  ductus 
Arantii,  which  is  absent  in  the  latter.  There  may  also  occur  a  kind  of 
aspiration  of  air  into  the  umbilical  vein.  However  this  may  be,  it  must 
not  be  forgotten,  when  considering  the  etiology  of  omphalitis  and  its 
frequency  in  ditl'erent  species  of  animals,  that  putrid  or  septic  diseases 
are  much  more  conunon  in  Cows  and  Ewes  than  Mares,  and  that  the 
latter  do  not  so  often  receive  manual  assistance  during  parturition  ;  so 
that  they  are  less  liable  to  parturient  fever  and  other  septic  disorders 
which  might  involve  their  offspring. 

When  the  remains  of  the  umbilical  cord  are  once  fairly  dried  and 
shrivelled,  omphalitis  is  very  seldom,  if  ever,  witnessed. 

Ulrich'  reports  that  he  saw  an  extensive  outbreak  of  the  disease  in  a 
flock  of  Lambs,  many  of  which  died  from  abscess  in  the  liver.  Jle 
attributed  the  outbreak  to  feeding  the  Ewes  on  rape-cake.  Changing 
the  food  to  oil-cake,  and  administering  Glauber  salts  to  the  Ewes, 
checked  the  malady.  Franck  was  inclined  to  think  that  infection  may 
have  bad  something  to  do  with  the  outbreak. 

Treatment. 

The  prophi/laxis  of  omphalitis,  or  purulent  phlebitis  of  the  umbilical 
cord,  is  very  important,  and  nmst  be  based  on  knowledge  of  the  etiology 
I  if  the  malady.  This  has  just  been  alluded  to.  Cleanliness  is  absolutely 
necessary,  and  the  young  creature  should  be  protected  from  every 
possible  source  of  septic  itifection.  The  danger  will  be  greatly  obviated 
if  the  extremity  of  the  umbilical  cord  is  dressed  immediately  after  birth 
with  a  concentrated  solution  of  carbolic  acid,  which  destroys  germs, 
keeps  away  flies,  and  renders  putrid  matters  innocuous,  while  it  quickly 
shrivels  up  the  cord  itself.  This  preventive  treatment  is  strongly  to  be 
recommended  for  Lambs,  and  particularly  when  there  have  been  abor- 
tions among  the  Ewes,  retention  of  dead  Lambs  or  the  placental  mem- 
branes, or  any  other  likely  cause  of  putridity  on  a  sheep-run  or  pasture. 
The  same  measure  is  applicable  to  the  Calf  and  Foal  under  similar  con- 
ditions, but  in  all  cases  care  must  be  observed  not  to  apply  the  acid  to 
the  parts  surrounding  the  umbilicus. 

Curative  treatment  must  be  principally  of  an  antiseptic  kind.  At  the 
commencement  it  should  be  chiefly  local,  and  the  applications  most 
likely  to  prove  beneficial  are  lotions  of  carbolic  acid,  boric  acid,  salicylic 
acid  (particularly  if  fever  runs  high),  salicylate  of  soda,  permanganate 
of  potass,  borate  of  soda,  alum  or  other  astringent.  If  the  umbilical 
vein  is  readily  accessible,  one  of  these  lotions  may  be  introduced  into 
it,  either  by  a  fine  bone  probe  wrapped  round  with  lint,  or  by  a  syringe. 
'  Canstatt's  Jahrcsberichf,  1860,  p.  41. 


71S        DISEASES  AXD  ABXOIUIALITIES  OF  THE  YOUXG  AXIMAL. 

Franck  states  that  a  five  per  cent,  solution  of  carbolic  acid  may  be 
passed  in  this  way  into  the  abdominal  portion  of  the  vein  of  small 
Calves  ;  this  vessel  can  be  penetrated  to  a  distance  of  nearly  ten  inches. 
He  does  not  approve  of  injecting  the  solution,  because  of  the  danger  of 
injuring  the  portal  vein. 

If  suppuration  is  superficial,  the  same  lotions  may  be  used,  or  the 
part  may  be  cauterised  with  solid  nitrate  of  silver. 

When  the  inflammation  is  very  intense,  several  authorities  recommend 
recourse  to  vesicating  agents;  others  employ  ammoniacal  liniment,  and 
Eueff  advocates  tartarised  antimony  ointment. 

When  there  is  danger  of  general  infection,  or  this  has  already 
occurred,  then  the  internal  administration  of  antiseptic  agents  must  be 
resorted  to.  Franck  recommends  salicylate  of  soda  in  doses  of  about 
one  gramme  every  hour.  Carbolic  acid,  sulphite  of  soda,  quinine,  or 
other  agents  of  this  class,  may  also  be  given  with  advantage. 

Constipation  may  be  averted  by  castor-oil  or  a  suitable  diet — skimmed 
milk  alternately  with  new  milk.  Preparations  of  iron  may  also  be 
administered  ;  and  if  the  young  creature  is  still  at  the  teat,  its  dam 
should  be  well  fed. 

Franck  notes  that,  during  the  course  of  omphalitis,  the  most  serious 
complication  is  inflammation  of  the  umbilical  artery,  the  existence  of 
which  can  generally  only  be  detected  on  the  post  mortem  examination 
of  an  animal  which  has  died,  or  been  killed  because  of  the  disease. 
This  complication  is  more  frequent  in  the  Foal  than  the  Calf,  probably 
because  the  vessel  is  torn  at  the  umbilical  ring  in  the  first,  and  in  the 
abdomen  in  the  second.  The  peripheral  portion  is  thickened  and 
contains  a  reddish-coloured  thrombus,  or  it  is  filled  with  a  puriform 
breaking-up  mass,  and  often  the  vessel  is  surrounded  by,  or  imbedded 
in,  an  abscess  ;  a  sharp  line  of  demarcation  separates  the  inflamed  from 
the  health V  portion.  General  infection  or  pytemia  rapidly  follows 
umbilical  arteritis. 


CHAPTEE  VII. 
Arthritis. 

Disease  of  the  joints  of  young  animals,  occurring  soon  after  birth,  has 
been  for  a  long  time  recorded  in  districts  or  regions  where  breeding  is 
largely  carried  on;  the  animals  affected  belonging  to  the  Equine,  Bovine, 
and  Ovine  species — much  less  frequently  are  Dogs  and  Pigs  attacked. 
In  France  it  is  usually  known  as  the  "  x\rthrite  "  or  "  Paralysie  des 
Jeunes  Animaux,"  in  Germany  as  the  "  Fohlenlahme,"  "  Kalbliihme," 
and  "  Liimmerliihme  "  ;  and  in  this  country — where  it  has  evidently 
been  but  little  studied,  it  has  been  popularly  known  as  "  Joint  III,"  and 
technically  as  "Scrofulous  Disease  of  the  Joints,"  or  "Specific"  or 
"  Constitutional  Synovitis." 

The  disease  was  first  described,  we  believe,  by  Brugnone  -^  then  it 
was  noticed  by  Eoupp,-  Lecoq  in  1828,  Strauss-'  in  1831,  Benard*  in 

1  Traltato  clelJe  Bazzf  de'  Cavalli.     Turin,  1781. 
-  Recueil  dt  Mn/cci)!,;  Vt'ttrinaire,  1S25. 
'  Darr-fucht  der  Fohlen.     Vienna.  1831. 
**  Rtcue'd  de  Alidtrint  Vtterinaire,  1832. 


AiriJUUI  IS.  719 

1S32,  Triiger'  in  1S30,  Noll  in  1S40,  Darreau^  in  1842,  Anacker'  in  1848, 
Roloff^  in  ISGo,  and  Bollinger'  in  1S73  and  in  1875.''  In  Jhiglaiid, 
perliaps  the  most  valuable  description  of  the  malady  which  has  appeared 
is  by  SValley."  It  has  been  more  particularly  described  as  it  occurs  in  the 
Equine  race  in  Normandy,  by  Lecoq  and  Darreau,  and  in  Poitou  by 
Terai  ;  in  North  (lermany  by  Thiger,  Bollinger,  Strauss,  and  Koloff. 
In  the  Bovine  species,  it  has  been  portrayed  as  it  prevails  in  Bour- 
honnais,  by  Bt'nard  and  Gay  ;  in  Switzerland,  by  Anacker,  and  in 
Bavaria  by  Bollinger.  In  the  Ovine  species,  Hull  describes  it  as  existing 
in  Hungary,  llaubner  in  Saxony,  Kuers  in  Prussia,  and  Chambert  and 
Cauvert  in  the  South  of  France.  Walley  alludes  to  its  principal 
features  as  it  is  witnessed  in  Lambs  in  England. 

In  some  years  it  prevails  very  extensively,  and  appears  to  be  almost 
■  nzotitic  in  some  portions  of  the  above-mentioned  countries. 

By  some  authorities  it  has  been  supposed  to  be  a  constitutional 
disease,  by  others  as  scrofulous  in  its  nature  ;  while  others,  again, 
consider  it  as  essentially  pyiemic,  and  a  sequel  of  purulent  omphalo- 
phlebitis. 

Roloff  is  of  opinion  that  the  afifection  is  due  to  an  alteration  in  the 
blood — to  a  diminution  in  the  amount  of  mineral  salts  in  that  Huid — a 
veritable  cachexia,  in  fact,  allied  to  rachitism  or  osteomalacia.  In  this 
view,  the  inflammation  which  attacks  the  joints  and  is  symptomatic  of 
the  disorder,  should  be  attributed,  primarily,  to  a  cachectic  or  scrofulous 
diathesis,  and,  secondarily,  to  the  traction  exercised  by  the  ligaments, 
connective  tissue,  and  periosteum  imperfectly  attached  to  the  soft  and 
unequally  consistent  bones,  when  the  animal  moves. 

Walley  defines  it  as  an  inflammatory  affection  of  the  synovial  mem- 
brane of  the  joints,  of  a  specific  character ;  hence  the  terms  "  Specific 
Synovitis"  and  "  Specific  Arthritis." 

Causes. 

If  there  is  some  diversity  of  opinion  as  to  the  etiology  of  this  joint 
disease  of  young  animals,  there  is  absolute  unanimity  as  to  its  predis- 
posing cause — the  period  of  youth,  as  it  only  appears  dui-ing  lactation. 
This  fact  disposes  of  its  constitutional  or  hereditary  nature,  and  has 
inclined  some  veterinary  pathologists  to  attribute  its  occurrence  to  an 
alteration  in  the  composition  of  the  milk  of  the  parent. 

Darreau  believed  that  the  malady  is  more  frequent  among  Foals 
which  do  not  receive  the  first  milk,  which  contains  colostrum  ;  but  this 
view  is  not  borne  out  by  other  obsen-ers.  RolofT  witnessed  its  advent 
in  such  a  manner,  that  he  thought  it  nmst  be  sometimes  congenital. 
Walley  stated  that  the  causes  are  entirely  local,  and  can  be  traced  to  an 
impure  or  antemic  condition  of  the  milk  of  the  dam,  as  the  result  of 
improper  systems  of  management,  or  giving  food  deficient  in  the 
necessary  constituents  of  the  blood.  Hence,  he  asserted,  it  is  seen 
when  Ewes  have  been  fed  on  an  abundance  of  turnips,  without  a  sulfi- 
cient  allowance  of  hay  or  corn,  particularly  if  the  turnips  are  decaying, 
or  have  been  unduly  forced  with  artificial  manures. 

'  Fiihlenkrankhfi'en.     Berlin,  1839. 

-  Rentfil  df  Mnierine  Velerinaire,  1842. 

'  Kalhfrlahme.     Zurich,  1848. 

••  Fohlnihihm''.     Berlin,  lSt).'>. 

'"  Zur  Kntt !>%■<.<<  dtr  Fohknlahmf,  Virchow'a  Archh;  Band,  58,  1S"3. 

"  Dutlirli^  Zrit-^chrijt  fur  Thitrnudicin,  187.'». 

"■  "  Joint  111  in  Lambs,"  Vtttrinary  Journal,  1876,  p.  406. 


720        DISEASES  AND  ABNOIUIALITIES  OF  THE  YOUXG  AXIMAL. 

It  has  also  been  remarked  that  it  often  occurs  on  heath  lands  which 
are  much  exposed,  and  have  been  top-dressed  with  marl ;  but  the 
appearance  of  the  malady  only  when  the  young  creatures  are  at  the 
teat,  rather  negatives  the  idea  that  exposure  has  anything  to  do  with  it. 
It  has  likewise  been  noted  that  when  Ewes  are  fed  on  decaying  turnips 
or  mangold-wurtzel,  the  Lambs  are  frequently  the  subjects  of  effusions 
of  lymph  between  the  muscles — the  eifusion  being  arrested  when  corn 
is  given  to  the  Ewes. 

Walley  insisted  upon  an  altered  condition  of  the  milk  as  the  cause  of 
the  disease.  "  That  it  is  due  to,  and  must  be  associated  with,  an  altered 
condition  of  the  mother's  milk,  is  proved  by  the  fact  that  it  only  attacks 
young  animals  Vv'hiie  sucking  the  dam  ;  that  the  Ewes  coincidentally 
die  from  malignant  parturient  fever  (though  it  must  be  borne  in  mind 
that  it  is  not  necessary  that  the  Ewe  should  exhibit  any  external 
symptoms  of  a  diseased  condition  of  the  blood)  ;  and  that  it  is  frequently 
found  to  disappear  on  farms  which  have  been  heavily  limed  and  drained, 
and  also  when  a  different  system  of  management  has  been  adopted. 
Again,  the  general  post  mortem  appearances  bear  a  strong  resemblance 
to  those  of  distemper  in  the  dog,  especially  of  the  hepatic  form  of  the 
disease  ;  and  the  enlarged  and  softened  state  of  the  liver,  where  external 
symptoms  have  not  been  manifested,  points  to.  disease  of  a  typhoid 
character,  brought  on  by  the  imbibition  of  impure  milk."  He 
enumerates  the  exciting  causes,  as  "  exposure,  cold  damp  pastures 
(hence  the  more  frequent  localization  of  the  disease  in  the  joints), 
neglect  at  birth,  allowing  the  young  animals  to  become  covered  with 
mud  and  dirt,  thus  preventing  the  dam  licking  them,  excess  of  wet 
weather,  etc." 

Eoloff,  as  just  mentioned,  thought  the  development  of  the  disease  was 
due  to  the  insufficient  ingestion  of  calcareous  salts ;  and  as  the  malady 
is  originated  during  intra -uterine  life  or  the  sucking  period,  it  is  evident, 
he  added,  that  it  is  in  the  regime  to  which  the  dam  is  submitted  during 
gestation,  when  the  osseous  system  of  the  foetus  is  being  developed,  and 
when  suckling,  that  the  cause  of  the  disorder  must  be  especially  sought 
for.  Careful  analyses  have  shown  that  the  ash  of  the  herbage  or  hay 
in  the  localities  where  the  malady  makes  the  largest  number  of  victims, 
does  not  contain  more  than  six  to  eight  per  cent,  of  lime  salts,  while 
that  of  good  quality  should  have  from  eleven  to  thirteen  per  cent.  It  is 
also  remarked  that  this  form  of  arthritis  sometimes  prevails  in  those 
places  where  osteoclasty  of  cattle  is  frequent :  and  this  coincidence,  it 
is  affirmed,  should  indicate  a  common  origin  of  the  two  affections — a 
defective  supply  of  calcareous  salts,  and  particularly  of  the  phosphates. 
This  deficiency  is  sometimes  noticed  when  the  food  is  relatively  of  a 
rich  character  ;  though  then  the  amyloid  and  proteic  constituents  are 
in  excessive  proportion. 

Bollinger,  whose  scientific  and  most  valuable  researches  in  compara- 
tive pathology  entitle  his  opinions  to  the  greatest  consideration,  enter- 
tained different  views  as  to  the  origin  of  the  malady  ;  and  his  anatomo- 
pathological  investigations  in  this  direction  are  of  the  highest  interest 
and  importance.  His  observations  on  the  disorder  commenced  in  1869, 
at  the  Government  Stud  at  Graditz,  Silesia,  where  it  prevailed  enzooti- 
cally  and  caused  considerable  loss.  In  that  year  forty-seven  Foals  were 
attacked,  and  in  1870  twelve.  Nineteen  cases  were  not  very  serious ; 
but  of  the  other  forty,  twenty-nine  succumbed — a  mortality  of  72  per 
cent,   of  those  affected.     The  Foals  were  generally  seized  with  it  (75 


ARTHIUTIS.  721 

per  cent,  of  the  cases)  during  the  three  weeks  succeeding  birth.  Of  tho 
forty  Foals  above  alluded  to,  twenty  were  ill  within  the  lirst  eight  days, 
ten  in  fifteen  days,  and  the  others  in  the  fourth  or  sixth  week.  The 
period  of  the  malady  was,  of  course,  related  to  the  foaling  season — 
April,  May,  and  June.  After  an  attentive  study  of  the  symptom  and 
making  post  /«o/-/t'»i  examinations,  Bollinger  came  to  the  conclusion  that 
there  is  a  complete  analogy  between  the  arthritis  of  Foals — particularly 
in  the  lesions  observed — and  the  results  noticed  as  a  consequence  of 
omphalitis  in  infants.  In  his  opinion,  this  joint  disease,  with  its  com- 
plications, is  due  to  metastatic  pyasmia,  which  has  its  point  of  departure 
in  the  purulent  umphalo-phlebitis  described  in  the  preceding  section  of 
this  work. 

In  a  more  recent  publication,  Bollinger  returns  to  this  subject ;  and 
after  alluding  to  his  former  opinion,  founded  on  literary  studies  and 
clinical  observations,  that  the  lameness  or  disease  of  the  joints  which 
attacks  Foals  and  Calves  during  the  first  weeks  after  birth,  are  due  to 
l)rimary  alterations  in  the  apparatus  of  the  circulation,  viz.— inflamma- 
tion of  the  umbilicus  and  umbilical  vessels,  he  gives  further  evidence  in 
support  of  this  supposition.  The  autopsies  of  the  Calves  which  form 
tlie  subject  of  his  second  communication,  will  be  noticed  hereafter;  but  it 
may  be  mentioned  that  they  afford  indubitable  evidence  of  the  existence 
of  purulent  omphalo-phlebitis  and  its  consequences.  As  in  Foals,  so  in 
Calves,  he  traces  the  origin  of  joint  disease  to  violent  inflanmiation  of 
the  umbilical  veins.  He  notes  that  in  Calves — which  have  a  ductus 
ccnosus  Arantii  and  Foals  have  not — the  direct  opening  of  the  vessels 
into  the  posterior  vena  cava,  as  well  as  the  general  implication  of  the 
latter,  causes  a  proportionately  larger  number  of  cases  in  them  than  in 
Foals.  The  influences  at  work  in  the  production  of  omphalitis  have 
been  enumerated  ;  but  Bollinger  lays  great  stress  on  the  want  of  care, 
which  is,  as  a  rule,  bestowed  on  the  umbilical  cord  in  newly-born 
animals,  and  compares  this  neglect  with  the  scrupulous  attention  paid 
to  that  of  infants,  which  is  severed  and  bandaged  immediately  after 
birth  ;  while  the  former  have  to  lie  with  an  open  wound  in  all  kinds  of 
filth,  and  are  thus  readily  exposed  to  inoculation  witli  poisonous  or 
injurious  matters,  which  cannot  be  excluded  even  from  stables  built 
specially  for  the  purpose,  and  kept  thoroughly  clean.  If  the  navel 
wound  of  an  infant  were  exposed  to  the  filth  which  young  Foals  and 
Calves  have  to  lie  in,  it  would  be  quite  as  liable  to  blood-poisoning  as 
animals,  and  to  the  consequent  afifection  of  the  joints. 

Bollinger  contests  the  influence  of  food  in  the  production  of  the 
disease,  as  strong,  no  less  than  weak,  animals  are  attacked;  it  also 
appears  when  every  kind  of  diet  is  given  to  the  parent. 

He  also  denies  that  it  is  produced  by  chills,  and  attributes  its  advent 
chiefly  to  pyajmic  or  septic  infection.  He  compares  the  enzootic  appear- 
ances of  joint  lameness  with  the  endemic  outbreaks  of  pya}mia  and 
septicaemia  (or  puerperal  fever),  and  points  out  that  the  only  real 
difference  between  man  and  beast  lies  in  the  simultaneous  appearance 
of  puerperal  fever  epidemics  with  pyaemia  in  infants.  One  point  is 
certain,  he  adds,  and  that  is  that  there  is  a  physiological  and  anatomical 
difTerence  between  woman  and  the  domestic  animals.  The  anatomical 
structure  of  the  placenta  and  its  villi,  and  its  relations  with  the  placenta 
inatcrna,  are  of  such  a  nature  in  animals  as  to  prevent  (on  the  normal 
detachment  of  the  placenta)  any  rupture  of  bloodvessels,  and  conse- 
-quent  haemorrhage.     In  other  words,  if  deUvery  has  been  successfully 

46 


722        DISEASES  AND  ABKOBMALITIES  OF  THE  YOUNG  ANIMAL. 

accomplished,  no  injury  in  the  shape  of  wounds  or  abrasions  is  inflicted 
on  the  inner  surface  of  the  uterus ;  and  owing  chiefly  to  this  fact  is  the 
inflammatory  reaction  and  consecutive  lochial  fever  reduced  to  a 
minimum  among  animals,  the  introduction  of  poisonous  matters  (be 
they  vegetable  organisms  or  other  injurious  substances)  into  the  uterus 
being  rendered  much  more  difficult ;  while  we  frequently  find  instances 
of  the  pyemic  process,  due  to  inflammation  of  the  navel  and  its  vessels, 
among  sucking  animals,  with  the  parent — except  in  the  case  of  the  Cow 
— this  process  is  rare. 

SymiHoms. 

The  symptoms  of  this  form  of  arthritis  are  variously  enumerated. 
The  principal  is  extreme  difficulty  in  moving,  which  is  often  noticed 
without  any  other  premonitory  indication.  The  movements  are  pain- 
fully and  reluctantly  performed,  so  that  the  young  creature  generally 
persists  in  lying.  Around  the  epiphyses  of  the  bones,  and  consequently 
near  the  articulations,  there  is  swelling  not  only  of  the  proper  tissues  of 
the  joints,  but  also  of  the  surrounding  connective  tissue,  with  hot,, 
cedematous,  and  very  painful  infiltration  of  the  region.  From  the  very 
commencement  the  symptoms  are  most  acute,  and  similar  to  those  of 
ordinary  arthritis  ;  and  they  are  rendered  more  marked  by  the  least 
movement,  the  lameness  being  then  extremely  great ;  generally  all  the 
joints  are  involved.  The  fever  is  extreme,  the  respiration  hurried,  and 
the  visible  mucous  membranes  highly  injected;  sometimes,  and  especially 
with  Lambs,  there  are  quasi  tetanic  spasmodic  contractions.  The 
appetite  is  lost,  but  thirst  is  intense,  and  the  suffering  creature  will 
often  be  observed  dragging  itself  along  the  ground  to  reach  water  or  the 
teat  of  its  dam.  Not  unfrequently  there  is  at  the  same  time  a  debili- 
tating diarrhoea  or  dysentery,  and  sometimes  in  Lambs  a  purulent  nasal 
discharge. 

The  progress  of  the  disease  is  sometimes  very  rapid,  death  occurring 
in  twenty-four  or  forty-eight  hours  after  the  manifestation  of  the  earliest 
symptoms.  This  rapid  course  is,  however,  rare,  and  the  animal  may 
live  for  twenty  or  thirty  days,  or  even  longer.  Eecovery  is  also  rare,, 
and  death  is  the  usual  termination ;  it  is  quite  exceptional  that  the 
disease  becomes  chronic.  The  malady  usually  ends  in  suppuration, 
which  nearly  always  becomes  general,  numerous  abscesses  forming 
around  the  joints,  the  capsules  of  which  contain  pus  ;  there  are  also- 
purulent  deposits  in  other  regions  of  the  body.  Generally  after  the 
fourth  day,  when  the  joints  are  greatly  swollen,  the  hair  falls  off  in 
these  parts,  and  a  yellowish  or  citron-coloured  fluid,  then  pus,  begins- 
to  exude  through  the  skin,  which  sloughs  away  ;  the  ligaments  are  also- 
involved  in  this  sloughing  process,  and  at  last  the  articulations  are  com- 
pletely disorganised.  In  some  cases  the  limb  is  only  retained  by 
remains  of  tendons,  the  bones  being  exposed,  the  articular  surfaces 
destroyed,  and  the  odour  almost  insupportable.  The  complications 
may  be  pneumonia,  pleurisy,  pericarditis,  and  the  usual  indications  of 
pyaemia. 

In  Foals,  Bollinger  noted,  as  the  chief  symptoms,  violent  fever  with 
very  hurried  respiration  ;  the  animals  did  not  suck  so  much  as  usual,  and 
if  lively  and  attentive  at  the  commencement  of  the  disease,  they  quickly 
became  extremely  weak  and  torpid.  They  also  became  emaciated,  and 
the  coat  was  harsh  and  lustreless ;  often  there  was  nasal  catarrh  and 
discharge,  tumefaction  of  the  submaxillary  lymphatic  glands,  sometimes- 


AirnmiTix.  723 

capillary  bronchitis,  and  generally  diarrhcra.  With  the  majority  there 
was  tumefaction  of  certain  joints,  and  particularly  of  the  hocks.  In 
addition  to  the  swelling',  there  were  heat  and  pain,  with  ^a-eat  lameness. 
Not  infrequently  there  were  immense  subcutaneous  abscesses.  Stupor 
c\eutually  set  in,  and  the  creatures  looked  as  if  half  asleep;  then  coma 
was  soon  manifested ;  there  was  dysenteric  diarrhcea,  the  dejections 
being  quite  fluid,  greyish-coloured,  and  extremely  fcetid  ;  while  the 
visible  nmcous  membranes  had  often  a  yellowish  tint,  denoting  the  exist- 
ence of  icterus. 

In    Lambs  the   symptoms   are   similar   to  those   just   enumerated. 
Walley  described  them  as  follows  : — A  general  febrile  condition  of  the 
system,  as  shown  by  the  injected  state  of  the  mucous  membranes; 
quick,  irritable  pulse,  irregularity  of  the  bowels,  hurried  respiration,  and 
refusal  to  suck.     The  animal  persistently  lies,  and  if  made  to  move  does 
so  unwillingly  and  very  stiffly,  with  the  back   arched,  and  placing  as 
little    weight  as   possible   on  the   afifected   limb  or  limbs,  which   are 
usually  flexed,  even  in  recubation,  to  remove  pressure— this  persistent 
flexion  ultimately  leading  to  contraction  of  the  tendons  and  distorted 
limbs.     If  the  disease  continues,  the  muscles  waste,  causing  the  affected 
joint  to  appear  larger   than  it  really  is.     The  characteristic  swellings 
usually  appear  in  the  hocks,  knees,  and  stifles,  though  they  are  not  by 
any  means  confined  to  these  particular  joints.     In  character  they  are 
round,  have  a  doughy  feel,  are  intensely  painful  to  the  touch,  very  hot, 
immovable,  and  increase  in  size.     Thus  they  are  like,  yet  dissimilar  to, 
rheumatismal  swellings — like  them  in  being  located  in  the  joints,  and 
being  hard,  round,  and  tender ;  unlike  them  in  being  stationary,  and 
attacking  the  internal  structures  of  the  joints — the  primary  lesions  in 
rheumatism   being  confined  to  the  external  ligamentous  structures  of 
these  organs,  and  when  attacking  the  interior  of  the  joints  formative 
processes  are  evidenced;  while  in  "joint-ill"  degenerative   processes 
predominate.      As  the   disease  progresses,  and  life  is  prolonged,   the 
animal  becomes  emaciated,  diarrhoea  sets  in,  the  wool  falls  olT,  and  a 
variety  of  changes  are  detected  in  the  joints.     Erysipelatous  inflamma- 
tion makes  its   appearance  in  various  parts  of  the  skin  of  the  body, 
especially  at  the  external  orifice  of   the  urino-genital  organs,  at  the 
postero-inferior  part  of  the  abdomen,  and  round  the  navel,  in  the  latter 
position   constituting   "  navel-ill."      Local  dropsies  are   frequent  under 
the  jaw  and  other  dependent  positions — as  the  navel,  which  is  said  to 
be  pocked.     If  blood  is  abstracted  during  life,  or  collected  after  death, 
and  set  at  rest  for  a  time,  it  deposits  a  peculiar  dark-coloured,  grumous 
mass  at  the  bottom  of  the  vessel,  composed,  so  far  as  can  be  seen  by 
the  microscope,  of  altered  blood-cells.     This  deposit  lacks  the  firmness 
of  the  other  parts  of  the  clot,  and  bears  a  close  resemblance  to  half- 
fermented  damson  pulp.     Bacteria  are  developed  in  the  blood  shortly 
after  death,  and  long  before  any  putrefactive  odour  can   be  detected. 
Al-'irption  of  pus  into  the  blood — py.rmia — is  indicated  by  elevation  of 
tl.'    temperature,   foctor  of  the  breath,   diarrhoea,   dark   yellowish-red 
colour  of  the  mucous  membrane,  gnashing  of  the  teeth,  rigors,  and  hectic 
fever — the  latter  being  present  also  in  ulceration  of  the  joints. 

In  the  latter,  the  swellings  become  softer  and  very  irregular  in  outline, 
from  bulging  of  the  more  flaccid  portions  of  the  synovial  membrane  and 
skin :  and,  from  portions  of  the  effused  lymph  becoming  liquefied, 
fluctuation  is  produced — other  portions  remaining  solid.  The  fluctuating 
swellings  extend  along  the  thecae  or  sheaths  of  the  tendons — two  joints 


724       DISEASES  AND  ABNORMALITIES  OF  THE  YOUNG  ANIMAL. 

often  becoming  in  this  way  connected  with  each  other  ;  finally,  the  skin 
over  the  most  prominent  portions  of  the  joint  becomes  absorbed, 
ulcerates,  and  if  not  divided  by  the  lancet  or  by  accidental  violence, 
bursts— allowing  the  escape  of  the  contained  fluids  and  semi-solid 
matters,  and  being  followed  by  sinuous  ulcers,  caries,  or  abscess  proper, 
of  the  joint.  The  sinuses  may  extend  a  considerable  distance  from  the 
joint,  and  discharge  an  ichorous  unhealthy  fluid,  accompanied  by  fcetor 
if  bony  or  ligamentous  structure  is  involved.  In  some  cases  the  exuded 
lymph  simply  becomes  liquefied  and  absorbed,  without  any  external 
opening  being  formed;  in  others — i.e.,  when  the  lymph  is  plastic  and 
the  constitution  strong — it  undergoes  healthy  organisation,  and  remains 
as  a  part  of  the  joint,  producing,  however,  permanent  thickening,  dis- 
tortion, and  stif&iess. 

Prognosis, 

From  what  has  been  stated,  it  will  be  seen  that  the  prognosis  with 
regard  to  this  disease  must  always  be  unfavourable,  especially  when  the 
creature  is  very  young.  The  mortality  reaches  as  high  as  forty,  fifty, 
sixty,  and  even  more  per  cent.  Indeed,  Darreau  states  that  eighteen 
out  of  every  twenty  Foals  die  ;  and  Lecoq  says  that  the  breeders  in 
Normandy  have  an  axiom,  "  Poulain  boiteux,  poulain  perdu." 

Pathological  Anatomy. 

According  to  Eoloff,  the  predominant  lesions  are  the  characteristic 
alterations  of  rachitism  and  periostitis.  The  cartilage  uniting  the 
epiphyses  to  the  shaft  of  the  bones  is  soft  from  cellular  proliferation,  and 
injected  in  places  by  hsemorrhagic  spots ;  the  periosteum  is  also 
thickened,  injected,  and  here  and  there  detached  from  the  bones;  while 
towards  the  diarthrodial  surfaces  the  bone  tissue  is  greatly  involved. 
There  are,  in  fact,  all  the  lesions  of  arthritis,  but  they  are  of  a  much 
more  serious  character  than  those  observed  in  adult  animals.  The 
synovial  membrane  is  highly  inflamed,  and  there  is  great  infiltration  of 
the  connective  tissue  around  the  joints. 

Eeynal  has  found  in  the  intra-articular  cavities  of  the  joints,  deep- 
yellow-coloured  clots  streaked  with  red,  and  elastic  and  firm,  which  are 
nothing  more  than  false  membranes  that  have  had  time  to  form  in  the 
short  space  of  two  to  five  days. 

Walley  remarked  that,  in  Lambs,  the  2wst  mortem  appearances  are 
general  and  local.  The  general,  in  the  earlier  stages,  are  effusion  of 
lymph  between  the  intercostal  muscles,  beneath  the  pleura  and  into  the 
lungs,  and  in  other  organs ;  with  hyperemia  or  engorgement  of  the 
small  bloodvessels  of  the  mucous  membrane  of  the  stomach  (fourth 
compartment)  and  intestines. 

If  the  disease  has  existed  for  any  length  of  time,  erysipelatous  exuda- 
tions are  found  under  and  within  the  structure  of  the  skin  of  dependent 
parts,  or  effusion  of  serum  (dropsy)  into  the  connective  tissue  and  the 
various  cavities  of  the  body.  The  large  bloodvessels — even  those  of  the 
brain — are  filled  with  dark,  grumous,  damson-coloured  blood ;  the 
structure  of  the  brain  is  dark  ;  the  liver  is  often  enlarged,  friable,  and 
full  of  minute  abscesses,  which  give  it  a  mottled  appearance  that  is  fre- 
quently mistaken  for  tuberculosis  ;  all  the  organs  and  tissues  are  tinged 
with  the  colouring  matter  of  the  bile ;  the  small  vessels  of  the  omentum 
are  charged  with  blood,  and  the  mucous  lining  of  the  fourth  division  of 
the  stomach  is  congested  and  black  wherever  the  milk  has  lain  in  con- 


AIlTHIiiris.  72r. 

tact  with  it.  In  many  cases  the  urachus  is  black — a  bluish-black  hue 
extending  some  distance  along  the  mucous  membrane  of  the  bladder. 
The  umbilical  vein  is  also  black,  and  tilled  with  a  cheesy  material — de- 
generated lymph,  or  coagulum  of  blood. 

The  local  ai)pearances — /.c,  in  the  joints — are,  in  the  first  stages,  inflam- 
mation of  the  synovial  membrane,  which  in  a  short  time  extends  to  the 
ends  of  the  bones  and  to  the  ligamentous  structures^the  whole  iiaving 
an  intensely  scarlet  hue,  which  diminishes  in  a  few  days.  Coagulablf 
lymph  becomes  etVused  into  the  cavities  of  the  joints,  forming  perfect 
casts  of  their  interior,  and  tilling  up  the  interspaces  between  the  bones. 
In  time,  the  exuded  lymph  conunences  to  soften  and  break  down,  and 
owing  to  the  contraction  of  the  mass  the  fluid  portion  is  pressed  out, 
and  intermixes  with  the  degenerated  lymph.  Fluid  is  also  thrown  out 
from  the  irritated  vessels  of  the  joint,  and  aids  in  the  softening  of  the 
lymph.  After  a  time  suppuration  is  thoroughly  established,  and  pus 
cells  are  distinguished  by  the  aid  of  the  microscope.  The  sheaths  of 
the  tendons  running  over  the  fronts  of  the  joints  becomes  excessively 
inflamed,  and  the  bloodvessels  of  the  ligamentous  structures  are  filled 
with  scarlet  blood.  The  cartilage  covering  the  articular  ends  of  the  bones 
becomes  ulcerated  and  blackened,  as  is  also  the  cancellated  structure 
of  the  bones  themselves  ;  extravasations  of  blood,  from  perforation  of  the 
coats  of  the  vessels,  take  place,  the  coagula  either  undergoing  degenera- 
tion or  healthy  organization.  In  the  latter  case,  distinct  granulations 
are  formed,  wiiich,  on  recovery  of  the  animal,  fill  up  the  cavities  pro- 
duced by  the  lymph.  The  flakes  of  lymph  which  are  found  floating 
in  the  fluid  contents  of  the  joints  or  adherent  to  their  sides,  are 
often  mistaken  for  scrofulous  deposits.  If  animals  have  lived  sufli- 
ciently  long,  multiple  pyicmic  abscesses  are  found  in  the  various  organs 
and  structures  of  the  body.  Blood  from  deceased  Lambs  introduced 
into  the  veins  of  a  Dog,  has  given  rise  to  the  formation  of  multiple 
liepatic  abscesses. 

From  this  description  of  the  pathological  anatomy  of  the  malady, 
there  can  scarcely  be  any  doubt  as  to  its  pyirmic  or  septic  origin,  and 
this  is  further  demonstrated  by  the  description  of  its  morbid  anatomy 
by  Bollinger.' 

'  Jhnt-rhf  Z'i/'rhrif'/jiir  T/iif mifdirhi,  IS?'-.— A  nuile  Calf  Ix.rn  at  tlif  Agricultural 
School  of  Strickhof,  near  Zurich,  showed  H^inptoiiiH,  soon  aftrr  l>irth,  of  inHainination  of 
the  unihilicUM.  As  the  joints  began  to  swell,  ancl  there  wa«  nn  hoj)e  of  saving  the 
animal  from  the  efftcts  of  the  drea^lful  jnint  disease — "  gelenk.seuche  "—it  was  destroyed 
eight  days  afterwards.  The  body  was  dissected  an  hour  after  death,  but  the  examination 
w.-vs  imperfectly  made.  The  umbilical  ring  was  discovereil  to  be  still  open  ;  it  formed  a  cir- 
cular aperture  alxiut  two  centimetres  in  diameter,  the  sides  of  which  were  covered  with 
ulcers  and  a  greenish-yellow  pus.  The  umbilical  veins  and  the  joints  had  been  thrown 
away,  and  thertfore  the  investigation  cfjuld  not  be  continued.  Projecting  about  the 
upper  margin  of  lx)th  hmgs  were  several  cuneiform  tumours  of  a  dark-red  colcvur,  and  of 
a  solid  consistency.  In  the  ]>ericardium  was  a  quantity  of  pale  serum,  in  which  floated 
loose  stringy  fibres.  In  the  cavity  of  the  heart  were  »  few  detached  fibres  and  blood- 
clots.  Benrath  the  endix»rdium  were  various-sized  patches  of  ecchymoses  and  bloo«l 
extravasations.  Nothing  abnormal  was  observed  in  the  liver  and  kidneys  except 
bloodlessness. 

Another  Calf  was  bom  at  the  same  establishment  on  Febrtiary  Gth.  Its  birth  had 
been  laborious,  and  thy  umbilical  cord  was  divirled  in  the  ordinary  natural  manner.  The 
animal  did  not  appear  to  k>e  as  lively  as  it  ought.  About  eight  days  after  birth  a  swell- 
ing showed  itself  in  the  neighbourhood  of  the  navel  ;  this,  however,  disappeared  after 
the  application  of  poultices.  Fourteen  days  after  birth  the  Calf  could  not  stand,  and 
painful  swellings  app>eared  on  the  inner  aspect  of  the  knee  joints.  Until  this  time  the 
creature  had  a  gootl  appetite,  and  h.ad  taken  a  plentiful  supply  of  milk  regtilarly  every 
d.iy.     On   Febnian.-  27th,  the  appetite  entirely  failed,  and  on  the  28th  the  Calf  ^was 


726       DISEASES'  AND  ABNORMALITIES  OF  THE  YOUNG  ANIMAL. 

The  result  of  his  autopsies,  together  with  the  symptoms  observed 
during  life,  led  Bollinger  to  the  conclusion  that  the  development  of  the 
pathological  process  is  as  follows :  inflammation  of  the  umbilical  vessels, 
notably  the  vein,  with  its  decomposed  and  softened  thrombus,  which 
passes  into  the  vena  portae,  and  forms  the  point  of  departure  or  source 
of  a  metastatic  pygemia,  and  from  it  embolism  of  the  lungs  is  sometimes 
directly  originated  ;  or  at  other  times,  in  consequence  of  alteration  in 
the  blood,  which  is  septic,  and  of  the  general  character  of  the  inflam- 

killed,  in  order  that  the  carcase  might  realise  something.  The  most  important  organs 
were  sent  to  Bollinger,  and  their  examination  yielded  the  following  results  :  There  was 
purulent  emphalo-fhrombo-phlebitis,  loith  thrombosis  of  the  portal  vein ;  fibro-purtdent 
gonarthritis  of  the  stifle  joints  and  purident  peri-arthritis  ;  ptirident  tracheo-bronchitis, 
embolic  infarction  of  the  lungs,  commencing  endocarditis  of  the  mitred  valves,  and 
generalised  icterus.  The  parts  surrounding  the  stifle  joints  were  of  a  pale-yellow  colour, 
infiltrated  with  a  sero-purulent  fluid,  and  moderately  thickened.  In  the  cavity  of  the 
joints  there  was  a  tolerable  quantity  of  dark-tinted  serum,  and  on  the  synovial  membrane 
more  especially  was  a  mass  of  yellowish-green  and  firm  fibro-purulent  matter,  about  two 
centimetres  thick,  which  projected  into  the  synovial  cavity.  The  cartilages  of  the  joints 
were  covered  with  similar  matter,  and  in  some  places  they  were  quite  rough.  The  entire 
capsule  of  the  joint  was  inflamed,  softened,  and  purulent.  The  trachea  and  bronchial 
tubes  contained  a  quantity  of  muco-purulent  fluid,  which,  in  the  latter,  formed  itself  into 
one  mass.  The  mucous  membrane  was  pale  ;  the  almost  bloodless  lungs  had  ecchymosed 
spots  beneath  the  pleura,  and  in  one  place  were  two  wedge-shaped  masses  the  size  of  a 
pea,  which  on  being  cut  open  were  found  to  contain  pus  in  the  centre.  The  heart  and 
pericardium  were  normal,  with  the  exception  of  the  mitral  valve,  which  was  of  a  dark- 
red  colour,  thickened,  and  exhibited  hsemorrhagic  infiltration  in  places  ;  by  means  of  the 
microscope,  a  notable  cellular  opening  could  be  perceived  in  the  connective  tissue  close 
to  the  haemorrhage.  The  spleen  was  of  normal  size,  but  pale  and  bloodless  ;  the  liver 
was  enlarged,  full  of  blood,  icteric  in  tint  ;  in  parts  were  small,  subperitoneal  haemor- 
rhagic  deposits.  The  umbilical  vein  was  distended  throughout  its  entire  length  ;  its 
walls  were  considerably  thickened,  and  the  inner  surface  was  of  a  dirty-grey  colour, 
rough,  uneven,  and  studded  with  greyish -white  puriform  deposits.  This  alteration  in 
the  umbilical  vein  extended  as  far  as  its  junction  with  the  posterior  vena  cava,  which, 
owing  to  the  closure  of  the  ductus  venosus,  is  not  in  direct  communication  with  the 
umbilical  vein.  Where  the  latter  enters  the  portal  vein  was  a  purulent  cloaca,  beyond 
which  was  a  large  thrombotic  puriform  mass  that  obliterated  the  cavity  of  the  latter 
vessel  as  far  as  its  bifurcation.  As  fatty  degeneration  of  the  heart  was  suspected  from 
its  appearance,  the  tissue  of  that  organ  was  examined  microscopically,  but  it  was  found 
to  be  normal.  The  voluntary  muscles  in  the  vicinity  of  the  diseased  joints,  and  which 
appeared  very  pale  to  the  naked  eye,  were  only  clouded  with  granular  matter.  The  puri- 
form contents  of  the  umbilical  vein  consisted  of  fatty  granular  detritus,  in  which  it  was 
difficult  to  detect  pus  corpuscles  ;  bacteria  could  not  be  found  in  any  number.  The  liver 
offered  indications  of  a  violent  icterus,  and  exhibited  all  the  alterations  of  acute  paren- 
chymatous hepatitis,  with  marked  granular  degeneration  of  the  hepatic  cells. 

In  the  three  autopsies  of  Foals  made  by  Bollinger  at  Graditz  (Virchow^s  Archiv., 
1873),  he  found  double  broncho-pneumonia  of  the  anterior  lobes  of  the  lungs,  pulmonary 
abscesses,  purulent  arthritis,  intra-muscular  abscesses,  caries  of  the  bones,  and  fatty 
degeneration  of  the  muscles  of  animal  life,  particularly  in  the  neighbourhood  of  the 
affected  joints  ;  as  well  as  fatty  degeneration  of  the  heart  tissue,  liver,  and  kidneys.  In 
the  intestinal  canal  were  lesions  of  catarrhal  enteritis,  accompanied  by  hyperplasia  of 
the  mesenteric  glands.  Neither  in  the  animals  when  alive,  nor  at  their  autopsy,  were 
there  any  of  the  signs  of  rachitism  mentioned  by  Koloff.  The  umbilical  cord  was  unfor- 
tunately not  examined. 

On  another  occasion,  the  same  excellent  veterinary  pathologist  examined  the  bodies  of 
two  Foals — one  three  weeks,  the  other  five  weeks  old,  which  had  succumbed  to  this 
malady.  In  these  there  was  inflammation  and  thrombosis  of  the  umbilical  vessels,  con- 
tinuation of  the  thrombosis  of  the  umbilical  vein  (in  process  of  suppuration)  into  the 
portal  vein,  which  was  also  afifected  with  thrombosis,  as  well  as  its  hepatic  ramifications. 
In  one  of  these  cases  there  was  likewise  thrombosis  of  the  pulmonary  artery,  double 
pleurisy  with  pericarditis,  purulent  arthritis  affecting  several  joints,  vast  intra-muscular 
or  subcutaneous  abscesses,  and  cutaneous  erysipelas.  In  the  other  case  there  were  pul- 
monary abscesses,  circumscribed  pleurisj^  purulent  irido-choroiditis,  and,  finally,  in 
addition  to  general  anaemia  there  was  great  tumefaction  of  the  bronchial  and  mesenteric 
glands. 


ART  II  HIT  IS.  727 

Illations,  there  are  metastatic  intiaramations  of  the  serous  and  synovial 
membranes  (pleurisy,  pericarditis,  arthritis),  of  the  lungs,  iris  and  choroid 
coat  of  the  eye,  abscesses  in  the  muscles  and  connective  tissue — in  a 
word,  the  entire  series  of  clinical  and  anatomical  alterations  which 
constitute  the  complicated  arthritis  of  Foals. 

More  x-ecent  investigators  have  detected  special  micrococci  in  the 
fluids  and  tissues,  to  which  the  origin  of  the  disease  must  be  attributed. 
The  most  important  of  these  is  the  Streptococcus  pj/oijenes,  to  which  tlie 
more  ditTuse  suppurations  may  be  due  ;  and  the  Sta2)lii/lococcus  pyogenes 
<ilbus  and  Stitjilii/lococciis  aureus,  which  probably  produce  the  more 
localised  lesions  due  to  inflammation.  These  find  easy  access  to  the 
body  through  the  umbilicus  when  circumstances  are  favourable. 

Treatment. 

Curative  treatment  of  this  form  of  joint  disease  being,  under  the  most 
favourable  circumstances,  veiy  unsatisfactory  unless  it  is  adopted  at  the 
very  commencement,  the  greatest  importance  must  be  attached  to 
preventive  measures,  and  especially  if  the  malady  is  enzootic.  On  the 
Continent,  those  veterinarians  who  adopt  Eoloff's  view  lay  great  stress 
on  the  necessity  for  preserving  the  young  animals,  and  particularly  the 
female  parents,  from  the  effects  of  improper  feeding.  The  latter  are  to 
be  well  fed  during  pregnancy,  and  aliment  rich  in  earthy  salts  is  to  be 
;^'iven.  In  addition,  bone-dust  is  to  be  mixed  with  their  prepared  food, 
or  witli  bran,  meal,  or  oil-cake. 

When  it  is  continually  prevalent  in  districts,  it  is  recommended  to 
improve  the  pasture  lands,  and  to  restore  to  them,  by  means  of  top- 
<lressings,  the  mineral  elements  abstracted  by  the  growth  of  forage  or 
the  herbage  consumed  by  the  animals  grazing  upon  them.  Attention 
is  drawn  to  the  fact,  that  in  a  hundred  days  a  medium-sized  Cow  will 
remove  from  the  soil  about  a  kilogramme  of  phosphoric  acid,  which  is 
present  in  the  milk  yielded  during  that  period. 

But  as  there  is  every  reason  to  believe  that  the  malady  is  of  septic 
origin,  the  preventive  measures  recommended  for  omphalitis  must  be 
adopted. 

Curative  treatment,  as  has  just  been  said,  is  generally  unsatisfactory, 
and  this  not  only  from  the  comparatively  small  value  of  the  animals 
affected,  and  the  ditliculty  in  applying  remedies  to  tliem,  but  also  from 
the  very  serious  nature  of  the  disease,  and  the  character  of  the  tissues 
involved.  Even  when  the  life  of  the  creature  affected  with  arthritis  is 
preserved,  only  too  frequently  its  health  and  condition  are  irretrievably 
impaired. 

The  umbilicus  should  he  treated  as  in  omphalitis,  a  solution  of 
corrosive  sublimate  (1  to  1,00())  being  a  good  dressing,  and  some  of  the 
same  solution  may  also  be  injected  into  the  umbilical  vein ;  this  may 
be  repeated  twice  or  thrice  daily  for  the  first  few  days,  the  animal 
being  placed  on  its  back  during  the  application.  If  the  urachus  is  in- 
volved and  open,  a  solution  of  boracic  acid  ('2  drachms  to  16  ounces  of 
water)  should  be  injected  into  it ;  it  should  not  be  ligatured.  Hot 
water  fomentations  ought  to  be  applied  to  the  abdomen,  and  the 
animal  should  be  kept  in  a  clean  cool  place,  great  attention  being  paid 
to  the  diet. 

Zundel  remarks  that  counter-irritants  to  the  joints  augment  the  pain 
and  increase  the  debility,  and  emollients  have  only  a  doubtful  effect. 
In  the  hands  of  Strauss,  refrigerants  were  productive  of  good  results, 


72S       DISEASES  AND  ABNORMALITIES  OF  THE  YOUNG  ANIMAL. 

the  inflamed  joints  being  enveloped  afterwards  in  linen  bandages. 
Anodyne  lotions  and  embrocations  have  also  been  recommended,  in 
order  to  allay  the  pain  and  irritative  fever  ;  as  well  as  the  application 
of  tinctm'e  of  iodine  before  the  suppuration  period.  "When  suppuration 
is  established,  the  abscess  should  be  opened  at  the  proper  time. 

Tonics  have  been  given  with  advantage,  as  well  as  cod-liver-oil» 
castor-oil,  and  even  ordinary  oils  and  fats.  These  not  only  aid  in  the 
assimilation  of  earthy  salts  and  nitrogenous  matters,  but  to  some 
extent  act  as  a  laxative — a  service  of  some  importance.  Small  doses 
of  sulphate  of  magnesia  or  soda,  or  even  aloes,  may  also  be  given  with 
the  last-named  object,  or  to  produce  continuous  purgation  for  some 
time. 

With  regard  to  the  ti-eatment  of  the  disease  in  Lambs,  Walley 
advises  that  those  affected  be  removed  from  the  dam,  and  receive  milk 
from  healthy  animals.  This  milk  may  be  mixed  with  beaten-up  eggs, 
and  good  nitrogenised  gruels  may  also  be  allowed.  "  Place  in  dry, 
warm  houses,  and  give  gentle  aperients  —  as  castor-oil — or  better,  a 
small  dose  of  mercury  with  chalk ;  follow  up  by  febrifuges  and 
diuretics,  as  nitrate  of  potash  and  camphor,  with  nitric  ether,  or  car- 
bonate of  ammonia  ;  if  much  pain  is  evinced,  give  small  doses  of  opiates 
— Dover's  powder  being  the  best  agent  of  this  class  ;  or  inject  a  small 
quantity  of  the  solution  of  morphia  underneath  the  skin  of  the  joints. 
In  the  course  of  a  few  days,  tonic  treatment  should  be  adopted,  as  the 
administration  of  iron,  alternated  with  iodide  of  potassium  ;  or  mineral 
acids  with  cinchona,  or  other  vegetable  tonics ;  and  allow  a  little  wine, 
good  old  ale,  or  porter."  The  same  authority  recommends,  as  local 
treatment,  the  application  of  a  strong  blister — as  the  compound  tincture 
of  iodine  ointment — all  round  the  joint,  at  the  commencement  of  the 
disease ;  and  when  the  subsequent  inflammation  has  subsided,  to  keep 
the  joints  at  rest  and  in  their  proper  position  by  the  use  of  light  splints 
and  bandages,  leaving  the  joint  exposed  for  further  observation.  As 
soon  as  any  tendency  towards  "  pointing  "  in  suppuration  is  perceived, 
the  joint  is  to  be  opened  freely,  the  inflammatory  products  removed, 
and  the  interior  washed  out  with  a  solution  of  carbolic  acid  in  glycerine 
and  warm  water — one  part  of  the  first,  two  of  the  second,  and  forty  or 
fifty  of  the  last.  Afterwards,  pads  of  soft  lint  or  linen  and  tow,  saturated 
in  carbolised  oil  (one  to  eight  or  ten)  should  be  applied,  leaving  an 
aperture  inferiorly  for  the  escape  of  discharge  ;  the  dressings  are  to  be 
renewed  every  day.  Mild  caustics  or  astringent  lotions  are  to  be 
applied  if  granulations  project  above  the  skin.  If  the  ends  of  the  bones 
are  carious,  they  must  be  scraped,  and  nitric  or  muriatic  acid  applied  ; 
should  sinuses  have  formed,  they  must  be  obliterated  by  the  use  of 
setons,  or  laying  them  open  with  the  knife,  and  treating  them  after- 
wards as  ordinary  wounds.  "  In  treating  the  results  of  this  disease,  it 
must  be  borne  in  mind  that  in  young  animals  the  reparative  processes 
go  on  very  rapidly  ;  and  that  what  appears  to  be  a  very  formidable 
wound,  is  soon  converted  into  a  comparatively  simple  one.  Animals, 
too,  may,  with  a  little  trouble,  be  fattened  and  their  flesh  utilised  ;  few 
can  be  preserved  for  breeding  purposes."^ 

As  salicylic  acid  is  unrivalled  for  its  antipyretic  properties,  and  par- 
ticularly in  inflammation  of  the  fibro-serous  membranes,  its  internal 
administration  should  be  tried  in  this  arthritis  of  young  animals.     The 

^  The  flesh  of  animals  which  have  been  suffering  from  this  disease  should  be  interdicted 
as  food,  as  it  is  positively  dangerous  to  those  who  consume  it. 


IXninKSTloX.  72» 

soda  salt  (salicylate  of  soda)  is  the  best  form,  perhaps.  The  internal 
administration  of  other  antiseptic  remedies — as  preparations  of  carbolic 
acid  and  boracic  acid,  sulphite  of  soda,  quinine,  etc.,  might  also  be 
tried. 


CHAPTER  YIII. 
Indigestion. 

Indigestion  sometimes  attacks  young  animals  soon  after  birth,  and  is 
perhaps  most  frequently  observed  in  Calves,  seldoinor  in  Lambs  ;  in 
Foals  and  the  young  of  Carnivora  it  is  rarely  met  with. 

Causes. 

The  principal  cause  would  appear  to  be  too  rich  milk,  or  even  milk  diffi- 
cult of  digestion  from  its  poorness,  or  fi-om  its  containing  some  extraneous 
ingredient  to  which  the  young  creature  is  not  accustomed.  The  quan- 
tity of  milk  may  also  prove  as  potent  a  cause  as  its  quality.  Therefore 
it  often  happens,  that  too  copious  sucking  after  abstinence  will  give  rise 
to  an  attack  ;  and  among  Calves  reared  by  hand,  those  which  receive 
artificial  food  of  improper  quality  or  in  undue  quantity,  are  frequently 
the  subjects  of  indigestion.  An  alteration  in  the  milk  of  the  Cow,  pro- 
duced by  fatigue,  or  bad  food  or  water,  will  also  lead  to  the  same  acci- 
dent ;  while  altered  secretions  in  the  stomach  of  the  Calf  itself — as  too 
much  acidity — will  undoubtedly  cause  coagulation  of  the  milk,  and,  as  a 
consequence,  indigestion. 

Indigestion  is  often  witnessed  in  high-bred  Calves  which  are  un- 
naturally forced,  in  order  to  produce  greater  and  premature  develop- 
ment. 

Siimptoms. 

The  young  animal  looks  dull  and  dejected,  and  evinces  uneasiness  or 
suffering ;  the  movements  are  torpid ;  the  coat  is  dry  and  staring ;  it 
yawns  now  and  again,  and  there  are  sharp  gaseous  eructations  which 
cause  it  to  elevate  its  head.  Soon  it  refuses  to  suck  or  to  partake  of 
food,  and  the  nausea  is  more  marked  ;  there  may  be  vomiting  of  coagu- 
lated milk  ;  the  brenth  has  an  acid  odour,  and  the  tongue  is  coated 
with  a  white  or  greyish  fur;  the  abdomen  is  swollen  and  tympanitic,  and 
pressure  made  towards  the  upper  part  of  the  right  side,  as  well  as  along 
the  cartilages  of  the  ribs,  causes  pain  ;  flatus  is  expelled  when  diarrhoea 
— the  ficces  being  yellow  and  fcetid— sets  in,  which  is  frequent — though 
constipation  is  not  rare  ;  and  at  this  period  symptoms  of  colic  are  often 
noted,  and  the  respiration  is  at  times  hurried.  The  diarrhcra  is  a  means 
of  cure  ;  though  should  it  persist  too  long,  inflammation  of  the  stomach 
and  intestines  may  ensue.  Then  there  is  emaciation,  the  abdomen  is 
retracted  and  flanks  tucked  up ;  fever  is  present ;  signs  of  great  pain 
are  manifested ;  the  dejections  are  small  in  quantity,  and  consist  of  a 
yellow  glairy  mucus,  mixed  with  lymph  or  false  membranes. 

Indigestion  runs  its  course  rapidly  in  the  Calf — in  the  majority  of 
cases  only  occupying  two,  three,  or  four  days.  It  may  be  considered  a 
serious  condition,  as  death  often  occurs.  As  it  is  frequently  induced  by 
causes  which  are  in  operation  for  some  time,  even  when  recovery  takes 
place  relapses  are  to  be  apprehended  ;  at  last  the  stomach  and  intes- 
tines become  inflamed,  and  enteritis  brings  about  a  fatal  termination. 


730        DISEASES  AXD  ABXORMALITIES  OF  THE  YOUXG  AXIMAL. 

Under  the  most  favourable  circumstances  it  causes  loss  of  condition, 
and  often  retards  growth. 

Treatment. 

Preventive  treatment  is  to  be  based  on  the  predisposing  or  exciting 
•causes  just  enumerated.  Over-repletion  with  milk  should  be  guarded 
against,  and  if  the  animal  is  being  reared  artificially,  great  care  must 
be  paid  to  the  diet.  If  at  the  teat,  the  food  and  water  of  the  mother 
should  be  attended  to  ;  and  if  the  milk  is  too  rich,  this  may  be  remedied 
by  giving  less  stimulating  food.  With  Mares  which  are  worked  during 
the  suckling  period,  the  milk  is  often  retained  for  a  long  time  in  the  udder, 
and  becomes  altered ;  on  returning  to  the  Foal,  this  is  ravenously  hungry, 
and  over-gorges  itself  with  the  unhealthy  fluid.  The  preventive  measures 
are  obvious  in  such  a  case. 

Indigestion  may  be  due  to  an  insufficiency  of  oily  matters  in  the  milk 
■of  the  mother  ;  here  the  diet  of  the  latter  must  be  altered. 

The  curative  measures  in  mild  cases  are  simple.  Some  French  and 
Italian  veterinarians  recommend  the  administration  of  barley-water  or 
very  weak  beef-tea,  and  if  there  is  not  speedy  amendment  they  prescribe 
a  spoonful  of  rennet,  which,  they  assert,  readily  effects  a  cure. 

When  the  indigestion  is  due  to  acidity,  alkaline  agents — as  carbonate 
of  potass  or  soda,  lime-water,  calcined  magnesia,  etc. — and  afterwards 
castor-oil — are  generally  effective.  A  mild  purgative — such  as  castor- 
oil,  manna,  cream  of  tartar,  olive-oil,  or  a  dose  of  glycerine  in  albumin- 
ised  water — is  very  useful,  even  when  diarrhoea  has  set  in.  Manna  has 
proved  an  excellent  remedy  for  Lambs,  and  even  Calves.  When  con- 
stipation is  present,  enemata  of  soap  and  water  may  prove  serviceable. 
Vegetable  bitters — as  tincture  of  gentian — and  mild  stimulants,  are 
often  beneficial;  much  success  has  attended  the  administration  of  a 
spoonful  of  very  finely-powdered  vegetable  charcoal,  given  twice  a  day 
mixed  with  water  in  which  an  egg  has  been  beaten  up. 

When  there  is  pain  and  uneasiness,  chlorodyne  will  be  found  an 
excellent  medicine,  particularly  if  diarrhoea  has  persisted  for  some  time. 
Of  course,  a  change  of  regimen  is  generally  necessary.  In  chronic  indi- 
gestion of  Calves,  Philippi  omits  all  medical  treatment,  which  he  asserts 
is  usually  found  to  be  inefficacious  in  these  cases,  and  puts  them  to  be 
suckled  by  Cows  which  have  newly  calved,  dieting  them  carefully  at  the 
same  time. 


CHAPTEE  IX. 
Gastro-intestinal  Catarrh. 

According  to  Friedberger  and  Frohner,^  by  its  etiology  and  course,  as 
well  as  in  the  treatment  to  be  adopted,  the  gastro-intestinal  catarrh  of 
young  animals  differs  essentially  from  the  same  affection  in  adults.  It 
has  been  confounded  with  the  dysentery  of  young  animals,  and  in  the 
first  edition  of  this  work,  this  error  was  committed  ;  indeed,  for  more 
than  a  century  the  two  diseases  have  been,  and  are  even  now,  described 
as  one.  But  a  distinction  must  be  made,  and  they  are  separately  dealt 
with  here. 

^  Lehrhuch  der  Specidlen  Pathologie  unci  Theraple  der  Hausthiere,  vol.  i.,  p.  199, 
Stuttgart,  1887. 


GASTROIXrESTIXA L  CA T. i lUill,  731 

Sjimptoms. 

The  early  symptoms  vary  somewhat,  according  to  the  exciting  causes. 
SoniL'times  they  are  suddenly  manifested,  and  at  other  times  they  are 
so  gradually  developed  that  they  do  not  attract  attention  for  a  day  or 
longer.  With  sucking  animals  the  principal  symptom,  diarrhcea,  is 
usually  preceded  by  slight  anorexia,  dulness,  and  weakness  ;  but  with 
animals  which  are  weaned,  and  especially  if  the  attack  is  due  to 
drinking  very  cold  water  or  an  external  chill,  the  first  signs  are  fever 
and  general  disturl)ance — the  temperature  of  the  body  being  irregularly 
distributed,  limbs  cold  and  muHle  dry,  and  much  nervous  depression — 
sensory  and  motor.  Diarrhoea  soon  sets  in,  the  dejections  quickly 
becoming  watery,  and  frequently  energetically  expelled  ;  they  are  not 
long  before  they  are  fcetid  and  mucous,  yellow  or  greenish-gray  in  tint, 
spumous  and  foul-smelling,  and  containing  fibrinous  flakes  or  clots  ;  at 
a  later  period  they  are  blood-streaked  or  sanguinolent,  and  ejected  at 
very  short  intervals,  soiling  the  hind  legs  and  tail,  and  by  their  acridity 
causing  the  hair  around  the  anus,  perinieum,  and  thighs,  to  be  shed. 

Usually  there  is  tenesmus  and  signs  of  colic,  the  animal  standing  with 
its  back  arched  and  its  feet  drawn  together.  The  skin  is  dry  and  there 
is  horripilation  ;  the  debility  becomes  extreme,  and  the  exhalations  most 
offensive.  Tympanitis  is  often  present,  the  gases  accumulating  in  the 
rumen  and  intestines  of  the  Calf  producing  great  distension — though 
this  may  be  present  before,  during,  and  after  the  diarrhoea  stage,  being 
due  to  abnormal  fermentation. 

In  some  cases  death  occurs  within  a  few  days  or  as  many  weeks,  and 
is  generally  the  result  of  exhaustion,  amemia  or  hydrajmia;  though 
sometimes  the  disease  is  complicated  by  catarrhal  pneumonia— a  con- 
sequence, probably,  of  pulmonary  atelectasis,  which  is  so  frequent  in 
weakly  new-born  creatures. 

Etiology. 

With  animals  at  the  teat,  it  is  recognised  that  the  health  or  alimenta- 
tion of  the  mother  has  a  powerful  influence  in  the  production  of  this 
diarrhea.  Constitutional  diseases,  antrmia,  debility  and  disturbance  in 
the  digestive  apparatus  or  in  nutrition,  which  are  usually  accomjianied 
by  alterations  in  the  milk,  have  an  unfavourable  effect  on  young  animals; 
infectious  maladies — sucli  as  aphthous  fever,  generalised  tuberculosis, 
etc.,  are  very  inimical  to  the  progeny  ;  while  simple  congestion  of  the 
udder  and  mammitis  may  be  the  cause  of  gastro-intestinal  catarrh  in 
the  Calf. 

The  food  consumed  by  the  parent  has  likewise  an  influence  on  the 
quantity  and  fjuality  of  the  milk  which  the  progeny  receives.  When  it 
is  too  rich  or  too  poor  in  nitrogenous  constituents,  or  of  inferior  or  bad 
quality,  it  may  produce  diarrhcea  in  the  young  ;  or  excessive  fatigue 
will  so  alter  it  as  to  render  it  no  less  objectionable ;  while  certain 
medicaments  given  to  the  mother  will  irritate  the  intestinal  mucous 
membrane  of  the  offspring. 

Irregular  lactation,  cold,  or  cold  and  wet,  ovcrgorging  with  rich  milk, 
and  constipation  from  any  cause — as  when  the  meconium  is  retained  in 
the  intestines  from  the  first  milk  or  colostrum  not  being  allowed — all 
these  may  induce  gastro-intestinal  catarrh.  W'ith  weaned  animals  this 
may  also  be  due  to  inopportune  weaning  ;  improper  food,  which  gives 
rise  to  acetic,  butyric,  or  lactic  fermentation,  and  so  irritates  the  stomach 
and  intestines ;  cold   and   damp  weather ;  as  well   as  the  ingestion  of 


732        DISEASES  AXD  ABNORMALITIES  OF  THE  YOUXG  AXIMAL. 

injurious  foreign  matters,  and  the  presence  of  entozoa  in  the  digestive 
canal. 

Of  course,  the  occurrence  of  the  disease  is  favoured  by  general  pre- 
disposing causes — such  as  innate  weakness  or  great  sensibility  of  the 
digestive  organs,  disease  of  the  mesenteric  glands,  etc. 

Pathological  Anatomy. 

The  changes  observed  after  death  in  fatal  cases,  are  not  unlike  those 
seen  in  the  same  malady  in  adults ;  though  in  some  instances  in  which  the 
morbid  process  has  been  very  intense,  the  alterations  do  not  always 
correspond  with  the  symptoms  observed  during  life.  The  stomach 
usually  contains  large  masses  of  dense  clotted  milk  (casein)  in  sucking 
animals,  and  in  those  which  are  weaned  there  are  similar  masses  of 
undigested  matters.  The  mucous  membrane  of  the  stomach  and  intes- 
tines presents  variable  appearances — redness,  tumefaction,  follicular 
catarrh,  acute  ulceration  ;  with  atrophy,  thickening,  granulation,  pig- 
mentation, etc.,  in  the  chronic  form  ;  the  mesenteric  glands  are  enlarged. 
Emaciation  is  marked,  and  all  the  signs  of  anaemia  or  hydraemia  are 
present. 

Prognosis. 

The  prognosis  must  always  be  carefully  given,  and  will  be  based  on 
the  cause  or  causes  of  the  attack.  It  is  generally  unfavourable  when  the 
diarrhoea  and  tympanitis  have  continued  for  a  considerable  time. 

Treatment. 

If  possible  the  exciting  cause  should  be  removed ;  and  with  sucking 
animals  the  condition  of  the  parent  should  be  more  particularly  attended 
to,  in  the  direction  already  indicated.  The  diet  of  the  young  animal 
must  be  regulated  according  to  circumstances,  and  especially  in  the 
allowance  of  milk,  w^hich  ought  to  be  given  in  small  and  frequent  quan- 
tities, and  diluted  with  lime  water.  Calves  should  not  be  weaned  until 
they  are  from  four  to  six  months  old,  and  Lambs  not  under  three  or 
four  months — the  weaning  being  gradual,  and  the  food  given  easily 
digested  and  non-irritating. 

The  diarrhoea  is  to  be  combated  by  gum  or  Hnseed  mucilage,  raw  eggs, 
gelatine  water,  decoction  of  malt,  almond  milk,  rice  pulp,  etc.  It  may 
be  necessary  to  clear  out  the  intestines  by  means  of  a  mild  laxative — as 
castor-oil,  or  sulphate  of  soda,  or  magnesia  in  small  doses.  When  the 
diarrhoea  is  due  to  intestinal  fermentation,  the  carbonates  of  soda  or 
magnesia  may  be  advantageously  administered,  in  addition  to  the  castor- 
oil.  Three  to  five  drops  of  creosote  have  been  prescribed  for  the  Calf, 
and  a  half  to  one  drop  for  the  Lamb,  in  a  mucilaginous  excipient ;  also 
creolin,  salicylic  acid,  and  some  other  antiseptics.  Should  the  diarrhoea 
be  due  to  worms,  these  will  probably  lead  to  their  expulsion. 

When  the  diarrhoea  is  very  intense,  opium  and  rhubarb  have  rendered 
good  service,  as  well  as  Dover's  powder,  tincture  of  opium,  or,  perhaps 
better  still,  chlorodyne.  Styptics  or  astringents  are  likewise  useful 
when  carefully  given  ;  and  astringent  enemas — as  solutions  of  alum  or 
tannin  (1  per  cent.),  or  nitrate  of  silver  or  lead  (^  per  cent.)  have  been 
recommended. 1  Filliatre-  has  been  particularly  successful  with  enemas 
of  tar  water,  prepared  by  mixing  a  small  quantity  of  vegetable  tar 
(150  grammes)  in  boiling  water  (6  litres) ;  when  tepid  one-third  of  a 

1  Friedberger  and  Fruhner,  o;?.  cit.,  vol.  ii.,  p.  389. 
-  Rfcueil  de  Midecine  VeU'rivaire,  1886. 


nysExrj-JL'y  of  ynrxc  ammals.  733 

litre  is  given  in  enema  every  half-hour  until  the  diarrhoea  is  arrested. 
In  some  cases  this  rapidly  ensues.  Milk  diluted  with  one-fourth  of  the 
tar  water  is  to  be  given  as  food,  and  the  treatment  must  be  continued 
for  two  days. 


CHAPTER  X. 
Dysentery  of  Young  Animals  (Dysenteria  Neonatorum). 

The  peculiar  dysentery  which  attacks  young  creatures  while  at  the  teat 
has  for  very  many  years  attracted  particular  attention,  because  of  its 
specific  nature,  its  almost  incuraVjle  character,  and  the  great  mortality 
which  attends  it  ;  but  as  yet  it  is  perhaps  the  infectious  diseases  of 
animals  of  which  least  has  been  ascertained.  Known  by  various  names 
in  different  animal-rearing  countries  (as  "  White  Scour  "  in  England — 
the  "  \Veisse  Kuhr"  of  the  Germans,  and  the  "  Diarrhee  des  Jeunes 
Animaux  "  of  the  French),  it  is  generally  acknowledged  that  Calves  are 
far  more  fi-equently  attacked  than  other  animals  ;  though  it  is  also  an 
extremely  fatal  disease  among  Foals.  Brugnone^  long  ago  asserted  that 
it  is  one  of  the  maladies  which  cause  most  destruction  among  Foals 
in  breeding  establishments  ;  and  to  my  own  knowledge,  it  is  sometimes 
a  most  serious  scourge  among  the  young  thoroughbred  stock  in  this 
country.  It  is  also  a  fatal  malady  among  young  Lambs ;  and  it  is 
observed  in  piggeries  and  kennels  as  a  very  destructive  disorder.  It 
appears  to  be  much  more  frequent  among  animals  reared  in  dwellings 
than  among  those  at  pasture,  and  seems  to  be  related  to  the  artificial 
way  in  which  they  are  kept. 

Like  the  pyiRmic  polyarthritis  of  young  animals,  it  is  one  of  the  most 
fatal  disorders  to  which  tliey  are  liable.  According  to  Roll  it  is  very 
prevalent  in  some  parts  of  Austria,  and  in  one  region  alone,  of  3,318 
Calves,  1,196  were  attacked,  of  which  l,lo2 — 97  percent. — perished; 
in  1884,  in  the  same  districts  the  mortality  was  55  per  cent. 

In  the  order  of  frequency,  the  Calf  stands  first ;  then  the  Lamb,  the 
Foal,  the  Dog,  and  the  Cat. 

It  sometimes  haunts  breeding-stables  and  cowsheds  for  years,  and 
among  Calves  is  seen  more  frequently  in  some  localities  than  others — 
low-lying  districts  being  perhaps  \novQ  often  and  severely  visited  than 
elevated,  dry  situations. 

Epizo()tic  abortion  and  this  disease  have  been  noted  to  co-exist,  and 
it  has  been  supposed  there  is  some  relationship  between  the  two 
maladies. 

It  generally  appears  within  a  few  days  after  birth — from  the  first  to 
the  third  ;  beyond  the  fourth  day  it  is  much  less  frequent.  In  some 
instances  tlie  young  creatures  are  atTected  before  they  liavc  sucked  ;  so 
that  the  milk  could  not  have  had  any  influence  in  its  production. 

Symptoms. 

The  symptoms  are  described  as  somewhat  similar  in  all  the  species 
it  attacks.  In  Foals  it  usually  appears  within  the  first  three  days 
after  birth.  The  animals  are  dull  and  restless,  and  the  dejections  are 
mucous,  or  very  fluid  and  extremely  ftetid ;  while  the  expired  air  and 
cutaneous  exhalations  often  have  a  foul  odour.     The  eyes  become  sunk 

'  La  Moicalcia,  Turin,  1S93. 


734        DISEASES  AXD  ABXOItMALITIES  OF  THE  YOUNG  ANIMAL. 

in  their  orbits  ;  great  debility  sets  in  ;  thirst  is  intense  ;  the  abdomen  is 
retracted ;  and  in  some  cases  a  cutaneous  eruption  is  observed,  which 
is  generalised  or  is  located  in  the  parts  around  the  anus. 

More  than  a  century  ago,  Brugnone  described  the  symptoms  in  the 
Foal  as  follows  :  The  diaiTha3a  commences  two  or  three  days  after 
birth  ;  a  yellow,  acrid,  sometimes  purulent-looking  fluid  is  evacuated  ; 
the  animal  becomes  rapidly  emaciated,  and  is  nearly  always  lying  ;  it 
is  weak  and  staggers  about,  sucks  little  or  none  at  all,  and  at  last  falls 
into  a  state  of  complete  marasmus.  During  the  first  period,  it  is  not 
rare  to  observe  a  general  ophthalmia  occur  :  the  humours  of  the  eyes  are 
turbid  and  these  organs  are  painful ;  tears  flow  continually ;  the  eye- 
balls become  buried  in  their  sockets  and  are  atrophied;  and  vision 
appears  to  be  lost. 

When  the  Calf  becomes  affected,  it  ceases  to  suck,  if  it  has  begun  to 
do  so ;  for  Franck  has  known  the  diarrhoea  to  appear  immediately  after 
the  Calf  was  born  and  before  it  went  to  the  teat — indeed,  it  was  dead 
before  it  could  do  so ;  though  in  the  great  majority  of  cases  it  has  two 
or  three  good  meals  from  the  udder  before  acute  diarrhoea  sets  in. 
When  it  no  longer  sucks,  it  becomes  uneasy  and  bellows  ;  the  faeces, 
expelled  violently,  are  at  first  very  soft,  then  fluid  and  white  (mucous 
diarrhoea),  or  mixed  with  particles  of  casein  (white  dysentery),  and  very 
often  streaked  with  blood  ;  at  a  later  period  the  evacuations  are  con- 
tinuous and  made  involuntarily.  Exhaustion  is  rapid  and  the  creature 
cannot  rise  ;  convulsions  occur  frequently,  similar  to  those  witnessed  in 
infantile  diarrhoea ;  saliva  or  foam  flows  from  the  mouth  ;  the  expired 
air  has  a  sour  or  foetid  odour,  and  great  emaciation  is  observed.  There 
may  be  slight  tenesmus,  and  the  anal  opening  is  dilated  as  if  the 
sphincter  were  paralysed  ;  while  the  air  passing  into  the  rectum  pro- 
duces a  peculiar  sound.  Towards  the  end  the  creature  lies  immovable, 
and  dies  without  a  struggle  in  from  one  to  three  days.  Allusion  has 
been  made  to  its  fatality  ;  in  Bovines  from  50  to  100  per  cent,  die,  and 
in  many  outbreaks  it  kills  all  the  Calves  in  an  establishment ;  if  any 
chance  to  survive  an  attack,  they  are  sickly  and  feeble  for  a  long 
time. 

The  Lamb,  when  attacked,  also  ceases  to  suck  and  becomes  dull  and 
very  weak  ;  the  dejecta  are  watery  and  mucous,  and  foul-smelling ; 
frequently  there  is  tenesmus ;  and  the  temperature  may  rise  to  106' 
Fahr.,  though  it  quickly  falls  again.  The  respiration  is  hurried,  and 
foam  and  saliva  accumulate  about  the  mouth.  The  disease  generally 
manifests  itself  within  three  days  after  birth ;  Nikolski^  gives  its 
appearance  as  30  per  cent,  the  first  day,  40  per  cent,  the  second  day, 
25  per  cent,  the  third  day,  and  only  5  per  cent,  for  the  fourth  and 
succeeding  days.  It  runs  its  course,  on  the  average,  in  from  one  to 
three  days ;  though  in  some  cases  death  may  ensue  in  a  few  hours.- 

1  Veterinary  Archives  of  St.  Petershirg,  188.5. 

-  With  regard  to  the  disease  in  Lambs,  Benedikt{SachsenJahreKberichf,  1871,  p.  140) 
describes  it  under  the  head  of  "  typhous  diarrhoea  in  Sheep  "  {Typhose  Bulir  bei  Scha/en). 
He  writes  :  "  At  the  commencement  of  lambing-time,  the  Lambs  are  observed,  soon  after 
birth,  to  be  dull  and  dejected  ;  they  do  not  care  to  suck  ;  there  is  great  debility  ;  the 
eye  is  dull  and  sunken  ;  there  are  involuntary  evacuations  of  a  fcBtid,  brownish-yellow 
colour,  which  are  ejected  some  distance  ;  and  in  three  or  four  hours  death  ensues.  In  all 
the  cases  the  Lambs  appeared  to  be  quite  healthy  when  born  ;  but  in  two  or  three 
hours  afterwards  they  began  to  exhibit  these  symptoms,  and  during  the  fir.-t,  seldom  the 
second,  day  they  perished.  On  examination  of  the  carcase,  bright-rtd  spots  were  observed 
in  the  true  stomach  and  intestines,  which  contained  matter  having  an  unpleasant  odour. 
The  Ewes  remained  healthy." 


DYSKXTEIiV  OF  YOUXiJ  AXIMALS.  73S 

Pathological  Anatomy. 

There  is  nothing  very  characteristic  in  the  alterations  observed  after 
death.  The  intestinal  mucous  membrane  is  covered  by  amuco-purulent 
exudate  containing;  numerous  bacteria  ;  the  epithelium  is  desquamated 
in  dilTerent  parts,  and  the  coriuin  and  Peyer's  patches  are  tumehedand 
softened  ;  while  in  acute  cases  the  contents  of  the  intestine  are  san- 
guinolent.  Ulceration  is  not  present,  probably  owing  to  the  very  brief 
duration  of  the  malady.  The  mucous  membrane  of  the  true  stomach 
(fourth  compartment)  is  congested  on  the  summit  of  its  folds,  particularly 
in  the  pyloric  portion  ;  it  is  also  ecchymosed  and  infiltrated,  frequently 
looking  as  if  it  had  been  sodden,  while  there  are  often  traces  of  hicmor- 
rhage  ;  this  compartment  generally  contains  clots  of  casein  which  have 
an  acid  reaction. 

General  amemia  of  the  body  is  most  marked,  and  in  some  cases  there 
may  be  evidence  of  globular  broncho-pneumonia,  induced  by  fluids 
obtaining  access  to  the  air  passages.^ 

'  Franck  is,  perhaps,  the  best  authority  on  this  malady,  and  his  observations  are  of 
great  imiwrtance,  not  only  from  the  care  with  which  ho  studied  it,  but  also  from  the 
scientiKc  manner  in  which  he  investigated  its  pathological  anatomy.  He  examined  a 
number  of  b*>dies  of  Calves  which  had  recently  died  of  the  disease,  and  alwayd  found  the 
same  characteristic  alterations,  of  which  the  following  are  given  as  typical  : 

A  Bull-calf  of  the  Algiiuer  breed,  which  died  on  the  third  day  after  birth,  the  second 
day  of  the  disease.  Weight  37 '4  kilogrammes.  The  remaining  portion  of  the  umbilical 
cord  is  perfectly  dry.  The  hind  parts  are  somewhat  soiled  by  fieces,  the  eyes  are  deep  in 
their  sockets  ;  there  is  no  meteorismus.  Eight  incisors  are  cut.  There  is  a  remarkable 
and  general  bliKkllessness  observed,  and  this  is  more  particularly  noted  in  the  digestive 
organs,  which  look  very  white.  (This  aniemia  was  present  in  all  the  castas  to  the  highest 
degree  :  so  much  so,  indeed,  that  the  tanner  who  bought  the  skins  thought  they  were 
from  calves  which  had  been  slaughtered  in  the  ordinary  way,  i.e.,  bled  to  death — "  white 
Veal.")  The  umbilical  artery  is,  at  the  torn  extremity,  retracted,  dark-red  in  colour,  and 
contracted  towards  the  pelvic  opening  ;  it  is  distended  by  a  dark-red  blood-clot,  which 
extends  as  fur  as  the  aorta.  The  umbilical  vein  is  not  inflamed,  b<it  contains  a  (piantity 
of  dark,  small  blood-clots  (these  were  not  always  present)  ;  it  had  been  torn  through 
towards  the  outer  half  of  the  navel-ring,  so  that  both  divisions  were  visible.  The 
nrachus  is  ruptured  at  the  inner  portion  of  the  umbilical  opening.  Around  the  latter  are 
a  numV)er  of  generally  small  ecchymoses.  The  abdominal  cavity  is  filled  with  a  dark 
fluid,  which  extends  through  the  second  and  third  compartments  of  the  stomach,  as  far 
as  the  fourth  compartment.  This  fluid  is  also  found  in  the  mouth  and  pharynx,  as  well 
as  in  the  trachea  ;  though  none  is  observed  in  the  lungs.  In  the  tnie  stomach  is  dis- 
ct)vered  a  greater  ((uantity  (about  one  and  a  half  litre)  of  curdled  milk,  in  which  were 
dirty-white  tuaases  of  casc^in  ;  this  fluid  has  an  .icid  reaction — m:ikiiig  litmus  paper 
double-red  :  its  normal  condition.  The  mucous  membrane  of  tlii^  jxirtion  of  the 
stomach  is  o-dematous,  of  a  dirty  ytllowishred  colour,  with  traces  of  pout  mortem  solu- 
tion. In  the  third  compartment  are  a  number  of  isolated  ecchymoses  al>out  the  size  of 
a  pin's  head.  The  intestines  are  (|uite  empty,  and  their  lining  membrane  is  covered  by 
a  thin  layer  of  purulent-looking  matter,  which  has  a  feeble  alkaline  reaction.  Peyer's 
glands  are  slightly  swollen,  somewhat  injected,  but  otherwise  normal.  The  aecum  is 
remarkably  void  of  solid  or  fluid  contents,  and  is  full  of  gits.  The  liver  is  very  small, 
pale,  clay-c<iloured,  and  bloodless  ;  the  little  gall-bladder  is  completely  empty  ;  the 
spleen  is  normal.  The  lungs  are  speckled  red  ;  at  some  jwints  the  patches  are  reddish- 
brown  ;  the  organs  are  permeable  to  air.  The  cavities  in  lx)th  sides  of  the  heart  are  full 
of  dark,  coagtdated  blood,  and  l>eneath  the  epicardiiim  are  a  number  of  small  ecchy- 
moses. Otherwise  the  heart  and  its  %-alves  are  very  he;illhy.  The  dura  mater  of  the 
brain  is  strongly  attached  to  the  cranium.  The  minuses  are  dark  coloured,  and  fidl  of 
coagulated  bloo<l.  The  brain  is  remarkablj-  aujemic  ;  its  lateral  ventricles  are  di»tended 
by  a  clear  serous  fluid  ;  the  rete  mirabile  at  its  baie,  and  the  neighlxiuring  membranes, 
are  also  distended  by  coagulated  blood. 

Microscopic  examination  of  the  blood  and  the  blood-clots  in  the  heart,  umbilical  vein 
and  artery,  proved  that  these  were  perfectly  normal.  The  red  and  white  corpuscles  in 
them  were  unaltered,  and  there  were  no  special  organisms  ;  the  colour  of  the  bl'Hxi  was 
not  diminished.  All  those  appearances  which  are  particularly  noted  in  putrid  diseases — 
as  in  puerperal  fever,  and  particularly  in  septicaimia,  were  absent.     The  liver-cells  were 


736        DISEASES  AND  ABNORMALITIES  OF  THE  YOUNG  ANIMAL. 

Etiology. 

From  its  mode  of  origin  and  extension,  as  well  as  its  com'se,  this 
•disease  is  now  generally  recognised  as  due  to  micro-organisms,  though 
their  exact  characters  are  not  yet  accurately  ascertained.  The  best 
authorities  class  it  with  the  miasmatico-contagious  maladies,  trans- 
missible from  a  diseased  to  a  healthy  animal,  the  infecting  agent  being 
most  abundant  in  the  excreta.  Kotelmann^  asserts  he  was  successful  in 
conveying  the  malady  from  the  Calf  to  the  Lamb  ;  though  Gutmann- 
did  not  succeed  in  producing  it  by  making  animals  ingest  diseased 
excreta.  Neither  could  Pranck  produce  the  disease;  for  though  he 
administered  in  milk  a  quantity  of  the  intestinal  matter  (which  swarmed 
with  bacteria)  to  Sheep,  Goats,  and  Eabbits,  no  positive  result  was 
noted.  This,  however,  can  scarcely  be  deemed  a  satisfactory  experi- 
ment ;  and  it  would  be  better  to  try  the  effects  of  the  morbid  products 
on  sucking  calves  or  other  creatures  at  the  teat. 

According  to  Roloif,^  it  is  due  to  a  "  stable  miasma  "  ;  while  Obich,* 
who  was  the   first   to  differentiate  it  from  gastro-intestinal  catarrh, 


certainly  partly  filled  with  fat  granules,  but  there  was  otherwise  no  indication  of  fatty 
degeneration. 

A  very  special  feature  of  the  disease  was  always  found  in  the  microscopical  examina- 
tion of  the  contents  of  the  true  stomach  and  small  intestine.  In  these  were  discovered 
great  quantities  of  epithelium,  and  crowds  of  minute  organisms.  This  purulent-looking 
matter  appeared  to  be  a  kind  of  bacteria-pulp  {Balcterien-hr-ei).  Besides  innumerable 
micrococci,  there  were  also  immense  numbers  of  vibratile  staff-shaped  bodies  {achwingende 
Stcibcken).  In  the  present  state  of  uncertainty  of  the  question  with  regard  to  minute 
vegetable  organisms,  Franck  declines  to  give  an  opinion  as  to  the  species  to  which  the 
last-described  bodies  belong. 

^  Archiv.  fur  WissenschaftUche  unci  Praktische  Thierhtilkunde,  1885,  p.  298. 

^  Ellenberger's  JahresbericJit  for  1883,  p.  93. 

^  Miitheiiungen  aus  der  Thierdrztlicheii  Praxis,  1875,  p.  119.  Eoloff  says  :  "The 
malady  will  suddenly  appear  in  a  cowshed,  and  vanish  again  after  a  time,  without  any 
alteration  having  been  made  in  the  feeding  or  management  of  the  Cow.  I  was  consulted 
in  a  case  of  this  kind,  where,  in  a  large  cowshed,  during  eight  weeks  every  Calf  pro- 
duced therein  had  perished.  The  Calves  were  generally,  about  the  second  day  after  birth, 
uneasy  ;  they  bellowed,  appeared  to  be  suffering  from  abdominal  pain,  had  no  appetite, 
rapidly  lost  conditicm,  passed  watery  stools,  and  died  within  twenty-four  hours.  All 
remedies  tried — among  them,  large  doses  of  opium — were  useless.  Some  of  the  new- 
born Calves  were  fed  on  skimmed  milk,  othera  on  boiled  milk  diluted  with  water,  while 
others  received  no  milk  at  all,  but  were  fed  on  oatmeal  gruel  with  which  preparations  of 
iron  were  mixed— but  all  to  no  purpose,  as  they  died  all  the  same.  The  feeding  of  the 
Cows  was  in  every  way  good,  and  had  not  varied  from  that  of  other  times,  when  this 
disease  did  not  appear.  Roloff  therefore  concluded  that  the  mortality  was  due  to  a 
miasma  in  the  shed  ;  consequently  all  the  Cows  which  had  not  yet  calved  were  removed 
to  another  dry  and  airy  shed.  In  this  they  brought  forth  at  various  times,  and  the 
Calves  remained  healthy." 

In  a  second  instance,  the  malady  broke  out  suddenly  in  a  cowshed  at  the  commence- 
ment of  1874.  The  Calves  were  apparently  healthy  when  born,  but  in  about  two  days 
they  became  unwell  and  soon  died  in  the  usual  way.  As  an  experiment,  some  new-born 
Calves  were  not  allowed  to  get  milk  from  their  parent,  but  were  fed  on  milk  from  Cows 
in  other  sheds  where  the  disease  did  not  exist.  On  the  second  day,  however,  the  Calves 
sickened  all  the  same,  and  succumbed.  The  feeding  of  the  Cows  was  modified,  but 
without  benefit. 

In  a  third  instance,  Roloflf  mentions  that,  for  a  long  time,  all  the  Calves  in  a  large 
cowshed  had  perished  in  a  similar  manner,  and  though  many  of  them  had  not  received 
any  of  their  mother's  milk — some  of  them  no  food  at  all — yet  it  made  no  difference. 
This  instance  was  particularly  conclusive  that  the  milk  of  the  parenb  was  certainly  not 
the  cause  of  the  disorder.  The  Cows  near  their  time  for  calving  were  moved  from  this 
shed  into  another  some  distance  away,  and  the  change  was  attended  with  the  happiest 
results. 

*  Wochenschri/t fur  Thierheilhmde,  1865. 


l>ySEXTKi:V  OF  YOUXG  AXIMALS.  737 

thought  the  infecting  agent  must  be  volatile,  and  gives  instances  which 
he  believed  proved  it  to  bo  so. 

Franck  admitted  the  possibility  of  intra-uterine  infection  through  the 
genital  canal,  and  in  this  way  he  explained  the  appearance  of  the 
tlisease  in  the  young  animal  so  soon  after  birth  ;  while  Ellenberger  and 
Frohner'  think  it  probable  that  this  intra-uterine  infection  is  realised 
by  tiie  transmission  of  an  infective  catarrh  of  the  vagina  and  uterus  of 
the  parent  to  the  digestive  mucous  membrane  of  the  fcetus.  In  this 
respect  it  is  interesting  to  note,  that  wlien  pregnant  Cows  are  trans- 
ferred from  an  infected  to  a  healthy  stable,  and  soon  after  calve  there, 
their  progeny  may  still  be  attacked.  But  if  the  transfer  has  taken 
place  so  long  as  six  weeks  or  two  months  before  parturition,  then  there 
is  indeed  but  little  risk  of  the  young  creatures  being  seized  with  this 
dysentery. 

The  malady  is  most  intense  during  permanent  stabling ;  with  the 
advent  of  grazing,  when  the  cattle  are  driven  to  pasture,  it  begins  to 
disappear,  and  is  no  more  heard  of  until  the  pregnant  Cows  are  again 
^tabled  and  commence  to  calve.  Bad  food,  cold  and  wet,  and  other 
similar  influences,  will  not  cause  the  disease,  though  they  may  more 
or  less  predispose  to  it. 

Diagnosis. 

The  diagnosis  of  the  disease  is  established  by  the  very  rapidly  fatal 
diarrhaa  prevailing  in  an  enzootic  manner,  and  at  or  soon  after  birth. 

The  only  disorder  it  might  be  mistaken  for  is  the  gastro-intestinal 
catarrh  already  described  ;  but,  as  will  be  seen,  it  is  different  to  that 
disease,  which  usually  appears  at  a  later  period  of  life,  and  has  a 
milder  course. 

Prognosis. 

The  prognosis  of  this  disease  in  generally  unfavourable.  Nearly  all 
the  young  animals  seized  with  it  perish  ;  and  when  a  few  recover,  it  is 
either  through  energetic  and  appropriate  treatment,  from  their  being 
attacked  in  a  less  severe  manner,  or  from  being  endowed  with  greater 
vital  tenacity.  And  even  those  which  recover  are  usually  so  reduced 
in  strength  and  condition,  and  convalescence  is  so  protracted  and 
unsatisfactory,  that  there  is  little  if  any  profit  in  rearing  them.  As  a 
rule,  all  those  born  about  the  same  period  succumb ;  but  after  the 
malady  has  prevailed  for  one  or  two  years  in  a  shed,  it  assumes  a 
milder  form,  and  more  recoveries  are  recorded.  When  the  disease 
appears  in  small  cowsheds,  where  there  are  fewer  calves  and  compara- 
tively more  space,  it  is  much  less  to  be  dreaded.  Sometimes  it  dis- 
appears from  a  cowshed  for  some  months.  Old  calves  are  not  so 
readily  affected,  and  recover  more  readily.  Weaned  calves  which  are 
fed  on  fodder,  appear  to  enjoy  immunity  from  attack. 

Treatment. 

As  with  every  other  animal  malady,  preventive  treatment  is  the  most 
important  with  regard  to  this  dysentery  of  young  animals.  Attention 
to  hygiene  is  very  necessary  at  all  times,  and  more  so  when  the  disease 
has  shown  itself  in  a  stable  or  shed.  It  is  much  the  safer  plan,  how- 
ever, to  remove  all  pregnant  animals  from  the  dwelling  in  which  it  has 
appeared,  and  the  longer  the  inten'al  which  elapses  between  their 
removal  and  the  occurrence  of  parturition,  so  the  more  likeHhood  there 
>  Op.  cil.,  vol.  ii.,  p.  391. 

47 


738       DISEASES  AND  ABNORMALITIES  OF  THE  YOUNG  ANIMAL. 

is  of  their  progeny  escaping.  If  moved  in  three  to  four,  or  four  to  six 
weeks  before  parturition,  their  safety  may  be  fairly  assured.  The  stable 
or  shed  in  which  the  malady  has  occurred  should  be  well  disinfected, 
and,  if  possible,  left  unoccupied  during  the  grazing  season.  The  floor 
particularly  demands  attention,  as  it  is  not  at  all  improbable  that  the 
infection  is  retained  there  ;  if  possible,  the  floor  should  be  renewed. 
Strong  carbolic  acid,  or  chloride  of  lime  wash,  must  be  freely  employed, 
and  especially  where  the  excreta  from  the  sick  animals  have  fallen. 
Thorough  disinfection  of  the  building  with  sulphurous  acid  or  chlorine 
gas  is  advisable. 

With  regard  to  curative  measures,  but  little,  unfortunately,  can  be 
said.  The  history  of  the  outbreak  may  suggest  the  nature  of  predisposing 
causes,  and  furnish  indications  for  their  removal. 

With  regard  to  medical  treatment  of  the  affected  animals,  this  should 
commence  with  a  slight  laxative — such  as  castor-oil — to  be  followed  by 
doses  of  opium  and  calomel  or  Dover's  powder,  if  deemed  desirable  ; 
but  there  have  been  so  many  drugs  recommended,  that  it  is  difficult  to 
say,  without  actual  experience  of  their  use,  which  should  be  adopted. 
Hertwig  had  a  recipe  which  he  averred  was  almost  a  specific  ;  it  is  as 
follows  : 

Pulv.  rad.  rhei         -         -         -         -     4-0  grammes. 
,,     magnes.  carb.  -         -         -     1-  ,, 

,,     opii  pulv.        ...         -     2-  ,, 

This  is  to  be  given  to  the  Foal  or  Calf  in  100  to  120  grammes  of 
camomile  tea,  or  in  fifty  grammes  of  whisky — the  dose  to  be  repeated  in 
tvv'elve  hours  if  necessary. 

Salicylate  of  bismuth  in  two  drachm  doses  for  Foals  and  Calves,  as 
well  as  salicylate  of  iron,  has  been  highly  spoken  of. 

A  mode  of  treatment  said  to  be  very  effective  in  Italy,  is  the  follow- 
ing :  Salol,  2  drachms  ;  oxide  of  bismuth,  4  drachms  ;  carbonate  of 
lime,  1  oz.  Mix  and  divide  into  six  equal  parts  or  doses,  the  first  two 
doses  to  be  administered  at  an  interval  of  two  hours,  and  the  other 
four  every  four  hours.  Each  dose  is  to  be  given  in  a  glass  of  camomile 
infusion,  to  which  add,  if  the  animal  is  very  ill,  half  a  glass  of  good 
wine.  A  cure  is  almost  always  obtained  in  two  or  three  days,  and 
there  is  no  necessity  to  prolong  the  treatment  after  this.  The  remedy 
has  failed  only  in  those  cases  where  it  has  been  applied  too  late.  The 
antiseptic  washing  of  the  Cow's  udder  is  also  recommended,  and  the 
disinfection  of  the  stables.  During  the  treatment  the  Calf  should  not 
be  forced  to  take  milk,  but  left  to  do  as  it  likes. 

Tannic  and  salicylic  acids,  2  drachms  of  each  for  a  dose,  given  once 
or  twice  a  day  in  an  infusion  of  camomile,  to  affected  Calves,  have  also 
been  prescribed.  Creolin  in  one  gramme  doses,  dissolved  in  water,  and 
administered  three  times  a  day,  has  been  favourably  reported  upon. 

Zundel  speaks  of  enemeta  of  starch  or  dextrine,  or  water  slightly 
carbolised ;  and  he  particularly  recommends  those  composed  of  a 
dilute  solution  of  permanganate  of  potass  (1  or  2  to  100).  Franck 
suggests  the  employment  of  tepid  enemas  of  the  neutral  salicylate 
of  soda  (about  ten  grammes  per  diem),  in  doses  of  one  or  two 
grammes. 

If  the  animal  can  take  food  it  should  be  given  in  small  quantities, 
and  each  meal  of  milk  is  to  be  diluted  with  about  one-fourth  of  lime- 
water,  to  prevent  the  formation   of  curd  in  the  stomach.     In  more 


nKTEXTinX  (>F  .VEroxir.V.  739 

seriouB  cases,  milk  should  be  withheld,  and  instead  of  it  may  be  sub- 
stituted well-boiled  ^Tuel  made  with  wheaten  Hour,  Liebig's  farinaceous 
food,  or  even  eggs  and  beef-tea  may  be  administered. 

The  patient  should  be  kept  warm  and  comfortable;  warm  baths  have 
sometimes  proved  useful. 


cn apti:k  xi. 

Retention  of  Meconium— Constipation. 

The  contents  of  the  intestines — the  meconium — are  generally  ex- 
pelled immediately  after  birth,  when  the  umbilical  circulation  is 
tirst  interrupted.  When  the  meconium  is  retained  much  longer  it 
is  abnormal ;  and  this  perhaps  occurs  more  frequently  with  the  Foal 
than  other  creatures.  The  prolonged  retention  of  the  meconium 
gives  rise  to  constipation,  and  this  is  often  a  serious  condition. 
The  animals  in  which  it  occurs  are  generally  weakly,  and  not  well 
developed. 

Causes. 

Constipation  is  usually  observed  in  Foals  which  have  been  dropped 
in  February  or  March,  and  whose  dams  have  been  fed  exclusively  on 
dry  fodder  during  the  winter.  This  result  is  still  more  likely  to  follow 
if  the  dams  have  been  worked  until  near  foaling-time.  Their  milk  is 
then  deficient  in  those  purgative  qualities  which  are  so  necessary  for 
the  new  born  animal.  It  is  the  same  with  Cows  which  have  been 
stall-fed  all  the  winter  with  dry  food  ;  and  the  Calves  are  almost 
certain  to  suffer  from  retention  of  the  meconium  if  deprived  of  the  first 
milk,  oven  if  the  mothers  have  been  properly  fed. 

Si/m2)toms. 

One  or  two  days  after  birth  the  Foal  appears  to  be  uneasy,  refuses  to 
suck,  has  tenesmus,  makes  efforts  to  defecate,  exhibits  symptoms  of 
colic,  rolls  on  the  ground,  and  often  looks  towards  the  abdomen  ;  the 
back  is  arched,  micturition  is  suspended,  pulse  and  respiration  are 
frequent,  the  eyes  are  injected,  and  there  is  grinding  of  the  teeth. 
Enteritis  sets  in,  and  death  takes  place  in  struggles  and  convulsions. 

The  symptoms  are  similar  in  the  Calf :  the  abdomen  is  very  much  re- 
tracted ;  the  respiration  hurried  ;  the  back  is  raised  when  the  creature 
is  standing,  though  it  generally  persists  in  lying  ;  it  moans  continually; 
refuses  to  suck ;  and  is  very  restless. 

Treatvient. 

The  jyrcventivc  treatment  consists  in  attending  to  the  feeding  and 
condition  of  the  pregnant  animal  some  time  before  parturition.  The 
young  creature  should  be  fed  on  the  first  milk  its  parent  yields  ;  if  this 
cannot  be  given,  then  the  animal  should  have  a  dose  of  castor-oil. 

The  curative  treatment  must  be  directed  towards  removing  the 
meconium  from  the  intestines.  This  may  be  eCfected  by  giving  a  soap 
or  oil  enema,  or  previously  removing  as  much  as  is  accessible  to  a  well- 
oiled  finger. 

That  which  is  beyond  reach  of  the  finger,  Franck  recommends  to  be 
brought  away  by  means  of  a  flexible,  but  not  too  weak,  noose  of  wire. 
The  Cow  should  have  an  abundance  of  fluid  to  drink,  and  this  may  be 


740        DISEASES  AND  ABKOllMALITIES  OF  THE  YOIWO  AXIMAL. 

rendered  slightly  laxative  by  the  addition  of  cream  of  tartar  or  sulphate 
of  soda. 

If  the  constipation  persists,  purgatives  may  be  administered.  These 
may  be  castor-oil,  manna,  sulphate  of  soda,  aloes,  etc.  If  there  is  pain 
from  10  to  20  drops  of  chlorodyne  in  water  should  be  administered. 
Frequent  enemas  will  aid  the  action  of  the  purgatives. 

Sometimes  constipation  is  due  to  giving  too  rich  food,  or,  in  artificial 
rearing,  to  an  excessive  allowance  of  meal  or  flour.  The  treatment  will 
be  the  same. 


CHAPTEE  XII. 
Eclampsia  of  Young  Animals. 

This  nervous  affection  has  been  observed  in  the  CaK,  Pig,  and  Dog 
within  a  variable  period  after  birth,  and  presents  somewhat  the  same 
features  as  that  disease  (eclamjjsia  infantum)  in  young  children. 

Si/mjjtoms. 

In  the  Calf  no  premonitory  symptoms  have  been  observed,  except 
that  perhaps  when  it  goes  to  the  teat  it  is  not  so  hvely  as  usual,  lags 
behind  the  other  Calves,  and  is  rather  unsteady  on  its  limbs.  Before 
it  catches  the  teat,  or  very  soon  after,  it  is  suddenly  and  violently  seized 
with  spasms  of  the  voluntary  muscles  ;  all  the  limbs  become  rigid,  the 
jaws  are  convulsively  champed,  and  foam  flows  from  the  mouth  ;  in  a 
few  minutes  the  creature  begins  to  bellow  loudly  and  repeatedly,  and  to 
perform  strange  antics — jumping  forward  as  if  thrown  by  a  powerful 
spring,  and  heedless  of  injury.  The  eye  looks  haggard  and  wild,  the 
respiration  is  hurried,  and  the  heart  beats  tumultuously.  When  held, 
it  continues  to  struggle  and  bellow  ;  at  last  exhaustion  ensues  after  an 
hour  or  two,  and  if  the  Calf  does  not  succumb  it  lies  in  a  state  of  extreme 
lassitude  for  a  long  time  ;  then  it  gradually  regains  its  faculties,  and  in 
the  course  of  some  days  is  well  again  ;  but  for  some  months  it  does  not 
look  thriving,  and  not  infrequently  there  is  a  renewal  of  the  attacks 
before  that  time  elapses. 

The  animal  may  die  from  the  first  or  second  attack — rarely  it  has 
more  than  two.  Revel^  states,  that  of  eleven  Calves  on  a  farm,  five 
were  affected — three  males  and  two  females ;  the  males  perished  at  the 
first  seizure,  but  the  females  survived  it,  though  one  of  them  died  from 
a  second  attack  three  days  subsequently,  the  other  remaining  well. 

In  the  Pig  the  symptoms  are  similar.  Before  the  seizure  the  creature 
perhaps  sucks  less  than  usual ;  it  begins  to  cry  and  become  restless — 
running  here  and  there  and  standing  up  against  the  side  of  its  sty, 
screaming  loudly  ;  suddenly  the  screams  cease,  the  animal  falls  down 
in  convulsions ;  the  respiration  is  noisy,  the  eyes  pirouette  in  their 
orbits,  the  masseter  muscles  have  clonic  spasms,  the  limbs  are  violently 
agitated,  and  there  is  loss  of  sensation  and  consciousness.  The  attack 
may  continue  for  a  variable  period — from  fifteen  minutes  to  an  hour  or 
more,  and  death  may  occur  at  the  first,  second,  or  third  attack — it  is. 
usually  the  second. 

In  the  Dog  the  symptoms  differ  very  little  from  those  just  described. 

^  Revue  Viterinaire,  1S79,  p.  356. 


TKT.IM'S  AnxonrM.  —  TETAXUS  XEOXATOltUM.  1\\ 

Treatment. 

Little  can  be  done  for  this  disease  in  such  young  animals,  beyond 
giving  antispasmodic  remedies — such  as  chloral  hydrate,  bromide  of 
potassium,  and  the  tincture  of  valerian  in  enema.  Attention  should 
also  be  paid  to  the  food  of  both  mother  and  offspring,  and  if  constipation 
is  present  it  may  be  combated  by  the  means  already  mentioned. 


CHAPTER  XIII. 

Tetanus  Agnorum.— Tetanus  Neonatorum. 

Tetanus,  or  a  form  of  that  disease,  is  not  infrequently  witnessed  in 
Lambs,  and  sometimes  it  is  so  prevalent  that  it  is  regarded  as  en/.ocitic 
or  epizootic.  It  cannot  be  considered  as  in  any  way  allied  to  tetany  in 
children. 

It  most  frequently  affects  Lambs  of  the  liner  breeds,  and  usually 
during  the  tirst  two  or  three  weeks  after  birth. 

Symptovis. 

The  earliest  symptoms  are  weakness,  loss  of  vivacity,  and  diminished 
appetite  ;  then  the  limbs  become  stiff"  and  the  gait  stilty,  the  back  is 
arched,  and  the  neck  and  legs  undergo  convulsive  contortions,  so  that 
there  is  difficulty  in  rising  or  walking.  Tlie  cramps  extend  gradually 
to  other  parts  of  the  body,  until  at  last  tlie  animal  cannot  move,  and 
to  obtain  food  it  has  to  be  carried  to  the  mother's  teat,  where  it  needs 
to  be  supported. 

There  is  generally  constipation  at  the  commencement  of  the  attack, 
but  at  a  later  period  diarrha-a  sets  in,  though  there  is  no  fever. 

Under  ordinary  circumstances  the  animal  succumbs  in  about  eight  or 
ten  days — rarely  after  several  weeks — in  a  state  of  marasmus,  the  fatal 
termination  being  preceded  by  grinding  of  the  teeth,  diarrhoea,  con- 
vulsions, and  not  infrequently  complete  paralysis. 

Etiology. 

It  is  believed  that,  in  many  outbreaks,  tiie  Lambs  are  predisposed  to 
the  disease  through  improper  feeding  and  management  of  the  Ewes, 
whose  milk  may  be  obnoxious  from  the  food  they  receive.  lOxposure 
to  extreme  heat  and  cold,  and  particularly  to  cold  winds,  is  supposed  to 
have  much  influence  in  the  production  of  the  malady. 

Pathology. 

Little  appears  to  be  known  as  to  the  pathology  of  the  disease,  but  it 
is  evidently  nervous — in  its  origin  at  least ;  though  no  alteration  lias  as 
yet  been  detected  in  the  spinal  cord  to  account  for  the  tetanoid 
symptoms.  Only  the  characteristics  of  general  antemia,  with  some- 
times congestion  of  the  true  stomach  and  intestines,  have  been  hitherto 
noted. 

Prognosis. 

This  is  generally  unfavourable,  as  a  complete  cure  is  very  rare  ;  while 
delicate  Lambs  perish  quickly,  those  which  become  convalescent  are  a 
long  time  before  the  rigidity  leaves  their  limbs  ;  they  do  not  thrive,  and 
often  succumb  to  some  other  disease. 


742       DISEASES  AXIJ  ABXOIIMALITIES  OF  THE  YOUXG  AXIMAL. 

Treatment. 

Preventive  treatment  must  be  directed  to  keeping  the  Ewes  in  a 
healthy  condition  by  proper  feeding,  and  sheltering  them  from  the 
•weather  if  this  be  severe  at  lambing  time.  The  Lambs  should  also  be 
kept  from  cold  winds  and  wet,  especially  if  they  are  of  the  more  delicate 
breeds. 

With  regard  to  medical  treatment,  it  is  recommended  to  give  a 
purgative  at  the  onset  of  the  disease,  and  especially  if  there  is  any 
reason  to  apprehend  that  the  meconium  is  retained  in  the  intestines. 
Chloral  hydrate  or  chlorodyne  may  be  given  in  small  and  frequent  doses, 
alternated  with  sulphate  of  quinine.  Friction  may  be  applied  to  the 
limbs,  either  without  or  with  some  stimulating  liniment. 


CHAPTEE  XIV. 

Cyanosis. 

At  page  105,  in  describing  the  foetal  circulation  and  the  modifications 
which  occur  in  it  at  birth,  it  was  mentioned  that  the  lungs  then  become 
the  organs  of  respiration,  and  rapidly  increase  in  capacity,  while  the 
thorax  enlarges  in  a  commensurate  degree ;  the  pulmonary  artery  also 
dilates  to  admit  the  increased  How  of  blood,  and  the  ductus  arteriosus 
is  obliterated  to  prevent  mingling  of  the  arterial  and  venous  blood. 
It  was  also  stated  that  the  ductus  venosus  likewise  aids  in  the  isolation 
of  the  two  kinds  of  blood,  by  becoming  atrophied  ;  as  does  also  the  occlu- 
sion of  the  foramen  ovale,  though  the  latter  opening  not  infrequently 
remains  intact  in  young  animals.  Eemarking  upon  the  patency  of  the 
foramen  ovale,  it  was  stated  that,  as  a  rule,  this  accident  did  not  greatly 
affect  the  circulation  ;  for  when  the  heart  contracts,  the  auricles  are 
isolated  by  the  narrowing  of  the  orifice  and  the  elevation  of  a  valve. 

Cases  occur,  nevertheless,  in  which,  either  from  the  persistence  of 
the  foramen  ovale,  with  perhaps  defective  auricular  contraction,  or  an 
abnormal  disposition  of  the  large  bloodvessels  at  their  origin,  the  arte- 
rial and  venous  blood  is  mixed,  and  we  have  the  condition  known  as 
cyanosis  or  the  "  blue  disease."  Then  there  is  a  deep-blue  or  violet 
coloration  of  the  visible  mucous  membranes,  more  or  less  debility  and 
difficulty  in  respiration,  especially  during  exertion,  coldness  of  the  limbs 
and  surface  of  the  body,  and  a  great  predisposition  to  haemorrhage. ^ 

Cyanosis  may  occur  in  otherwise  well-developed  individuals,  and  be 
due  to  a  congenital  adhesion  between  the  lungs  and  pleura  or  pericar- 

'  Vemant  {Recueil  de  MM.  Veterinaire,  1887,  p.  592)  was  called  to  see  a  Calf  which 
had  been  born  the  previous  evening,  and  with  such  ease  that  it  was  found  behind  the 
Cow,  no  one  being  present  at  its  birth.  It  was  viable,  in  very  good  condition,  fat,  and 
so  well  developed  that  it  looked  as  if  fifteen  days  old.  But  it  could  not  stand,  and  lay 
constantly  in  the  sternal  position,  refusing  to  suck.  The  symptoms  it  presented  were 
markedly  those  of  asphyxia  ;  the  tongue  was  half-protruded  from  the  mouth,  the  eyes 
prominent,  the  respiration  plaintive  and  hurried,  and  the  flanks  very  agitated.  When 
raised  it  could  not  stand  ;  its  limbs  were  constantly  and  convulsively  moved,  and  were 
unable  to  sustain  the  weight  of  the  body. 

The  animal  was  bled  at  the  tail,  but  this  afforded  no  relief,  and  in  forty-eight  hour.s 
after  birth  it  died.  The  lungs  were  then  found  to  be  collapsed,  and  looked  very  con- 
gested ;  the  anterior  extremities  of  the  lobules  floated  well  in  water,  but  the  entire  mass 
was  rather  heavy.  The  foramen  ovale  was  incompletely  closed,  so  that  the  two  auricles 
could  communicate  with  each  other  ;  the  opening  was  as  large  as  a  tive-franc  piece,  and 
the  auricular  septum  was  extremely  thin. 


SKIXJfKVXESS  OF  TIIK  XKli'linllX  AXIMAL.  7  I.} 

dium ;  it  is  also  a  symptom  of  asphyxia,  and  is  sometimes  witnessed 
in  colic  in  the  Horse,  complicated  with  meteorismus  ;  it  likewise  accom- 
panies certain  forms  of  poisonin>;. 

When  due  to  the  tirst-nanied  causes,  this  condition  is  manifested 
during  or  immediately  after  hirth  ;  it  is  only  in  rare  instances  that  it  is 
developed  at  a  later  period.  It  is  needless  to  mention  that  such  a 
conformation  is  heyond  remedy,  though  animals  so  affected  will  some- 
times live  for  a  long  time  ;  Zundel  has  seen  a  horse  seven  years  old 
which  was  in  this  condition. 


CHAPTEK  XV. 
Skin  Dryness  of  the  New-born  Animal. 

ObichI  is,  to  my  knowledge,  the  only  writer  who  has  alluded  to  this 
peculiar  condition  of  the  Foal  at  birth.  He  says  :  "  In  the  case  of 
some  primiparous  Mares,  a  fatal  accident  often  happens  to  their 
progeny.  When  parturition  takes  place  without  anyone  being  present, 
the  young  creature,  on  being  expelled  from  the  mother,  continues  lying 
away  from  her  until  its  skin  is  dry.  The  consequence  is  that  the  Mare 
does  not  care  for  it,  does  not  lick  or  attend  to  it,  and  opposes  all 
attempts  to  compel  her  to  suckle  it.  For  some  days  constraint  is 
necessary,  and  nmch  trouble  and  danger  may  be  incurred  before  she  is 
accustomed  to  it.  This  may  be  averted  if  the  new-born  creature  is 
rubbed  over  with  the  *  after  -  birth  '  (placental  membranes).  The 
instinct  of  the  ^lare  impels  her  then  to  lick  and  fondle  her  offspring, 
and  to  take  to  it  kindly  and  in  a  natural  manner." 


CH.\PTER  XVI. 
Imperforate  Anus. 

Impeufouate  anus  is  not  a  very  rare  occurrence  in  new-born  animals  ; 
it  has  been  observed  in  Foals,  Calves,  Pigs,  and  Lambs.  Tlie  latter 
appear  to  furnish  the  largest  number  of  cases.  This  condition  is,  of 
course,  very  serious  unless  surgical  aid  is  quickly  afforded,  and  even 
then  the  young  creatures  are  not  always  saved. 

The  meconium  cannot  be  evacuated,  nor  yet  the  residue  of  the  milk 
the  animal  may  have  ingested  after  birth  ;  whence  results  an  accumu- 
lation of  irritating  matters  in  the  intestines,  which  give  rise  to  inflam- 
mation, and  this  (juickly  causes  death. 

This  occlusion  or  imperforation  may  exist  in  various  degrees.  There 
may  be  merely  a  membrane  covering  and  occluding  the  anal  opening; 
the  borders  of  the  anus  may  be  adherent  to  a  greater  or  less  extent ; 
the  rectum  may  be  more  or  less  absent  or  incomplete  ;  or  it  may  open 
into  the  genito-urinary  passages  instead  of  at  the  anus. 

SymiHoms. 

W^hen  no  ficces  can  bo  expelled,  usually  towards  the  second  or  third 
day  after  birth,  uneasiness  and  symptoms  of  acute  colic  are  manifested; 
the  animal  does  not  suck,  the  abdomen  becomes  distended,  expulsive 
'   WochtiuKhrift  fur  Thkrheilkunde,  1869,  p.  105. 


742       DISEASES  AXD  ABXOIIMALITIES  OF  THE  YOUXG  AXIMAL. 

Treatment. 

Preventive  treatment  must  be  directed  to  keeping  the  Ewes  in  a 
healthy  condition  by  proper  feeding,  and  sheltering  them  from  the 
weather  if  this  be  severe  at  lambing  time.  The  Lambs  should  also  be 
kept  from  cold  winds  and  wet,  especially  if  they  are  of  the  more  delicate 
breeds. 

With  regard  to  medical  treatment,  it  is  recommended  to  give  a 
purgative  at  the  onset  of  the  disease,  and  especially  if  there  is  any 
reason  to  apprehend  that  the  meconium  is  retained  in  the  intestines. 
Chloral  hydrate  or  chlorodyne  may  be  given  in  small  and  frequent  doses, 
alternated  with  sulphate  of  quinine.  Friction  may  be  applied  to  the 
limbs,  either  without  or  with  some  stimulating  liniment. 


CHAPTEE  XIV. 

Cyanosis. 

At  page  105,  in  describing  the  foetal  circulation  and  the  modifications 
which  occur  in  it  at  birth,  it  was  mentioned  that  the  lungs  then  become 
the  organs  of  respiration,  and  rapidly  increase  in  capacity,  while  the 
thorax  enlarges  in  a  commensurate  degree ;  the  pulmonary  artery  also 
dilates  to  admit  the  increased  flow  of  blood,  and  the  ductus  arteriosus 
is  obliterated  to  prevent  mingling  of  the  arterial  and  venous  blood. 
It  was  also  stated  that  the  ductus  venosus  likewise  aids  in  the  isolation 
of  the  two  kinds  of  blood,  by  becoming  atrophied  ;  as  does  also  the  occlu- 
sion of  the  foramen  ovale,  though  the  latter  opening  not  infrequently 
remains  intact  in  young  animals.  Eemarking  upon  the  patency  of  the 
foramen  ovale,  it  was  stated  that,  as  a  rule,  this  accident  did  not  greatly 
affect  the  circulation  ;  for  when  the  heart  contracts,  the  auricles  are 
isolated  by  the  narrowing  of  the  orifice  and  the  elevation  of  a  valve. 

Cases  occur,  nevertheless,  in  which,  either  from  the  persistence  of 
the  foramen  ovale,  with  perhaps  defective  auricular  contraction,  or  an 
abnormal  disposition  of  the  large  bloodvessels  at  their  origin,  the  arte- 
rial and  venous  blood  is  mixed,  and  we  have  the  condition  known  as 
cyanosis  or  the  "  blue  disease."  Then  there  is  a  deep-blue  or  violet 
coloration  of  the  visible  mucous  membranes,  more  or  less  debility  and 
difficulty  in  respiration,  especially  during  exertion,  coldness  of  the  limbs 
and  surface  of  the  body,  and  a  great  predisposition  to  hemorrhage. ^ 

Cyanosis  may  occur  in  otherwise  well-developed  individuals,  and  be 
due  to  a  congenital  adhesion  between  the  lungs  and  pleura  or  pericar- 

'  Vemant  {Recueil  de  MM.  Veterinaire,  1887,  p.  592)  was  called  to  see  a  Calf  which 
had  been  born  the  previous  evening,  and  with  such  ease  that  it  was  found  behind  the 
Cow,  no  one  being  present  at  its  birth.  It  was  viable,  in  very  good  condition,  fat,  and 
so  well  developed  that  it  looked  as  if  fifteen  days  old.  But  it  could  not  stand,  and  lay 
constantly  in  the  sternal  position,  refusing  to  suck.  The  symptoms  it  presented  were 
markedly  those  of  asphj'xia  ;  the  tongue  was  half-protruded  from  the  mouth,  the  eyes 
prominent,  the  respiration  plaintive  and  hurried,  and  the  flanks  very  agitated.  When 
raised  it  could  not  stand  ;  its  limbs  were  constantly  and  convulsively  moved,  and  were 
unable  to  sustain  the  weight  of  the  body. 

The  animal  was  bled  at  the  tail,  but  this  afforded  no  relief,  and  in  forty-eight  hours 
after  birth  it  died.  The  lungs  were  then  f.iund  to  be  collapsed,  and  looked  very  con- 
gested ;  the  anterior  extremities  of  the  lobules  floated  well  in  water,  but  the  entire  mass 
was  rather  heavy.  The  foramen  ovale  was  incompletely  closed,  so  that  the  two  auricles 
could  communicate  with  each  other  ;  the  opening  was  as  large  as  a  five-franc  piece,  and 
the  auricular  septum  was  extremely  thin. 


SKIXI'JnWESS  OF  THE  XKiriiDUX  AXIMAL.  713 

dium  ;  it  is  also  a  symptom  of  asphyxia,  and  is  sometimes  witnessed 
in  colic  in  the  Horse,  complicated  with  meteorismus ;  it  likewise  accom- 
panies certain  forms  of  poisoninj^. 

When  due  to  the  tirst-named  causes,  this  condition  is  manifested 
durinj^  or  immediately  after  birth  ;  it  is  only  in  rare  instances  that  it  is 
developed  at  a  later  period.  It  is  needless  to  mention  that  such  a 
conformation  is  beyond  remedy,  though  animals  so  atl'ected  will  some- 
times live  for  a  long  time  ;  Zundel  has  seen  a  horse  seven  years  old 
which  was  in  this  condition. 


CHAPTER  XV. 
Skin  Dryness  of  the  New-born  Animal. 

OniCH^  is,  to  my  knowledge,  the  only  writer  who  has  alluded  to  this 
peculiar  condition  of  the  Foal  at  birth.  He  says  :  "  In  the  case  of 
some  primipiirous  Mares,  a  fatal  accident  often  happens  to  their 
progeny.  When  parturition  takes  place  without  anyone  being  present, 
the  young  creature,  on  being  expelled  from  the  mother,  continues  lying 
away  from  her  until  its  skin  is  dry.  The  conse(]uence  is  that  the  Mare 
does  not  care  for  it,  does  not  lick  or  attend  to  it,  and  opposes  all 
attempts  to  compel  her  to  suckle  it.  For  some  days  constraint  is 
necessary,  and  much  trouble  and  danger  may  be  incurred  before  she  is 
accustomed  to  it.  This  may  bo  averted  if  the  new-born  creature  is 
rubbed  over  with  the  '  after  -  birth  '  (placental  membranes).  The 
instinct  of  the  Mare  impels  her  then  to  lick  and  fondle  her  offspring, 
and  to  take  to  it  kindlv  and  in  a  natural  manner." 


CH-\PTER  XVI. 
Imperforate  Anus. 

I>ri'F.KF0i{.\TE  anus  is  not  a  very  rare  occurrence  in  newborn  animals  ; 
it  has  been  observed  in  Foals,  Calves,  Pigs,  and  Lambs.  The  latter 
appear  to  furnish  the  largest  number  of  cases.  This  condition  is,  of 
course,  very  serious  unless  surgical  aid  is  quickly  afforded,  and  even 
then  the  young  creatures  are  not  always  saved. 

The  meconium  cannot  be  evacuated,  nor  yet  the  residue  of  the  milk 
the  animal  may  have  ingested  after  birth  ;  whence  results  an  accumu- 
lation of  irritating  matters  in  the  intestines,  which  give  rise  to  inflam- 
mation, and  tliis  <}uickly  causes  death. 

This  occlusion  or  imperforation  may  exist  in  various  degrees.  There 
may  be  merely  a  membrane  covering  and  occluding  the  anal  opening; 
the  borders  of  the  anus  may  be  adlierent  to  a  greater  or  less  extent ; 
the  rectum  may  be  more  or  less  absent  or  incomplete  ;  or  it  may  open 
into  the  genito-urinary  passages  instead  of  at  the  anus. 

Symptoms. 

When  no  faices  can  be  expelled,  usually  towards  the  second  or  third 
day  after  birth,  uneasiness  and  symptoms  of  acute  colic  are  manifested; 
the  animal  does  not  suck,  the  abdomen  becomes  distended,  expulsive 
'   WochtivKhriftfur  Thierhtilkunde,  1869,  p.  105. 


742       DISEASES  AND  ABNORMALITIES  OF  THE  YOUNG  ANIMAL. 

Treatment. 

Preventive  treatment  must  be  directed  to  keeping  the  Ewes  in  a 
healthy  condition  by  proper  feeding,  and  sheltering  them  from  the 
weather  if  this  be  severe  at  lambing  time.  The  Lambs  should  also  be 
kept  from  cold  winds  and  wet,  especially  if  they  are  of  the  more  delicate 
breeds. 

With  regard  to  medical  treatment,  it  is  recommended  to  give  a 
purgative  at  the  onset  of  the  disease,  and  especially  if  there  is  any 
reason  to  apprehend  that  the  meconium  is  retained  in  the  intestines. 
Chloral  hydrate  or  chlorodyne  may  be  given  in  small  and  frequent  doses, 
alternated  with  sulphate  of  quinine.  Friction  may  be  applied  to  the 
limbs,  either  without  or  with  some  stimulating  liniment. 


CHAPTER  XIV. 

Cyanosis. 

At  page  105,  in  describing  the  foetal  circulation  and  the  modifications 
which  occur  in  it  at  birth,  it  was  mentioned  that  the  lungs  then  become 
the  organs  of  respiration,  and  rapidly  increase  in  capacity,  while  the 
thorax  enlarges  in  a  commensurate  degree ;  the  pulmonary  artery  also 
dilates  to  admit  the  increased  How  of  blood,  and  the  ductus  arteriosus 
is  obliterated  to  prevent  mingling  of  the  arterial  and  venous  blood. 
It  was  also  stated  that  the  ductus  venosus  likewise  aids  in  the  isolation 
of  the  two  kinds  of  blood,  by  becoming  atrophied  ;  as  does  also  the  occlu- 
sion of  the  foramen  ovale,  though  the  latter  opening  not  infrequently 
remains  intact  in  young  animals.  Pvemarking  upon  the  patency  of  the 
foramen  ovale,  it  was  stated  that,  as  a  rule,  this  accident  did  not  greatly 
affect  the  circulation  ;  for  when  the  heart  contracts,  the  auricles  are 
isolated  by  the  narrowing  of  the  orifice  and  the  elevation  of  a  valve. 

Cases  occur,  nevertheless,  in  which,  either  from  the  persistence  of 
the  foramen  ovale,  with  perhaps  defective  auricular  contraction,  or  an 
abnormal  disposition  of  the  large  bloodvessels  at  their  origin,  the  arte- 
rial and  venous  blood  is  mixed,  and  we  have  the  condition  known  as 
cyanosis  or  the  "  blue  disease."  Then  there  is  a  deep-blue  or  violet 
coloration  of  the  visible  mucous  membranes,  more  or  less  debility  and 
difficulty  in  respiration,  especially  during  exertion,  coldness  of  the  limbs 
and  surface  of  the  body,  and  a  great  predisposition  to  haemorrhage.^ 

Cyanosis  may  occur  in  otherwise  well-developed  individuals,  and  be 
due  to  a  congenital  adhesion  between  the  lungs  and  pleura  or  pericar- 

'  Vernant  {Recueil  de  MM.  Veterinaire,  1887,  p.  592)  was  called  to  see  a  Calf  which 
had  been  born  the  previous  evening,  and  with  such  ease  that  it  was  found  behind  the 
Cow,  no  one  being  present  at  its  birth.  It  was  viable,  in  very  good  condition,  fat,  and 
so  well  developed  that  it  looked  as  if  fifteen  days  old.  But  it  could  not  stand,  and  lay 
constantly  in  the  sternal  position,  refusing  to  suck.  The  symptoms  it  presented  were 
markedly  those  of  asphyxia  ;  the  tongue  was  half-protruded  from  the  mouth,  the  eyes 
prominent,  the  respiration  plaintive  and  hurried,  and  the  flanks  very  agitated.  When 
raised  it  could  not  stand  ;  its  limbs  were  constantly  and  convulsively  moved,  and  were 
unable  to  sustain  the  weight  of  the  body. 

The  animal  was  bled  at  the  tail,  but  this  afforded  no  relief,  and  in  forty-eight  hours 
after  birth  it  died.  The  lungs  were  then  found  to  be  collapsed,  and  looked  very  con- 
gested ;  the  anterior  extremities  of  the  lobules  floated  well  in  water,  but  the  entire  mass 
was  rather  heavy.  The  foramen  ovale  was  incompletely  closed,  so  that  the  two  auricles 
could  communicate  with  each  other  ;  the  opening  was  as  large  as  a  five-franc  piece,  and 
the  auricular  septum  was  extremely  thin. 


SKIXDJn'.VKSS  OF  TllK  XKH'  lioRX  AXIMAL.  743 

dium ;  it  is  also  a  symptom  of  asphyxia,  and  is  sometimes  witnessed 
in  colic  in  the  Horse,  complicated  with  meteorismus  ;  it  likewise  accom- 
panies certain  forms  of  poisoninj:;. 

Wlien  due  to  the  tirst-named  causes,  this  condition  is  manifested 
during  or  inunediately  after  birth  ;  it  is  only  in  rare  instances  that  it  is 
developed  ut  a  later  period.  It  is  needless  to  mention  that  such  a 
conformation  is  beyond  remedy,  though  animals  so  atTected  will  some- 
times live  for  a  long  time  ;  Zundel  has  seen  a  horse  seven  years  old 
which  was  in  this  condition. 


CHAPTER  XV. 
Skin  Dryness  of  the  New-born  Animal. 

OiucH*  is,  to  my  knowledge,  the  only  writer  who  has  alluded  to  this 
peculiar  condition  of  the  Foal  at  birth.  He  says  :  "  In  the  case  of 
some  primiparous  Mares,  a  fatal  accident  often  happens  to  their 
progeny.  When  parturition  takes  place  without  anyone  being  present, 
the  young  creature,  on  being  expelled  from  the  mother,  continues  lying 
away  from  her  until  its  skin  is  dry.  The  consequence  is  that  the  Mare 
does  not  care  for  it,  does  not  lick  or  attend  to  it,  and  opposes  all 
attempts  to  compel  her  to  suckle  it.  For  some  days  constraint  is 
necessary,  and  nmch  trouble  and  danger  may  be  incurred  before  she  is 
accustomed  to  it.  This  may  be  averted  if  the  new-born  creature  is 
rubbed  over  with  the  '  after  -  birth  '  (placental  membranes).  The 
instinct  of  the  Mare  impels  her  then  to  lick  and  fondle  her  offspring, 
and  to  take  to  it  kindly  and  in  a  natural  manner." 


CH.\PTER  XVI. 
Imperforate  Anus. 

iMrF.KFOH.VTE  anus  is  not  a  very  rare  occurrence  in  new-born  animals  ; 
it  has  been  observed  in  Foals,  Calves,  Pigs,  and  Lambs.  The  latter 
appear  to  furnish  the  largest  number  of  cases.  This  condition  is,  of 
course,  very  serious  unless  surgical  aid  is  quickly  alTordcd,  and  even 
then  the  young  creatures  are  not  always  saved. 

The  meconium  cannot  be  evacuated,  nor  yet  the  residue  of  the  milk 
the  animal  may  have  ingested  after  birth  ;  whence  results  an  accumu- 
lation of  irritating  matters  in  the  intestines,  which  give  rise  to  inflam- 
mation, and  this  quickly  causes  death. 

This  occlusion  or  imperforation  may  exist  in  various  degrees.  There 
may  be  merely  a  membrane  covering  and  occluding  the  anal  opening; 
the  borders  of  the  anus  may  be  adherent  to  a  greater  or  less  extent ; 
the  rectum  may  be  more  or  less  absent  or  incomplete  ;  or  it  may  open 
into  the  genito-urinary  passages  instead  of  at  the  anus. 

Symptoms. 

When  no  ftcces  can  be  expelled,  usually  towards  the  second  or  third 
day  after  birth,  uneasiness  and  symptoms  of  acute  colic  are  manifested; 
the  animal  does  not  suck,  the  abdomen  becomes  distended,  expulsive 
'    Wocherv*clir\jl  fur  Thkrheilkunde,  1869,  p.  105. 


744        DISEASES  AND  ABNORMALITIES  OF  THE  YOUNG  ANIMAL. 

eiforts  and  pawing  are  observed,  yet  nothing  is  passed.  The  animal 
shows  signs  of  great  pain  and  misery,  and  if  help  is  not  afforded  it  dies 
in  agony. 

In  young  female  animals  in  which  the  rectum  is  absent,  it  often 
happens  that  the  intestine  opens  into  the  vagina,  and  the  faeces  are 
expelled  by  that  canal.  Eainard  has  witnessed  this  malformation  in 
several  Fillies,  and  his  attention  was  also  drawn  to  four  young  Pigs — ■ 
male  and  females — in  which  the  anus  was  absent.  They  were  the  litter 
of  one  Sow.  It  is  therefore  well  to  ascertain,  in  the  case  of  female 
animals  destitute  of  an  anus,  whether  the  meconium  or  faeces  pass  by 
the  vulva. 

Treatment. 

The  symptoms  lead  the  veterinary  surgeon  to  examine  the  defecating 
organs,  and  to  discover  the  character  of  the  obstruction.  If  there  is 
only  a  simple  membrane  occluding  the  anus,  this  projects  like  a  large 
vesicle,  owing  to  the  pressure  made  upon  it  by  the  faeces.  This  mem- 
brane, which  is  really  the  skin,  has  usually  a  deep  red  tint,  and  is  soft 
and  thin,  offering  but  little  resistance.  The  prominence  it  forms  is 
quite  soft  and  pits  on  pressure.  In  such  a  case  all  that  has  to  be  done 
is  to  incise  the  membrane — in  a  crucial  manner,  if  deemed  best.  A 
long,  narrow,  sharp-pointed  bistoury  is  the  most  suitable.  After  well 
ascertaining  the  entrance  to  the  rectum,  the  skin  is  punctured,  care 
being  taken  not  to  allow  the  knife  to  pass  too  deep  ;  a  director  may  be 
employed  to  complete  the  incision,  and  to  guard  the  intestine  from 
injury.  No  sooner  is  this  incision  made  than  the  meconium  escapes ; 
then  the  crucial  division  may  be  made  with  a  pair  of  sharp  scissors. 
The  index  finger  should  be  introduced  as  far  as  possible  into  the  intes- 
tine, to  make  certain  that  all  is  right  there. 

In  order  to  prevent  the  opening  closing  by  cicatrisation,  a  suppository 
or  tent  may  be  introduced  into  the  rectum,  and  withdrawn  every  now 
and  again  in  order  to  allow  the  fteces  to  be  expelled — injections  assist- 
ing in  the  latter ;  or  the  angles  of  the  divided  skin  may  be  snipped  off 
by  scissors,  so  as  to  hinder  their  union.  The  lips  of  the  wound  are 
subsequently  lubricated  by  a  little  carbolized  oil  or  grease,  and,  provided 
inflammation  does  not  set  in,  recovery  is  certain. 

When  the  prominence  is  not  present,  and  yet  there  is  complete  occlu- 
sion, with  all  the  above-mentioned  symptoms,  the  operation  is  more 
difficult.  The  perineal  raphe  is  sought  for,  as  on  its  course  the  anus 
should  be  found.  This  is  carefully  felt,  when  the  prominence  formed 
by  the  end  of  the  intestine  will  be  discovered.  Then  a  short  incision 
is  made  through  the  skin  only,  in  the  middle  line  ;  the  subcutaneous 
tissues  are  dissected  away  until  the  bulging  of  the  intestine  is  reached  ; 
this  is  drawn  outwards  between  the  lips  of  the  wound  by  forceps  or  a 
ligature,  an  opening  is  made  into  it,  and  the  contents  removed.  The 
margins  of  the  opening  are  then  secured  to  the  borders  of  the  external 
wound  by  some  fine  sutures,  and  attention  is  paid  to  the  parts  during 
the  healing  process,  in  order  to  prevent  the  artificial  anus  becoming  too 
contracted. 

"When  the  rectum  is  absent  to  a  more  or  less  considerable  extent  (in 
some  cases  it  is  reduced  to  a  mere  fibrous  cord),  then  but  little  benefit 
can  be  conferred.  In  a  few  instances  nature  has  effected  a  partial 
remedy,  in  establishing  an  artificial  opening  by  ulceration  through 
organs  and  textures,  and  the  faeces  have  escaped  by  the  fistula. 
Eainard   mentions   this   natural  colotomy  as  occurring  in  two  young 


IMPERFORATE  VULVA  AXD  VAUIXA,  745 

Horses.  An  artificial  opening  may  be  made  either  in  the  perineal  or 
abdominal  region  ;  but  it  is  rare  indeed  that  the  animal  is  worth  the 
trouble  and  risk. 

In  those  female  animals  in  which  the  rectum  communicates  with  the 
vagina,  Rainard  makes  the  following  remarks  with  regard  to  operation. 
As  the  part  of  the  vagina  which  has  the  opening  into  the  rectum  is 
never  very  deep,  a  half  S-curved  sound  is  introduced  by  one  of  its  ends 
into  the  normal  track,  and  pushed  into  the  rectum  until  it  reaches  the 
cul-de-sac  in  it.  With  a  bistoury,  an  incision  is  made  where  the  anus 
should  be  ;  the  skin  and  subcutaneous  connective  tissue  being  divided, 
the  index  finger  is  passed  into  the  wound  in  search  of  the  curved  sound 
in  tlie  rectum.  When  met  with,  an  assistant  takes  the  sound,  while 
the  blade  of  the  bistoury  is  made  to  glide  over  the  nail  of  the  index 
finger,  and  the  intestine  opened  by  it.  The  same  finger  is  pushed  into 
this  new  opening,  and  serves  to  guide  the  bistoury  in  dilating  the  inci- 
sion as  much  as  may  be  deemed  necessary.  After  the  skin  and  connec- 
tive tissue  are  incised,  a  trocar  of  suliicient  size  may  be  employed  to 
puncture  the  intestine. 

CHAPTER  XVI r. 
Imperforate  Vulva  and  Vagina. 

Imperforatiox,  atresia,  or  occlusion  of  the  Vulva  is  not  infrequently 
observed  in  new-born  animals,  they  being  often  found  after  birth 
without  any  apparent  opening  into  this  passage,  the  labia  of  which 
are  adherent.  The  adhesion  may  be  general  or  partial.  In  the 
former  case  the  urine  cannot  escape ;  or  it  may  be  expelled  through  the 
urachus  by  the  umbilical  opening.  W^hen  the  retention  is  complete, 
the  bladder  soon  becomes  distended  and  ruptures,  and  death  (juickly 
ensues. 

Complete  occlusion  is  always  a  serious  condition,  as  there  is  no 
precise  indication  as  to  where  the  urethra  opens,  or  even  if  it  exists  at 
all ;  so  that  it  is  scarcely  possible  to  make  an  artificial  opening  for  the 
passage  of  the  urine  with  perfect  and  permanent  success.  When  the 
labia  are  merely  adherent,  then  there  is  no  dilliculty,  and  not  much 
danger,  in  the  case.  The  adhesion  being  destroyed  and  the  labia  freed, 
the  urine  is  no  longer  retained  and  the  malformation  is  remedied.  The 
only  precaution  necessary  is  to  prevent  the  labia  again  becoming  united  ; 
this  is  easily  effected  by  dressing  the  raw  margins  with  oil  or  grease, 
and,  if  need  be,  keeping  them  apart  until  healed. 

When  occlusion  is  only  partial,  the  interference  of  the  operator  may 
or  may  not  be  deemed  necessary,  according  to  circumstances  ;  but  it 
will  be  generally  most  judicious  to  enlarge  the  opening  to  its  natural 
dimensions  before  the  animal  becomes  full-grown. 

Imperforate  Vagina  is  much  less  frequent  than  imperforate  vulva. 
Nevertheless,  it  is  sometimes  met  with  in  new-born  creatures.  The 
danger  is  the  same  as  in  the  other  malformation,  as  the  external  open- 
ing of  the  urethra  is  situated  below  the  pubic  symphysis,  immediately 
anterior  to  the  entrance  to  the  vagina.  Consequently,  the  urine  may 
be  retained  and  the  animal  will  soon  perish  from  rupture  of  the  bladder, 
peritonitis,  etc. 

All  that  can  be  done  in  such  a  state  of  affairs,  is  to  compensate  for 
the  absence  of  the  natural  canal  by  making  an  artificial  opening,  and 


746        DISEASES  AND  ABNORMALITIES  OF  THE  YOUNG  ANIMAL. 

to  prevent  it  from  closing  by  introducing  a  dilator,  and  keeping  it  there 
(removing  it,  of  com^se,  from  time  to  time)  until  there  is  no  danger  of 
closure. 

When  the  obliteration  is  only  partial,  the  case  is  not  so  serious  ;  and, 
provided  the  urine  escapes  at  all  freely,  surgical  interference  may  not 
be  necessary — at  least  until  breeding-time  arrives. 


CHAPTER  XVIII. 
Imperforate  Prepuce. 

Imperforate  prepuce  of  new-born  creatures  is  evidently  a  very  unusual 
occurrence,  as  it  is  scarcely  mentioned  in  veterinary  literature.  Brug- 
none  notices  it  as  occurring  in  Foals,  and  he  recommends  that  an 
artificial  opening  be  made  in  the  prepuce  where  the  natural  aperture 
should  be ;  the  lips  of  the  wound  are  to  be  kept  apart  by  any  suitable 
contrivance,  which  may  be  secured  in  situ  by  attaching  tapes  to  it,  and 
passing  these  round  the  body,  securing  them  over  the  loins.  When  this 
artificial  opening  is  not  made,  the  same  grave  results  follow  as  in  com- 
plete occlusion  of  the  vulva. 

This  operation  is  successful  only  when  the  urethral  canal  is  patent 
throughout  its  length  ;  when  it  is  occluded  also,  the  operation  will  no 
longer  be  attended  with  benefit,  and  the  operator  must  then  endeavour 
to  discover  where  the  obstruction  is,  and  either  overcome  it,  or  make  an 
opening  somewhere  for  the  escape  of  the  urine. 

In  some  instances,  when  the  orifice  of  the  urethra  is  occluded,  the 
urine  escapes  by  a  congenital  opening  in  some  part  of  the  canal.  When 
this  opening  exists  at  its  upper  surface,  the  defect  receives  the  name  of 
episjxidias,  and  when  at  its  lower  kypospaclias.  Such  a  malformation 
has  been  seen  in  the  Dog,  Lamb,  and  Goat ;  it  is  not  of  much  import- 
ance, so  far  as  the  flow  of  urine  is  concerned.  If  the  opening  is  near 
the  end  of  the  urethra,  the  urine  runs  into  the  prepuce,  and  passes 
thence ;  but  if  it  is  more  behind,  between  the  scrotum  and  ischium,  it 
then  flows  over  the  skin,  abrades  it,  and  dust  and  dirt  accumulate; 
this,  together  with  the  repulsive  odour  of  the  decomposed  urine,  renders 
the  case  very  unpleasant  to  the  eye  and  nose. 

Treatment  is  only  too  often  unsuccessful,  and  it  is  always  troublesome. 
It  is  least  so  when  the  opening  is  near  the  termination  of  the  urethra, 
as  then  the  defect  is  more  accessible  and  easier  remedied. 


CHAPTER  XIX. 
Occlusion  of  the  Eyelids. 

Occlusion  of  the  eyelids  has  been  witnessed  in  Foals,  Calves,  and 
other  young  animals.  Of  course  we  do  not  allude  to  the  natural  occlu- 
sion of  the  eyehds  of  Puppies,  Kittens,  and  young  Rabbits,  which  pre- 
vents their  seeing  for  some  days  after  birth. 

This  accidental  occlusion  of  the  eyelids  presents  itself  in  two  forms. 
In  one,  the  margins  of  the  upper  and  lower  eyelids  are  only  adherent ; 
and  in  the  other  the  eyelids  are,  in  addition,  adherent  to  the  eye  itself 
throughout  then-  entire  surface. 


OCCLUSIOX  OF  THE  AUDITORY  CANAL.  747 

The  first  variety  is  alone  curable,  and  in  order  to  disunite  the  eyelids, 
the  operator,  after  producing  local  insensibility  by  the  application  of 
cocaine,  proceeds  as  follows :  Securing  the  head  of  tlie  creature  in  the 
hands  of  an  assistant,  the  upper  eyelid  is  elevated  by  another  assistant 
by  means  of  a  pair  of  forceps.  The  operator  himself  seizes  the  lower 
lid  by  the  same  means,  and  pulls  it  as  far  as  possible  from  the  eyeball 
beneath  ;  then  taking  a  pointed  bistoury  or  sharp  scissors  in  his  right 
hand,  a  small  puncture  or  notch  is  made  between  the  margins  of  the 
lids,  in  such  a  manner  as  to  injure  neither,  if  possible,  and  much  less 
to  wound  the  eye.  A  grooved  director  is  passed  into  the  puncture  in 
the  direction  of  one  of  the  canthi  of  the  eye,  the  bistoury  is  run  along 
it  and  separates  the  two  lids  ;  the  director  is  then  turned  towards  the 
other  canthus,  and  the  same  procedure  is  followed.  If  the  scissors  are 
used  the  director  is  not  necessary.  All  that  is  required  after  the  opera- 
tion, is  to  apply  a  little  lard  to  the  borders  of  the  lids,  should  there  be 
any  tendency  to  re-adhesion. 


CHAPTER  XX. 
Occlusion  of  the  Auditory  Canal. 

Occlusion  of  the  auditory  canal  is  much  less  rare  than  that  of  the 
eyelids,  and  when  it  exists  deafness  is  the  consequence,  as  well  as 
dumbness.  It  is  the  latter  condition  which  most  frequently  attracts 
attention,  and  leads  to  the  discovery  that  the  real  and  serious  defect  is 
deafness.  Then  a  small  prominent  tumour  is  detected  in  the  place  of 
the  ear,  or  where  the  external  auditory  canal  should  be.  Tliis  tumour 
is  rather  soft,  and  can  be  readily  seized  by  forceps,  when  it  may  bo 
punctured  with  a  bistoury  or  a  lancet  and  a  crucial  incision  made 
through  it,  or  it  may  be  resected  by  forceps  and  scalpel  or  scissors. 

When  the  membrane  forming  the  covering  of  the  tumour  is  removed, 
;i  quantity  of  grey  cerumen  is  found  obstructing  the  canal ;  this  can  be 
extruded  by  pressure,  injections  of  tepid  water,  or  a  small  scoop.  To 
iiinder  the  closure  of  the  canal,  a  little  morsel  of  lint  or  tine  tow  is  placed 
in  the  ear,  and  retained  there  by  a  bandage  round  the  head.  Witli  the 
1  )og,  which  is  most  frequently  affected  in  this  way,  the  bandage  requires 
to  be  more  carefully  f»xed  than  with  otiier  animals,  as  it  uses  its  paws 
iuid  does  not  rest  until  the  covering  is  removed. 

If  both  ears  are  affected,  one  only  should  be  operated  upon  at  a 
time  ;  and,  as  a  inilo,  it  is  better  to  wait  until  the  slight  inflammation 
which  follows  tlie  operation  subsides,  before  the  other  ear  undergoes 
the  same  treatment. 

So  far  as  hearing  is  concerned,  the  result  is  often  negative  ;  indeed, 
Rainard  confesses  that,  of  the  large  number  of  Dogs  he  operated  upon, 
not  one  recovered  its  hearing. 


CHAPTER  XXI. 
Tongue-tie. 

Anothkk  congenital  defect  of  young  animals  is  what  is  called  "  tongue- 
tie  "'  ;  it  is  most  frequently  obsen-ed  in  Calves,'  and  is  similar  to  the 

'  T}-vaert  (Animle'*  d>'  ^f'll.   Vtlt'rinaire,  June,  1877)  obB€r%ed  this  condition  on  six 
occasions  in  calves. 


748        DISEASES  AND  ABNORMALITIES  OF  THE  YOUNG  ANIMAL. 

condition  in  children  which  goes  by  the  same  name — being  characterized 
by  the  friBnum  hnguas  being  too  narrow  from  above  to  below,  and  too 
much  prolonged  forward,  sometimes  extending  to  the  root  of  the  lower 
incisor  teeth.  This  anomaly  greatly  hinders  the  prehension  of  food  and 
swallowing  of  fluids ;  the  Calf,  if  drinking  out  of  a  bucket,  vainly 
plunges  its  face  into  the  fluid  as  far  as  the  eyes.  The  teat  is  seized 
with  difficulty,  and  the  tongue  is  so  limited  in  its  movements  that  it 
cannot  be  protruded  to  lick  the  nostrils,  as  is  the  custom  with  Bovine 
and  some  other  creatures.  The  defect  is  often  unperceived,  and  the 
young  creature  loses  condition,  becomes  weak,  and  eventually  suc- 
cumbs. 

The  treatment  is  very  simple.  It  consists  merely  in  dividing  the 
frtenum  to  such  an  extent  that  the  organ  may  recover  its  liberty  of 
movement.  Immediately  after  the  operation,  the  creature  protrudes 
its  tongue  to  lick  the  blood  which  escapes,  and  it  can  drink  with  ease. 
The  wound  heals  in  a  few  days  without  any  precautions. 


CHAPTER  XXII. 
Cleft  Palate. 

I  CAN  find  no  mention  of  this  congenital  defect  in  animals,  though  of 
its  occurrence  there  can  be  no  doubt ;  as  some  years  ago  I  saw  a 
thoroughbred  Foal  with  a  cleft  palate  at  the  Eltham  Stud  Stables. 
When  it  sucked  or  drank  a  large  portion  of  the  fluid  escaped  by  the 
nostrils.  The  animal  was  not  submitted  to  treatment,  and  I  do  not 
know  what  became  of  it.  The  fissure  may  have  closed  as  the  creature 
grew  up. 

If  the  cleft  remains  permanent,  operative  treatment  might  be 
attempted.  The  procedure  would,  of  course,  depend  upon  the  extent 
of  the  fissure  and  the  species  of  animal  to  be  operated  upon. 


ADJ)]:X])L'M. 

Infectious  Abortion. 

So  much  attention  has  been  recently  duected  to  this  important  subject, 
because  of  its  increasing  prevalence  and  the  heavy  losses  it  occasions 
among  breeding  stock,  that  it  has  been  considered  necessary  to  add  some 
information  which  has  come  to  hand  since  the  sheets  (pp.  -!lG-22()) 
dealing  with  it  were  printed  oil". 

There  can  be  no  doubt  that  in  those  instances  in  which  abortions 
occur  on  an  extensive  scale,  so  as  to  assume  an  enzootic  or  epizootic 
character,  and  to  continue  in  certain  localities  or  establishments  for 
years,  infection  is  the  chief,  if  not  the  only  cause ;  the  agencies  usually 
supposed  to  operate  in  their  productions  merely  acting  as  predisposants, 
Ijy  weakening  the  constitution. 

In    addition    to   the   authorities   mentioned   as   having   proved    the 

xistence  of  an  infecting  agent  in  the  genital  discharges,  Lehnert'  must 
he  alluded  to  as  having  induced  abortion  in  Cows  at  the  end  of  twelve 
;ind  twenty  days,  by  introducing  into  the  vagina  of  pregnant  Cows 
mucus  from  that  of  animals  which  had  aborted  accidentally;  while 
Trinchera-  has  produced  a  vaginal  catarrh  and  abortion  in  from  nine  to 
thirteen  days,  by  inoculating  the  purulent  vaginal  discharge  from  a  Cow 
just  aborted,  and  the  matter  obtained  by  scraping  the  surface  of  the 
chorion  e.xpelled  by  another  which  had  likewise  met  with  the  same 
accident. 

It  is  now  recognised  by  the  most  competent  veterinary  authorities 
that  the  disease — for  so  it  must  be  considered — is  eminently  infectious 
or  contagious,  and  that  it  may  be  transmitted  either  directly,  or  through 
the  intervention  of  certain  media — as  infected  urine,  fteces,  or  litter, 
tiy  attendants  on  the  animals  which  luive  aborted,  by  the  veterinary 

hstetrist  who  has  recently  removed  the  placental  membranes  from  an 
i!iimal  that  has  aborted,  or  even  by  the  male  animal  in  the  act  of 
'   'pulation.    Whether  the  infecting  agent  produces  its  elTect  if  it  obtains 

Imission   through  the  respiratory,  digestive,  or  circulatory  organs  is 

>t  yet  ascertained  ;  but  there  is  every  probability  that  it  finds  access  to 
i'AO  interior  of  the  uterus  through  the  vagina  and  cervix,  as  in  parturient 
fever,  and  developing  in  the  fcetal  envelopes,  produces  alterations  there 
sufticient  to  kill  the  fcetus  without  affecting  to  any  considerable  extent 
the  health  of  the  female.  This  occurs  after  each  conception  ;  so  that 
repeated  abortions  eventually  lead  to  sterility  by  causing  the  uterine 
mucus  to  become  acid — a  change  which  is  fatal  to  the  spermatozoa. 

Galtier  ■  is  of  opinion  that  though  the  disease  chiefly  affects  the  Bovine 
species,  yet  it  is  transmissible  to  other  domestic  species,  and  offers 

'  Sdch-^fti  Jahrcibrricht,  1878. 

'  La  Clinica  Vtlerinaria,  1888. 

'  Journal  de  Midtciiu  ViUrinairt  de  Lyoni,  1890. 


750  ADDENDUM. 

some   characters  common  to  the   pneumo-enteritis  of   the  Pig  (Swine 
plague)  and  Sheep  (the  pneurao-enteritis  prevalent  in  the  Alps). 

In  a  German  periodical^  recently  published,  a  summary  of  the  views 
of  forty-five  Danish  veterinary  surgeons  is  given  on  this  malady.  It  is 
concluded  that  there  can  be  no  doubt  as  to  the  infectious  character  of 
abortion,  and  that  it  can  be  propagated  from  stable  to  stable,  or  cowshed 
to  cowshed  by  infected  animals — male  or  female  ;  immunity  is  acquired 
after  two  or  three  years,  as  the  disease  disappears  of  itself  from  an 
establishment  if  no  new  animals  are  introduced,  though  getting  rid  of 
those  which  abort  and  replacing  them  by  others  may  continue  the 
scourge  for  an  indefinite  period.  When  the  herd  is  not  renewed  the 
prevalence  of  the  malady  decreases  spontaneously,  the  abortions  gradu- 
ally become  fewer,  and  the  accident  only  occurs  towards  the  end  of 
pregnancy,  finally  ceasing. 

The  treatment  found  successful  in  combating  the  disease  in  Denmark 
consisted  chiefly  in  rigorous  disinfection  of  the  stables  or  cowsheds 
twice  a  year,  by  cleansing  them  and  washing  with  a  1  per  cent,  solution 
of  chloride  of  lime  ;  though  the  stalls,  walls,  etc.,  were,  when  possible, 
washed  once  a  week,  and  the  drains  flushed  everyday.  Animals  about 
to  abort  were  immediately  isolated,  and  looked  after  by  a  special 
attendant  who  was  not  allowed  to  go  among  healthy  pregnant  animals. 
The  foetal  membranes  were  removed  within  twelve  hours  after  abortion, 
and,  together  with  the  foetus,  buried  in  lime  ;  while  the  genital  cavity 
was  repeatedly  washed  out  with  a  1  per  cent,  solution  of  creolin,  or  i 
per  cent,  of  lysol,  until  all  vaginal  discharge  had  ceased.  Cows  which 
had  aborted  were  not  put  to  the  Bull  until  two  or  three  months  had 
elapsed,  so  as  to  prevent  extension  of  the  infection,  and  afford  a  better 
chance  for  their  becoming  pregnant  again.  Even  Cows  and  Heifers  in 
infected  places  and  apparently  healthy,  received  a  vaginal  injection 
before  copulation  ;  afterwards  the  parts  about  the  tail  and  vulva  were 
carefully  washed  every  day  with  a  mild  disinfectant.  The  Bull 
employed  in  an  infected  locality  was  treated  in  a  similar  manner,  the 
parts  about  the  generative  organs  being  cleansed  and  disinfected  before 
and  after  service. 

It  is  most  important  that  animals  from  infected  herds  or  studs  be 
not  introduced  among  healthy  pregnant  Cows  or  Mares,  unless  every 
precaution  is  taken  against  contamination  ;  and  if  these  suspected 
animals  are  pregnant  they  should  certainly  be  isolated  until  parturition 
is  completed. 

With  regard  to  the  symptoms,  there  is  not  much  to  be  added  to  what 
has  been  already  stated.  Abortion  generally  occurs  in  the  Mare  from 
the  fourth  to  the  ninth  month  of  pregnancy,  in  the  Cow  from  the  third 
to  the  seventh  month.  Before  it  happens  the  vaginal  mucous  membrane 
is  observed  to  be  reddened,  and  pimple-like  elevations  about  the  size  of 
a  millet-seed  are  often  seen  on  its  surface ;  while  there  is  a  reddish- 
tinted  discharge  from  the  vagina,  and  the  diminished  yield  of  milk  has 
the  consistency  of  colostrum.  In  about  three  days  after  the  appearance 
of  the  vaginal  discharge  abortion  occurs,  but  the  discharge  frequently 
continues  for  a  considerable  time  afterwards. 

1  Deutsche  Ztitschr'ift  fur  Thiermelichie  und  V ergleichende  Pathologie,  xxi..  1895. 


I  .\  D  i:  X . 


A. 

Abdominal  evisctration,  550 
AWnminal  fcitation,  175 
Abdominal  muscles,  rupture  of,  621 
Abdominal  taxis,  329 
Abnormal  anterior  presentation,  433 

posterior  presentations,  460 

iiuantity  of  placental  fluid,  3S1 

retention  of  the  fu-tus,  108 
Abnonnalities  uf  the  youn^  animal,  701 
Abortion,  204 

artificial,  294,  561 

enzootic,  216,  749 

epizo<>tic,  216,  749 

infectious,  216,  749 

sjjoradic,  205 
Accessory  cotyledons,  87 
Accidents  after  parturition,  564 

of  pregnancy,  191 
After-pains,  268 
At,'alactia,  696 
Aid  after  labour,  263 

during  labour,  256 
\l;c  visj>ertilionis,  39 
\n)uniinuria  during  pregnancy,  190 
Alimentary  canal  of  ftetus,  108 

appendages  of,  109 
V.lantoic  li<|uid,  S3 
!:intois,  SI 

ditfercncen  in  other  animals,  84 
Amaurosis  during  pregnancy,  190 
Amnion,  79 

differences  in  other  animals,  81 
Amniotic  acid,  80 
Amputation  of  the  limb<i,  544 

of  the  fore  limVm,  545 

of  the  hind  limbs.  547 

of  the  uterus.  600 
Anasarca  of  folus.  387 
Anatomy,  obstetrical,  1 
Anidian  monsters.  178 
Anomalies  in  pregnancy,  169 

in  the  f<ital  membranes,  380 

in  the  placenta,  367 

in  the  umbilical  conl,  373 
Ante-partum  paresis,  187 

prolapsus  of  vagina,  191 
rtipture  of  the  utenis,  194 
Anus,  imperforate,  743 
Apoplexy,  parturient,  636 


Appendatjes  of  the  firtus,  75 
Arbor  vitie  uteriiia,  10 
Area  pri'ligera,  71 

vasculosum,  71 
Arthritis,  718 

Articulations  of  the  j)elvis,  8 
Artificial  abortion,  294,  561 

passage  for  the  fietus,  297 

premature  birth,  561 
Ascites  in  fcrtus,  387 
Ascitic  hydronietra,  181 
Asphyxia  of  the  new-born  animal,  701 
Atresia  of  anus,  743 

of  OS  uteri,  365 

of  vulva,  745 
Attention  to  the  mother  during  and  after 
parturition,  256 

to  the  offspring,  265 
Auscultation  of  the  uterus,  146 
Axis  of  the  pelvis,  26 

B. 
Ballottemknt,  146 
Bandages  or  tnisses,  594.  707 
Bladder,  inversion  of,  608 

rupture  of,  620 
Blastoderm,  70 
Bones  of  the  pelvis,  2 
Broad  ligaments  of  titerus,  39 
Bulb  of  the  ovary,  51 


C.V-SAKiAN  section,  340,  554 
Calving  fever.  636 
Canal  of  cervix  uteri,  40 
Cancerous  tumours,  347 
Capacity  of  j)elvis,  21 
Causes  of  parturition,  228 
Cavity  of  {H-lvis,  12 
Cephaloilial  {K>siti<jns,  473,  478 

•sacral  jxjsition,  477,  481 
Cephalotomy,  540 

Cerebral  ojngestion  during  pregnane)*,  189 
Cervix  uteri,  39.  44 

canal  of.  40 

digital  irritation  of,  295 

induratiim  of,  361 

rigidity  of,  354 

8pa.->ni  of,  354 

structure  of,  41,  44 


752 


INDEX. 


Changes  in  the  ovum,  68 
Cliorda  dorsalis,  71,  96 
Chorial  cotyledons,  90 
Chorion,  75 

differences  in  other  animals,  77 

frondosum,  85 

schirrous,  367 
Cleft  palate,  748 
Clitoris,  29 
Coccyx,  6 
Colic,  184 

Collapse,  puerperal,  636 
Colostrum,  271 

Comparison  between  manual  and  mechani- 
cal force,  531 
Complete  deformity  of  the  pelvis,  290 
Complications  of  ruptured  vagina,  616 
Condylomatous  tumours,  348 
Constipation  in  pregnant  animals,  184 

of  young  animals,  739 
Constriction  of  vagina  and  vulva,  370 
Contorsio  uteri,  309,  341,  343 
Contractions  in  fffitus,  392 
Cords  and  bands,  499 
Cornua  of  uterus,  39 
Corpus  luteum,  53 
Cotyledonous  milk,  91 
Cotyledons,  foetal,  86 

maternal,  90 
Cough  during  pregnancy,  190 
Cramp,  188 
Craniotomy,  540,  542 
Cresyl  or  cresol,  634 
Crotchets,  511 
Crotchet-forceps,  517 
Cup-and-ball  pessary,  589 
Cyanosis,  742 

D. 

Death  of  the  fcetus,  259,  394 
Decapitation,  542 
Decidua  serotina,  91,  130 

vera,  217 
Decollation,  542 
Detruncation,  548 
Development  of  the  circulatory  system,  104 

of  the  digestive  apparatus,  108 

of  the  embryo,  71 

of  the  fcetus,  96 

of  the  genito-urinary  organs,  110 

of  the  locomotory  apparatus,  101 

of  the  nervous  system,  97 

of  the  organs  of  sense,  98 

of  the  ovaries,  51 

of  the  respiratory  apparatus,  107 

of  the  skin  and  its  appendages,  100 

of  the  uterus,  46 

periods  of,  115 
Deviation  of  the  uterus,  306 
Diagnosis  of  multiple  pregnancy,  163 
Diameters  of  pelvis,  15 
Diaphragm,  rupture  of,  620 
Differences  in  Fallopian  tubes,  48 

in  pelvis  according  to  sex,  19 

in  vulva  of  other  animals,  29 
Diffused  placenta,  93 
Digital  irritation  of  the  cervix  uteri,  295 


Dimensions  of  the  fcetus  at  birth,  126 
Diminution  in  the  size  of  the  foetus,  296 
Diseases  incidental  to  pregnancy,  181,  182 
of  the  fiL'tus,  381 
of  the  young  animal,  701 
Disproportion   in   size    between   male  and 

female,  375 
Distorted  monstrosities,  416 
Division  of  the  body  of  the  foetus,  548 
Dorso-pubic  position,  427 
Dorso-supra-cotyloidean  position,  428 
Double  monstrosities,  398 
Ductus  arteriosus,  107 

venosus  of  Aranzi,  94,  95,  106 
Duration  of  pregnancy,  148 
Dysenteria  neonatorum,  733 
Dysentery  of  young  animals,  733 
Dystokia,  foetal,  372 

general  considerations  on,  279 
maternal,  289 

due  to  abnormal  positions,  427,  457 
anterior  presentation,  426 
displacement  of  the  uterus,  297 
dorso-lumbar  presentation,  473 
fore  limbs,  433 
head,  443 
head  and  fore  or  hind  limbs,  455, 

459 
hind  limbs,  428 
malpresentation  of  fcetus,  424 
morbid  alterations  in  the  gene)'a- 

tive  organs,  344 
multiparity,  421 
pelvic  constriction,  289 
posterior  presentation,  456 
sterno  -  abdominal    presentation, 

478 
transverse  presentations,  472 
employment  of  force  in,  523 

E. 

Eclampsia,  661 

during  pregnancy,  189 

in  young  animals,  740 
Ectopia  cordis,  403 
Embryo,  development  of,  71 
Embryotomy,  532 

instruments,  534 

preliminary  arrangements  for,  540 
Emphysema  of  fostus,  391 
Employment  of  force  in  dystokia,  523 
Endo-metritis,  625 

septica,  629 
Enlargement  of  the  genital  canal,  29G 
Enzootic  abortion,  216 
Epilepsia  uterina,  668 
Epispadias,  746 
Epizootic  abortion,  216 
Establishing  an  artificial  passage  for  the 

foetus,  297 
Eutokia,  definition  of,  1 
Evisceration,  549 

abdominal,  550 

thoracic,  550 
Evolution  in  dystokia,  492 
Excess  in  growth  of  hair  of  fcetus,  379 

in  volume  of  the  foetus,  374 


TXPEX. 


763 


Exomphalus,  704 
Exostoses  on  pelvis,  liOl 
Expelling  powti-s  in  pjirturition,  228 
Kxpulsion  of  the  f.itns,  234 

of  the  fu'tal  membranes,  238 
Extension  anil  Ht-xion  in  delivery,  403 
External  gtnerative  organs,  27 

surface  of  pelvis,  12 
Extraction  of  fn-tus,  forcible,  295 
Kxtra-uterine  pregnancy,  173 

V. 
Fallopian  lubes,  47 

differences  in,  48 
Fecundation,  64 
Female  generative  organs,  27 
Fibroid  tumours,  348 
Fimbriit' of  Fallopian  tube,  47 
Fi>isures  in  the  teat*.  697 
Fistula  of  the  teat,  700 
recto- vaginal,  616 
vesico  vaginal,  618 
Foetal  cotyledons,  86,  90 
dystokia,  372 
envelopes,  7'> 

puncture  of.  29.'» 
retention  i>f,  .'164 
membranes,  anomalies  in,  380 
disease  in,  3^0 
FiEtus,  abnormal  retention   of  appendages 
of.  7:. 
artificial  pas<>age  for,  297 
death  of,  259,  394 
development  of,  96 
diminution  in  size  of,  296 
diseases  of,  381 
forcible  extraction  of,  295 
mechanical    means   for  extraction  of, 

498 
periods  ■  f  development  of,  11. '> 
physiological  phenomena  in,  11'^ 
positions  (jf,  242 
presentations  of,  241 
weight  and  dimensions  of,  12'> 
Force,    comparison    between    manual    and 
mechanical,  531 
employment  of  in  dystokia,  523 
means  for  developing,  528 
Forceps,  517 

Forcible  extraction  of  ff^tus,  295 
Fractures  of  pelvis,  291 
Free-martins,  161 
Fre<|uency  of  monstrosities,  415 
Functional  mixlifications  after  parturition, 

268 
Functions  of  placenta,  93 
Funic  souffle,  147 
Funis,  23 

G. 
Gal.\CTophorou.h  sinusta,  33 

obliteration  of,  698 
Gastro-hysterotomy,  310,  554 
Gastro- intestinal  catarrh  in  young  animals, 

730 
Gelatine  of  \\'harton,  93 
Gemelliparous  pregnancy,  153 


General  care  of  offspring,  266 

(Jeiicral  considerations  regarding  dystokia. 

279 
(Jeneral  mutatioi.s  of  the  fa-tus,  493 
Generation,  57 
(tenerative  organs,  27 

external,  27 

female,  27 

internal,  36 
Gern  inal  venicle,  50 
Germinative  area,  71 
Gestation  or  pregnancy,  127 

nnomalies  in,  169 

duratiin  of,  148 

gemelliparous,  153 

influence  of,  181 

multiparous,  1 53 

p:ithology  of,  169 

signs  of,  13S 
(ilanduliE  utriculares,  41 
GlanduliB  vaginie,  31 
Ciraafian  vesicles,  49 

maturation  of,  63 
Gubernaculnin  testis,  112 

H. 

H.KMATOMATA,  349 

Hiemorrhage,  post  partum,  571 

umbilical,  702 

uterine,  611 

vaginal,  (il5 
Halter,  head-cord,  or  head  collar,  501 
Heart,  riipture  of,  021 
Hernia  c  f  the  bladder  into  the  vagina,  351 

of  the  intestines,  611,  615 

of  the  uterus,  193,  297 

umbilical,  704 
Hipponianes,  83 
Hock  presentation,   162 
Hooks,  511 

Horizontal  diameter  of  pi'his,  26 
Hydatid  cysts,  ISO 
Hydi  amnios,  185 
Hvdrocephalus,  381 
Hydrometra,  180 
Hydrops  amnii,  185 
Hydrops  uteri,   ISO 
Hjdrothorax  in  futus,  387 
Hygiene  of  pre^'nant  animals,  166 
Hymen,  30,  369 

(>erttistent,  369 
HyjxjHpadia^,  745 
HysU^ria,  189 
Hysterocele,  193,  297 
Hysterotomy,  vaginal,  331 

I. 
Ilh  M.  3 
Imperforate  anus,  743 

prepuce,  746 

vagina,  715 

vulva,  745 
Indigestion  in  y-'Ung  animals,  729 
Induration  of  the  cervix  uteri,  361 
Infectious  abortion,  216,  749 
Inflammation  of  the  n  amniie,  676 

of  the  umbilical  cord,  714 

48 


"54 


INDEX. 


Influence  of  food  on  the  foetus,  376 
Influence  of  pregnancy  on  ordinary  diseases, 

181 
Injuries  to  the  teats,  697 
Inlet  of  pelvis,  14 
Internal  organs  of  generation,  36 
Internal  surface  of  pelvi's,  13 
Interstitial  foitation,  175 
Intestines,  development  of,  108 

hernia  of,  611,  615 

rupture  of,  620 
Inversion  of  the  bladder,  608 

of  the  uterus,  576 

of  the  vagina,  603 
Ischio-pubic  symphysis,  9 
Ischium,  4 

L. 

Labour  pains,  229 

protracted,  258 

tumultuous,  257 
Laceration  of  the  uterus,  609 

of  the  vagina,  613 
Lactation,  271 
Lamina  dorsalis,  71 
Laminitis,  parturient,  071 
Laws  of  teratology,  411 
Leucorrhoja,  624 
Ligamentum  ovarii,  49 
Lipomatous  tumours,  348 
Liquor  amnii,  80 
Lithopnedian  fcetus,  201 
Localised  placenta,  93 
Lochia,  269 
Locked  fojtu.-es,  424 
Lordosis,  291 

M. 
Mamm.e  of  Mare,  32 

congestion  of,  674 

differences  in  other  animals,  34 

inflammation  of,  676 
Mammitis,  190,  673,  676 

atrophy  succeeding,  681 

catarrhal,  677 

during  pregnancy,  190 

induration  succeeding,  681 

infectious,  678,  688 

parenchymatous,  678 

phlegmonous,  679 
Mania  pnerperalis,  (568 
Manual  and  mechanical  force  considered, 

531 
Mastitis,  673,  676 
Maternal  cotyledons.  86 
Maternal  dystokia,  289 
Maturation  of  Graafian  vesicles,  63 
Means  for  developing  necessary  force,  528 
Mechanical  means  for  the  extraction  of  the 

foetus,  498 
Mechanism  of  parturition,  239,  250 
Meconium,  retention  of,  739 
Menstrual  discharge,  60 
Menstruation,  59 
Metritis,  625 

phlegmonosa,  629 
Metro-peritonitis,  625,  629 
Metrorrhagia,  197 


Metrotomy,  600 

Micrococcus  septicus  puerperalis,  633 
Milk,  272 

Milk-fever,  270, -636 

Modifications  in  the  uterus  during  preg- 
nancy, 128 
Moles,  178 
Monstrosities,  394 

classification  of,  395 
distorted,  416 
double,  398,  420 
double-headed,  417 
frequency  of,  415 
origin  of,  411 
simple,  396 
treble,  398 

Acephalian  monstrosities,  396,  405 

Acephalus,  396 

Amorphus,  396 

Androgynus,  398 

Anencephalian  monstrosities,  405 

Anidian  or  zoomylian  monstrosities,  406 

Aschistodactylus,  397 

Atretocephalus,  397 

Atretocormus,  397 

Autositic,  401 

Camylorrhacchis,  398 

Camylorrhinus,  397 

Celosomian  monstrosities,  402,  418 

Cephalotridymus,  398 

Cormotridymus,  398 

Cryptodidymus,  400 

Cyclocephalian  monstrosities,  405 

Cyclopean  monstrosities,  416 

Cyclops  or  monophthalmus,  397 

Dicephalus,  399 

Dicranus,  399 

Diphallus,  398 

Diprospus,  399 

Dipygus,  399 

Ectromelian,  402 

Emprosthomelophorus,  400 

Epigastrodidymus,  400 

Eusomphalian  monstrosities,  407 

Exencephalian  monstrosities,  404 

Gastrodidymus,  400 

(4astro-thoracodidymus,  400 

Hemiterics,  401 

Hermaphrodites,  398 

Heteralian,  409 

Heterocephalus,  399 

Heterodidymus,  399 

Heterotaxies,  401 

Heterotypian,  409 

Ischiodidymus,  400 

Megalocephalus,  398 

Megalomelus,  395 

Melotridymus,  398 

Monocephalian  monstrosities,  400 

Monocranus,  399 

]\Ionomphalian  monstrosities,  407 

Monophthalmus,  397 

Monosomian  monstrosities,  409 

Nanocephalus,  396 

Nanocormus,  396 

Nanomelus,  396 

NanosomuB,  396 


/\/>KX. 


756 


M. instil >sities,  Octopus,  400 

( )mi>halochroiuxlidy inu8,  400 

Oiiiphalositic,  401 

( )pi8thoiuelophorus,  400 

Para-sitic,  401 

Perocephalus,  ;{!'<! 

Peroconnus,  3!'t! 

Peronu'lus,  39ii 

Perosouiiis,  3!*t> 

Pleurt)inelophonis,  400 

Polygnathian,  40'.' 

Polynielian,  410 

I'seudencephaliaii  inonstrohity,  401,  110 

Pseudo-lierinaphrodilus,  398 

Pynadidyiims,  400 

Schelddidyimis,  400 

Schistepigastrii-o-sternalis,  403 

Schist'Kephaliaii  monstrosities,  40ti 

Schistocephaliis,  3!'? 

Schistocormus,  3'.»7,  402 

SchistociTiuus  tissisternalis,  403 

Schistocorums  reHexus,  403 

SchistoniLlus,  397 

Schistosoiuus,  397 

Schistosomas  contortus,  403 

Si.iiiatotridynnua,  3'.'9 

Symt-lian  monstrosities,  402 

SyncLphalian  monstrosities,  4o7 

Sysomian  monstrosities,  409 

Tutrachinis,  400 

Tetrascuhis,  400 

Thoracodidymus,  400 

Trij,'eminal  monstrosities,  398 
Morbid  adhesion  between  f<t-tu8  and  uteni!', 

■itiS 
Morsus  dialx)li,  47 

Mother  and  progeny,  supplementary  obser- 
vations on,  :>ti2 
Mutations  of  the  f(i>tu8,  general,  493 

jiartial,  493 
Multiparity,  dystokiu  fri>m,  421 
MultijKinjus  pregnancy,  153 
diagnosis  of,  163 
positions  of  fa-tuses  in,  lo4 
Multiple  placenta,  93 
Muscles  of  vulva,  29 
Myomatxis  tumours,  348 

N. 
Navki.  .sTiu\<;,  93 

Necessary  aid  in  normal  |)arturition,  '2l>'i 
Normal  anterior  presentation,  427 

jHisterior  pre-it-ntation,  4'>7 
Normal  i>arturition,  227 
Nymphomania,  63 

O. 
Oblitek.\tion  of  the  golactophoruus  sinus, 
698 
of  the  OS  uteri,  36r> 
Obstacles  independent  of  preaentations  and 

positions,  372 
Obstetrical  anatomy,  1 
o{>erations  in.  483 
physiology  of,  ."«.'. 
Occlusion  of  the  au<Htory  canal,  717 
of  the  eyelids,  746 
of  the  uterus,  369 


Occlusion  of  the  vagina,  613 
«Kdema  during  j)regnancy,  1S4 

of  the  umbilicus,  713 
(Kdeniatous  hydrometra,  181 
<  Kstruni,  [19 
Offspring,  attention  to,  265 

general  care  of,  266 
Ouij>halocele,  704 
Omphalomesenteric  vessels,  91 
Organic    modifications    after    parturition, 

275 
Origin  of  monstrosities,  411 
Os  innominatum,  2 
Osteomalacia,  183 
Os  tincie,  40 
Ostium  abdominalis,  17 

uterinum,  47 
Os  uteri,  40 

obliteration  of,  365 
Outlet  of  pelvis,  lH 
Ova  of  Naboth,  41 
Ovarian  fa'tation,  174 
Ovaries,  48 

development  of,  51 

differences  in,  51 
Oviducts,  47 
Ovula  Nabothi,  41 
OvuTn,  changes  in,  68 

P. 

Pai.atk,  cleft,  748 
Palnia  plicata,  40 
Papillomatous  tumours,  348 
Paralysis,  post  |)artum,  659 
Parametritis,  629 
i'araplegia  of  pregnancy,  187 

jxjst  partum,  659 
Partial  niuUitious  of  the  fotus,  493 
Parts    into    which    crotchets   may   be   ini- 

l)lant»d,  515 
Parturient  apoi>lexy,  636 

collaji^e,  636 

eclampsia,  661 

fever,  625,  6*29 

laminitis,  670 
I'arturition,  227 

accidents  after,  56  t 

causes  of,  22"^ 

exi>elling  j)<)wers  in,  228 

mechanism  of,  239 

necessary  aid  in,  255 

normal,  physiology  of,  2*27 

pathology  of,  ti22 

sM'queljB  of,  268 

signs  and  course  of,  232 
Partus  pnecipitatus,  257 
Pa-HS-  or  portecords,  50'.t 
Pathological    congestion   of    the    maium«, 

674 
Pathology  of  parturition,  622 
T'athology  of  pregnancy,  169^ 
Pavilion  of  Fallopian  tube,  47 
Pelvic  cavity,  12 

openings  in,  1 4,  16 

tumours  in,  293 
Pelvic  cellulitis,  615 

symphysis,  relaxation  of,  619 


756 


JKDEX. 


•Pelvimetry,  ii'l 
Pelvis,  1 

•"Pelvis,  articulations  of,  3 
axis  of,  26 
bones  of,  2 
capacity  of,  2o 
cavity  of,  12 

complete  deformity  of,  290 
diameters  of,  22,  26 
differences  in,  6,  17 

according  to  sex,  IP 
exostoses  on,  291 
external  surface  of,  12 
fractures  of,  291 
internal  surface  of,  13 
openings  in,  14 
Perintfium,  31 

rupture  of,  617 
Periods  of  development,  115 
Persistent  hymen,  369 

urachus,  704 
Peritonitis,  611,  615 

Physiological  phenomena  in  the  fuetu.s,  11!: 
a^^sorption,  120 
circulation,  122 
nervous  functions!,  119 
nutrition,  121 
secretion,  124 
Physiology  of  parturition,  227 
Pica,  183 
Placenta,  85 

anomalies  in,  367 
differences  in,  86 
diffused,  92 
fluid  of,  80 
functions  of,  85,  93 
multiple,  81 
polycotyledonary,  86 
prtevia,  87,  380 
tufted,  86 
zonular,  92 
Placentee,  86 
Placental  fluid,  SO 

abnormal  quantity  of,  3S1 
Placentulffi,  78,  86 

accessory,  86 
Pluriparous  gestation,  153 
Polysarcia  of  foetus,  391 
Porte-cords,  509 
Positions  of  the  fretus,  242 
in  multiple,  137,  164 
at  parturition,  242 
in  pregnancy,  164 
in  the  uterus,  137 
Post  partum  hiemorrhage,  574 
paralysis,  659 
paraplegia,  659 
Pregnancy,  127 

accidents  of,  191 
anomalies  in,  169 
course  of,  176 
diagnosis  of,  177 
diseases  incidi-ntal  to,  181,  \t'l 
duration  of,  148 
in  bitch,  153 
in  cat,  153 
in  cow,  151 


Pregnancy,  duration  in  goat,  152 
in  mare,  149 
in  pig,  153 
in  sheep',  153 
extra-uterine,  173 
gemelliparous,  153 
multiparous,  153 
prolonsied,  375 
pseudo,  178 
signs  of,  138 

of  material,  149 
of  rational,  138 
of  sensible,  143 
s2)urious,  178 
symptoms  of,  176 
terminations  of,  176 
treatment  of.  177 
uniparous,  153 
Pregnant  animals,  diseases  of,  181,  182 

hygiene  of,  166 
Preliminary  precautions  and  operations,  484 
Prepuce,  imperforate,  746 
Presentations  of  the  fa'tus,  239,  241 
Prolapsus  of  the  bladder,  608 
vagina,  ante  partum,  603 
vesicae,  608 
Protracted  labour,  258 
Pseudo-pregnancy,  178 
Puberty,  57 
Pubis,  4 

Puerperal  collapse,  600,  636 
Puncture  of  the  cranium,  541 
of  the  fajtal  envelopes,  295 


C^UADRIGEMKLLAR  pregnancy,  156 
Quintuple  pregnancy,  157 

R. 

Rectal  exploration,  145 
Recto-vaginal  fistula,  616 
Rectification    of    presentations    and    posi- 
tions, 487 
Red  colostrum.  190 
Reduced  number  of  fa'tuses,  375 
Relaxation  of  the  pelvic  symph3-sis,  619 
Reproduction,  55 
Repulsion,  492 
Retention,  abnormal,  of  the  foetus,  198 

of  the  fretal  envelopes,  564 

of  the  meconium,  739 
Retropulsion,  487 
Rickets,  183 

Rigidity  of  the  cervix  uteri,  354 
Rotation,  491 
Rupture  of  abdominal  muscles,  621 

of  bladder,  620 

of  diaphragm,  620 

of  heart,  621 

of  intestines,  620 

of  perinfeum,  617 

of  sacro-sciatic  liiiament,  621 

of  uterus,  ante  partum,  194 
post  partum,  609 

of  vagina,  613 

of  water-bag,  234 
Rutting,  59 


L\J>KX. 


S. 
S.vcKO  rocTYfiKAL  articulations,  l» 
SacTo- iliac  iirticiilatioiis,  l> 
Sacruhimbar  artifulatii>ii,  8 
Sacro-sciatic  liganunt,  11 

rupture  of,  G'2\ 
Sacnuu,  '' 

SarCDiiiatous  tumours,  ^47 
ScliiiTous  chorion,  -W 
St.-(|M«.'lii'  of  I  arturition,  26S 
Soruus  cNst-",  ••  !!• 
S'-xual  maturity,  ;>7 
Signs  of  j>r«-^'narcy,  138 
matirial,  1  !'.• 
rational,  l^JSj 
sensible',  143 

Simi)lu  monstrosities,  39G 

Sini;k'  placenta,  '.'•] 

Sinus  lactei,  •"!:} 

Skin  dryness  of  the  newl>orn  animal,  ~i''> 

Spasm  of  the  cervix  uteri,  351 

Si>ora<lic  abortion,  20."i 

Spurious  prej;nancy,  178 

Sterility,  t).'- 

Stricture  of  uterus,  369 

Succus  intestinalis,  81 

Superfotiition,  160 

Suspensory  ligaments  of  uterus,  3'.* 

Sutures,  ;')91 

Symphysis,  pelvic,  relaxation  of,  61li 

Symphysiotomy,  r)61 

Symphysis,  ischio  pubic,  4 


Taxis,  abdominal,  32'.» 

vairinal,  331 
Teats,  structure  of,  33 
fisrtures  in,  607 
tistulif  in,  700 
injuries  to,  607 
T.at  syphon,  601 
Tiratol'-gy.  laws  of,  411 
Testes  muliibre-*,   10 
Tetanus  a&,,'noriun,  711 
Tetanus  neonatorum,  711 
Thigh  and  croup  presentation,   167 
Thoracic  evisceration,  ^>^>0 
Thrombi  or  hiematomata,  349 
Thrombus  of  the  vagina,  610 

of  the  vulva.  619 
Tokology,  definition  of,  1 
Tongue-tie,  747 
Torsion  of  the  uterus,  309 
in  the  i-ow,  312 
in  the  mare,  340 
in  other  animalu,  313 
Traction,  degree  of,  .'>2I 

direction  of,  .''24 
Traumatic   le.«iona  of   genital    and    neigli 

bouring  organs,  600 
Treble  monstri>sitie8,  398 
Trusses,  .'.94,  707 
Tubal  fn>Utinn,  174 
Tubuli  liictiferi,  33 
Tumours  in  fo-tus,  394 
in  j)elvic  cavity,  203 
in  vicinity  of  genital  organs,  353 


Timiuurs,  cancerous,  347 

condvlomatous,  348 

fibroid,  348 

lipomatous,  348 

myomatous.  348 

papillomatous,  34S 

sarcDUiatous,  317 

utero  vaginal,  31  I 
Tumidtuous  labour,  '^'il 
Turning,  401 

r. 

I'MitiLK  Ai.  cord,  O:! 
anomalies  in,  373 
ditferences  in,  04 
dimensions  of,  01 
hiemorrhasrt"  from,  702 
hernia  of,  7S4 
inHamniation  of,  71  1 
obstacle  to  birth,  ^'73 
vein,  94 
vesicle,  84 

ditferences  in,  8."i 
Umbilicus,  udema  of,  713 
Urachus.  83,  94 

persistence  of,  703 
Uterine  arteries,  41 
cvsta,  180 
dilator,  S.'iO 
inertia,  ill 
milk.  91 
Uterovaginal  tumours,  344 
Uterus,  39 

amputation  of,  600 

deviations  in,  306 

diflerences  in.  42 

direction  of,  134 

form  of,  39,  132 

hernia  of,  103 

influence  of  on  other  organs,  135 

inversion  of,  576 

laceration  of,  600 

modificationa    in,    during   pregnancy, 

12.-i 
occlusion  of,  360 
position  of  f<etus  in,  137 
re<luction  of,  585 
reposition  of,  385 
retention  of,  588 
rupture  of,  600 

of  ante  juiitum,  613 
of,  during  birth,  610 
sensibility  of.  131 
situation  of,  30,  131 
structure  of,  39,  128 
t«)r8ion  of,  309,  340,  343 
volume  of,  128 
Utricular  glan<ls,  41 

V. 
Vagina,  36 

atresia  of,  370 

complications  in  rupture  of,  616 

differences  in,  3*^ 

imperforate.  74.'' 

inversion  of,  603 

laceration  of,  613 

occlusion  of,  618 


758 

Vagina,  rupture  of,  613 

thrombus  of,  619 
^'aginal  bulb,  28 

constriction,  370 
cystocele,  351 
exploration,  146 
fcEtation,  175 
hysterotomy,  551 
irrigations,  295 
taxis,  331 
Vaginitis,  622 
Valvula  vaginfe,  369 
Venereal  cestrum,  59 
Ventral  f(ttation,  175 
Version,  491 

Vertical  diameter  of  pelvis 
Vesicle,  umbilical,  S4 


INDEX. 


l-l,  26 


Vesico-vaginal  fistulis,  61 S 
Vesicula  alba,  84 
Vomiting  during  pregnancy,  184 
Vulva,  27 

atresia  of,  370 

differences  in,  30 

imperforate,  745 

thrombus  of,  619 
Vulvar  atresia,  370 

W. 

Water-bag,  rupture  of,  234 
Weight  of  foetus  at  birth,  125 
Wharton's  gelatine,  93 
Wharton ian  jelly,  93 

Z. 

Zonular  placenta,  93 


THE   END. 


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autopsies,  to  be  of  any  value,  should  accurately 
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so  that  a  diagnosis  might  bo  made  by  the  reader  were 
not  the  examiners'  conclusions  stated.  To  make  the 
pathological  conditions  clear  to  the  reader,  some 
definite  system  of  dissection  is  necessary.  The 
absence  in  the  English  language,  of  any  guide  in 
making  autopsies  upon  the  lower  animals.  Induced 
Dr.  Clement  to  write  this  book,  trusting  that  it 
would  prove  of  practical  value  to  the  profession. 
12mo,  cloth,  illustrated , 75 


CLEAVELAND.        "Pronouncing     Medical     Lexicon." 

Pocket  edition.    Cloth 75 


COURTENAY,  '« Manual  of  Veterinary  Medicine  and 
Surgery."  By  Edward  Courtenay,  V.  S.  Crown,  8vo, 
cloth 2  75 


COX.        "  Horses  :     In     Accident    and    Disease."       The 

sketches  introduced  embrace  various  attitudes  which 
have  been  observed,  such  as  in  choking;  the  disorders 
and  accidents  occurring  to  the  stomach  and  intestines ; 
affection  of  the  brain  ;  and  some  special  forms  of  lame- 
ness, etc.  By  J.  Eoalfe  Cox,  F.R.C.V.S,  8vo,  cloth, 
fully  Illustrated 1  &0 


CURTIS.     "Horses,    Cattle,    Sheep    and    Swine."     The 

origin,  history,  Improvement,  description, characteris- 
tics, merits,  objections,  etc.  By  Geo.  W.  Curtis, 
M.S. A.  Superbly  illustrated.  Cloth,  $2  00;  half 
sheep,  $2.75  ;  half  morocco 3  50 


851-853  Sixth  Ai^nne  (cor.  48/)i  St.),  New  York. 


C')l)ALIiyMl'LE.  "Vetcriimry  Obstetrics."  A  compen- 
dium for  the  use  of  advanced  sludonts  and  Practi- 
tioners. By  W.  II.  Dairyniple,  M.  li.  C.  V.  S., 
principal  of  tiie  Department  of  Veterinary  Science  in 
the  Louisiana  State  University  and  A.  &  M.  College; 
Veterinarian  to  the  Louisiana  State  Bureau  of 
Agriculture,  and  Agricultural  Experiment  Stations; 
Member  of  the  United  Suites  Veterinary  Medical 
As-soelations,  etc.      8vo,  cloth,  illus 2  50 

Jt.lLZIEL,  "  The  Fox  Terrier."  Illustrated.  (Monographs 
on  British  Dogs) .      By  Hugh  Dalzlel 1  00 

—  "  The  St.  llernanl."    Illustrated 1  00 

—  "Tlie    IMseases   of   Dog's."      Their    Pathology,     Diagnosis 

an<l  Treatment,  with  a  dictionary  of  Canine  Materia 
Medlca.    By  Hugh  Dalzlel.  12rao,  cloth 80 

—  "  Diseases  of  Horses."     12rao,  cloth 100 

—  '•  Ilrealiint;     and      Training;        DoffS."       Being       concise 

directions  for  the  proper  education  of  dogs,  both 
for  the  field  and  for  companions.  Second  edi- 
tion, rovisoil  and  enlarged.  Part  I,  by  Pathllmler: 
Part  II.  by  Hugh  Dalzlel.      12mo,  cloth,  illus  ..,.2  60 

—  "The    Collie."    Its   History,    Points,     and    Breeding.     By 

Hii;,'h  Dalzlel.  Illustrated,  8vo,  cloth 1  00 

—  "The  Greyhound.  ■    8vo,  cloth,  Illus 100 

DANA.  "Tables  in  Comparalive  Pliyiiolopj."  By  Prof. 
C.  L.   Dana,  M.D 25 

DANCE.  "Veterinary  Tablet."  Fohled  In  cloth  case. 
The  tablet  of  A.  A.  Dance  i«  a  synopsis  of  thediseasee 
of  horses,  cattle  and  dogs,  with  the  causes,  symptoms 
and  CUP'S  75 

DAY.  "The  llace-horse  in  Training."  By  Wm.  Day, 
8vo 3  60 


Veterinary  Catalogue  of  William  li.  Jenkins 


{*)DE  BR  UIN.  "  BoYiue  Obstetrics."  By  M.  G.  De  Bruin, 
Instructor  of  Obstetrics  at  the  Stale  Veterinary 
School  in  Utrecht.  Translated  by  W.  E.  A.  Wyman, 
Professor  of  Veterinary  Science  at  Clemson  A.  &  M. 
College,  and  Veterinarian  to  the  South  Carolina 
Experiment  Station. 
8vo,  cloth,  382  pages,  77  illustrations 5  00 

Synopsis  of  the  Essential  Features  of  Work. 

1.  Authorized  translation. 

2.  The  only  obstetrical  work  which  is  up  to  date, 

3.  Written  by  Europe's  leading  authority    on    the 

subject. 

4.  Written  by  a  man  who  has  practiced  the  art  a 

lifetime. 

5.  Written  by  a  man  who,  on  account  of  his  eminence 

as  bovine  practitioner  and  teacher  of  obstetrics, 
was  selected  by  Prof.  Dr.  Frohner  and  Prof.  Dr. 
Bayer  (Berlin  and  Vienna),  to  discuss  bovine 
obstetrics,  both  practically  and  scientifically. 

6.  The  only  work  containing  a  thorough  differential 

diagnosis  of  ante  and  post  partum  diseases. 

7.  The  only  work  doing  justice  to  modern  obstetrical 

surgery  and  therapeutics. 

8.  Written  by  a  man  whose  practical  suggestions 

revolutionized  the  teaching  of  veterinary  obste- 
trics even  in  the  great  schools  of  Europe. 

9.  The  only  work  dealing  fully  with  the  now  no 

longer  obscure  contagious  and  infectious  dis- 
eases of  calves. 

10.  Ab3olutely  original  and  no  compilation. 

11.  The  only  work  dealing  fully  with  the  difficult 

problem  of  teaching  obstetrics  in  the  colleges. 

12.  The  only  work  where  the  practical  part  is  not 

overshadowed  by  theory. 
See  also  "  Wyman," 


851 -S^S  Sixth  Avenue  {eor.  iSth  St.),  New  Yurk. 


ODOLLAR.  "A  Siirgriciil  0|M'iallnir  Tabic  for  the 
Horse."     By  Jno.  A.  W.  Dollar,  M.K.C.V.S 0  '.»0 

I*)—  "Clinical  Veterinary  Medicine  and  Siirjferj."  By  John 
A.  W.  Dollar,  M.K.C.V.S 5  25 

.  .  .  Thi.s  Work.  containinK  as  it  doo.s  the  ripe  exper- 
ience of  tlie  author,  who  may  be  confiidered  one  of  the 
foremost  surgeons  nnd  cliiiieians  of  tlio  ihiy.  contains  a 
vast  amount  of  exact  sciontidc  information  of  the  utmost 
value  to  tlie  busy  workaday  practitioner,  while  for  the 
.student  of  either  human  or  compa'ative  medicine,  no 
l»«»tter  bouk  could  lie  placed  in  thoir  hands,  that  will  give 
them  a  cloar  insight  into  the  many  iiitricato  problems 
Willi  which  they  are  daily  confronted.  .  .  .—AmeririDi 
I'fleriuaiu  [{frietr.  Now  York,  August,  l'.»oi. 

[*)—  "A  Hand-book  of  Horsc-Sliocing',"  with  introductory 
i'hapters  on  the  anatomy  and  phy.siology  of  the 
horse's  foot.  By  Jno.  A.  W.  Dollar.  M.R.C.V.S., 
translator  and  editor  of  Mulltn's  "  Veterinary  Sur- 
gery," "An  Atlas  of  Veterinary  Surgical  Opt'rations," 
etc. ;  with  the  collaboration  of  Albert  Whoalley, 
F.R.C.V.S.   8vo,  cloth,  433  pp.,  4l6  illustrations  .  .4.75 


DUy.  "  Veterinary  Medicines."  By  Flnlay  Dun,  V.S.  Now 
revised  and  enlargi-d  English  edition.  8vo,  cloth. 3  75 

liWYEIi.  *•  Seats  and  Saddles."  Bits  and  Bitting, 
Draught  and  Ilaniess  and  the  Pn'venlion  and  Cure  of 
lifstlvone-ss  In  Horsi's.  By  Francis  Dwyer.  Illus- 
trated.    1  vol.,  12(uo,  cloth,  gilt 1  50 

FLEHIXO.  "  Veterinary  Obstetrics."  Including  the 
Accidents  and  Disfimes  Incident  I,)  Pr«»gnanoy,  Parturi- 
tion, and  the  early  Age  In  Doiiiostkalod  Animals. 
By  Geo.  Fleming.  F.R.C.V.S.  With  212  illustrations. 
New  edition  rrvutcd,  2 JO  Illustrations,  758  poget.  .-6  25 
773  pages,  8vo,  cloth  (old  edition) 3  50 


VeterinaTry  Catalogue  of  William  It,  Jenkins 


FLEMING.  "Operative  Veterinary  Surgery."  Part  I,  by 
Dr.  Geo.  Fleming,  M.R.C.V.S.  This  valuable  work, 
the  most  practical  treatise  yet  issued  on  the 
subject  in  the  English  language,  is  devoted  to  the 
common  operations  of  Veterinary  Surgery ;  and  the 
concise  descriptions  and  directions  of  the  text  are  illus- 
trated with  numerous  wood  engravings.  8vo,cloth.2  75 
Second  volume  in  preparation. 

—  "Tuberculosis."    From  a  Sanitary  and  Pathological  Point 

of  View.     By  Geo.  Fleming,  F.R.C.V.S .....25 

—  "  Tlie  Contag^ious  Diseases  of  Animals."    Their  influence  on 

the  wealth  and  health  of  nations.    12mo,  paper 25 

—  "  Human  and  Animal  Variolae."    A  Study  in  Comparative 

Pathology.     Paper 25 

—  "Animal      Plagues."         Their      History,     Nature,     and 

Prevention.  By  George  Fleming,  F.  R.  C.  V.  S.,  etc. 
First  Series.  8vo,  cloth,  $6.00;  Second  Series. 
8vo,  cloth 3  00 

—  "  Roaring     in     Horses."         By    Dr.     George      Fleming, 

F.R.C.V.S.  A  treatise  on  this  peculiar  disorder 
of  the  Horse,  indicating  its  method  of  treatment 
and  curability.    Svo,  cloth,  with  col.  plates 1  50 

FLEMING-NEUMANN.  "Parasites  and  Parasitic 
Diseases  of  the  Domesticated  Animals."  A  work 
which  the  students  of  human  or  veterinary  medi- 
cine, the  sanitarian,  agriculturist  or  breeder  or  rearer 
of  animals,  may  refer  for  full  information  regarding 
the  external  and  internal  Parasites — vegetable  and 
animal — which  attack  various  species  of  Domestic 
Animals.  A  Treatise  by  L.  G.  Neumann,  Professor 
at  the  National  Veterinary  School  of  Toulouse. 
Translated  and  edited  by  George  Fleming,  C.  B.,  L.L. 
D., F.R.C.V.S.   873  pages,  365  illustrations,  cloth.?  50 


861-853  Sixth  Avenue  {cor.  iSth  St.),  New  Vork. 


GRESSWELL.  "ITie  Diseases  and  Disordtrs  of  tlie 
Ox."  By  George  Grosswell,  B.A.  With  Notes  by 
James  B.  Gresawell.     Crown,  8vo,  cloth,  lllus 3  60 

—  "  Diseases  and  Disorders  of  the  Horse."    By  Albert,  James 

B.  ami  George  Gresswell.  Crown,  8vo,  illus, cloth. 1  76 

—  "  Veterinary      riiarniaeolo^y      and      Tlierapeutics."     By 

James  B.  Gresawell,  F.R.C.V.S.     16rao,  cloth  . .  .1  60 

—  "  The    Bovine    Presorlber."     For    the    use    of     Veterina- 

rians and  Veterinary  Students.  By  James  B.  and 
Albert  Gresswell.M. B.C. V.S    Cloth 75 

—  "The  Equine  Hospital  Preseriber."    For  the  use  of  Veter- 

inary Practitioners  and  Students.  By  Drs.  James 
B.  and  Albert  Gresswell,  M.R.C.V.S.     Cloth 76 

—  "Veterinary     Pliarninoopa'ia,       Materia       Medioa       and 

Therapeuties"  By  George  and  Cliaries  Gresswell, 
wltli  descriptions  and  physiological  actions  of  medi- 
cines.   By  Albert  Gresswell.    Crown,  8vo,  cloth.  .2  75 

—  Manual  of  "The  Theory  and  Praetlee  of  Equine  Modieine." 

By  James  B.  Gresswell,  F.R.C.V.S.,  and  Albert 
Gresswell,  M.R.C.V.S.,  second  edition,  enlarged, 
8vo,  cloth 2  75 

GOTTIIEIL.  "A  Manual  of  (icneral  lli.stolo^'y," 
By  Wm.  8.  Gottheil,  M  D.,  Professor  of  Pathdogy  in 
the  American  VoU'dnary  College,  New  York ;  etc.,  etc. 
Histology  Is  the  basis  of  the  phyhlcian's  art,  as 
Anatomy  is  the  foundation  of  the  surgeon's  science. 
Only  by  knowing  the  processes  of  life  can  wo  imder- 
stand  the  changes  of  disease  and  theactlon  of  remedies; 
as  the  architect  must  know  his  building  materials,  so 
must  the  prai'litloner  of  medicine  know  the  Intimate 
structure  of  the  body.  To  present  this  knowledge  In 
an  acoessll)lo  and  .'-linplt>  form  has  bet'U  the  author's 
tAsk.     8to.,  cloth,  148  pag>>8,  fully  Illustrated. . .  1  00 


ib  P^eterinary  Catalogue  of  Williavi  R.  Jenkins 


HASSLOCH.     "  A  Coinpend  of  Veterinary  Materia  Medica 

and  Tlierapeiitics."  By  Dr.  A.  C.  Hassloch,  V.S., 
Lecturer  on  Materia  Medica  and  Therapeutics,  and 
Professor  of  Veterinary  Dentistrj'  at  the  New  York 
College  of  Veterinary  Surgeons  and  School  of  Compa" 
rative  Medicine,  N,  Y,     12mo,  cloth,  225  pages  .  .1  50 


HEATLEY.  "  The  Stock  Owner's  Guide."  A  handy  Medi- 
cal Treatise  for  every  man  who  owns  an  ox  or  cow. 
By  George  S.  Heatley,  M.K.C.V.     12mo,  cloth..  .1  25 

—  "The   Horse   Owner's   Safeguard."       A    handy   Medical 

Guide  for  every  Horse  Owner.     12mo,  cloth  1  BO 

—  "Practical  Veterinary  Remedies."  12mo,  cloth. .  1  00 


HILL.    "Tlie   Management    and    Diseases    of   the    Dog." 

Containing  full  instructions  for  Breeding,  Rearing  and 
Kenneling  Dogs.  Their  Different  Diseases.  How  to 
detect  and  how  to  cure  them.  Their  Medicines,  and 
the  doses  in  which  they  can  be  safely  administered. 
By  J.  Woodroffe  Hill,  F.R.C.V.S.  12mo,  cloth,  extra 
fully  illustrated 2  00 

(*)-  "Tlie  Diseases  of  the  Cat."    By  J.  Woodroffe  Hill,  F.R. 
C. V.S.     12mo,  cloth,  illustrated 1  25 

Written  from  the  experience  of  many  years'  prac- 
tice and  close  pathological  research  into  the  maladies 
to  which  our  domesticated  feline  friends  are  liable — a 
subject  which  it  must  be  admitted  has  not  found  not 
prominence  in  veterinary  literature  to  which  it  is 
undoubtedly  entitled. 

HINEBAUCH.    "Veterinary  Dental  Surgery."     For  the 

use  of  Students,  Practitioners  and  Stockmen. 

12mo,  cloth,  illustrated 2  00 

Sheep 2  75 


861-863  Sixth  Ai'enne  {cor.  i8th  St.),  New  York.  11 


IIOARE.    "A     Maniuil    of    Veloriiiury  Tliorapoiitics    niid 

riiurmacoloir.v"      By  E.    Wallis   Hour.-.    F.K.('.V>. 
I'imo,  cloth,  5C0  pages 2  Tf) 

"Dosorvos  Ji  cood  place  in  tlio  lihrarios  of  all  voforina- 
rlans.  •  •  •  Cannot  help  but  be  of  the  Krcatest  assist- 
ance to  the  young  veterinarian  and  the  every  day  busy 
practitioner."— ^menVan  Veterinary  lievietc. 


OnOJtDA  y.  "  Canine  and  Folino  Surgery."  By  Fmlei ick 
T.  G.  Hobilay,  F.H.C.V.S.,  rrof.'ssor  In  Ciiurge  of  the 
Free  Out-Patlents'  Clinlquo  at  the  Royal  Veterituiry 
College,  London.  The  work  contains  7('>  illustrations 
in  the  text.     Demy  8vo,  152  pp.,  full-bound  cloth  ,2  00 


\")Hl'yTI\G.  The  Art  of  Horse-slioelnpr.  A  manual 
for  Farriers.  By  William  Hunting,  F.U.C.V.S.,  edi- 
tor of  the  Veterinary  Record,  ox-prtssidtMitof  the  Uoyal 
College  of  Veterinary  Surgeons.  Mvo,  cloth,  with 
nearly  M)  Illustrations 1  00 


( %/f;A'K  lys.     ''  .Model  of  tlie  llorNC." 10  00 

^See  Banhara). 


(  ')KOIiKRT.  "Practical  Toxicolopy  for  riiysioians  and 
Stndent.««."  l'>y  Professor  I>r.  Kudoijili  Kobert, 
Medical  Director  of  Dr.  Brehmer's  S.inilariuni  for 
Pulmonary  Di.seaac8  at  Goerbersdorf  in  Silesia  (l'ru.'>- 
sla),  hito  Director  of  the  Pharmacological  Institute, 
Dorpat,  Kussia.  Translated  anil  edited  by  L.  H. 
Frledburg,  Ph.D.  Authorized  Edition.  8vo,  cloth.2  50 


KOCH.      ".Ftlolosry   of  Tuberculosis."      By   Dr.  R.  Koch. 

Translated  by  T.  Sauf.     bvo,  cloth 1  00 


12  Veterinai'y  Catalogue  of  William  R.  Jenkins 


KEATING.  "A  New  Unabridged  Pronouncing  Diction- 
ary of  Medicine."  By  John  M.  Keating,  M.D.,LL.D., 
Henry  Hamilton  and  others.  A  voluminous  and 
exhausiive  hand-book  of  Medical  and  scientific 
terminology  with  Phonetic  Pronunciation,  Accentu- 
ation, Etymology,  etc.  With  an  appendix  containing 
important  tables  of  Bacilli,  Microcci  Leucomaines, 
Ptomaines ;  Drugs  and  Materials  used  in  Antiseptic 
Surgery ;  Poisons  and  their  antidotes ;  Weights  and 
Measures ;  Themometer  Scales ;  New  OflBcinal  and 
UnofBcinal  Drugs,  etc.,  etc.     8vo,  818  pages 5  00 

LAMBERT.       "The      (ierm     Theory       of      Disease." 

Bearing  upon  the  health  and  welfare  of  man  and  the 
domesticated  animals.  By  James  Lambert,  F.R.C.V.S. 
8vo.  paper 25 


LAW.  "Farmers'  Veterinary  Adviser."  A  Guide  to  the 
Prevention  and  Treatment  of  Disease  in  Domestic 
Animals.   By  Prof.  James  Law.  lUus.,  8vo,  cloth. 8  00 


{'■)LEGGE.  "Cattle  Tuherciilosis."  A  Practical  Guide 
to  the  Farmer,  Butcher  and  Meat  Inspector.  By  T.M. 
Legge,  M.A.,  M.D.,  D.P.H.,  Secretary  of  the  Eoyal 
Commission  on  Tuberculosis,  1896-98;  author  of 
"  Public  Health  In  European  Capitals,"  and  "  Harold 
Sessions,  F.R.C.V.S."    Cloth 1  00 


LI  A  UTxiRD,  "  Mnnnal  of  Operative  Veterinary  Surgery  " 
By  A.  Liautard,  M.  D.,  V.M.,  Principal  and  Professor 
of  Anatomy,  Surgery,  Sanitary  Medicine  and  Juris- 
prudence in  the  American  Veterinary  College; 
Chevalier  du  Merite  Agricole  de  France,  Honorary 
Fellow  of  the  Royal  College  of  Veterinary  Surgeons 
(London),  etc.,  etc.  8vo,  cloth,  786  pages  and  nearly 
600  illustrations 6  00 


«51-Sr)3  Si.rth  Ar-enne  {cor.  AHth  St.),  AVtr  York.  18 


LIAUTAIil).     "Median  Nt'iirotoinj   in  the  Troatmont  of 
Chronic  Tendinitis  and  rcriostosis  of  flio  Fetlock." 

By  C.  I'ellorin,  lato  KopoUtor  of  Clinii-  iiii<l  Surgriy  to 
the  Alfort  Volorinary  School.  Translated  with  addi- 
tional facts  relating  to  it,  by  Prof.  A.  Liauturd,  M.D., 
V.M. 

IIavin{?  rendered  good  results  when  performed  by 
himself,  the  author  l)elievos  the  operation,  which 
consists  in  dividing  the  cubito-plantar  nerve  and  in 
excising  a  portion  of  the  peripherical  end,  the  means 
of  improving  the  conditions,  and  consequently  the 
values  of  many  apparently  doomed  animals.  Agricul- 
ture in  particular  will  bo  benefited. 

The  work  is  divided  into  two  parts.  Tlic  first  covers 
the  study  of  Median  Neurotomy  itself;  the  second, 
the  exact  relations  of  the  facts  as  observed  by  the 
author.     8 vo. ,  boards 1  00 

—  "Animal    Castration."    A    concise   and    practical   Treatise 

on  the  Castration  of  the  Domestic  Animals.  The 
onlj-  work  on  the  subject  in  the  English  language. 
Illustrated  with  forty-four  cuts.      12mo,  cloth  .\.  2  00 

—  **Vade   Mocum   of  Equine   Anatomy."     By  A.  Liautard, 

M.D.V.S.  Dean  of  the  American  Veterinary  College, 
12tuo.  cloth.     Nf'W  edition,  with  illustrations   .  .  .2  00 

—  "Translation  ofZnndel  on  the  Horse's  Foot,"  Clotli..2  00 

—  "  lIoiT  to  Tell    the   Ape   of  the  Domestic  Animal."    By 

Dr.  A.  Liautanl,  M.D.,  V.S.  Profusely  illustrated, 
12mo,  cloth 50 

—  **0n     the    Lameness     of     Horses."      By    A.    Llautar.l, 

M.l).,V.S 2  50 

See  also  ^^CadioVs  Surgery." 

(•)  -"  A  Treatise  on  Veterinary  Tliorapentirs  of  the  Domestic 
Animals."    (SeeCadlot.) 


14  Veterinary  Catalogue  of  William  R.  Jenkins 


LONG.  "Book  of  the  Pig."  Its  selection,  Breeding, 
Feeding  and  Management.    8vo,  cloth 4  26 

{**)LOWE.  *' Breeding  Racehorses  by  the  Figure 
System."  Compiled  by  the  late  C.  Bruce  Lowe. 
Edited  by  William  Allison,  •'  The  Special  Commis- 
sioner," London  Sportsman,  Hon.  Secretary  Sporting 
League,  and  Manager  of  the  International  Horse 
Agenc}'  and  Exchange.  With  numerous  fine  illustra- 
tions of  celebrated  horses.     Quarto,  cloth 7  50 

L  UDL  O  W.    "  Science  in  the  Stable  ";  or  How  a  Horse  can 

be  Kept  in  Perfect  Health  and  be  Used  Without 
Slioes,  in  Harness  or  under  the  Saddle.  With  the 
Reason  Why.  Second  American  Edition.  Enlarged 
and  Exemplified.  By  Jacob  R.  Ludlow,  M.D.  Late 
Staff  Surgeon,  U.  S.  Army.    Paper,  166  pages 50 

LUPTON.  "Horses:  Sound  and  Unsound,"  with 
Law  relating  to  Sales  and  Warranty.  By  J.  Irvine 
Lupton,  F.R.C.V.S.     8vo,  cloth,  illustrated 1  25 

—  *'  The  Horse."  As  he  Was,  as  he  Is,  and  as  he  Ought  to  Be. 
By  J.  I.  Lupton,  F.R.C.V.S.    Illus.,  Crown,  8vo.  .1  40 

MAGNEB.  "  Facts  for  Horse  Owners."  By  D.  Magner. 
Upwards  of  1,000  pages,  illustrated  with  900  engrav- 
ings.    8vo,  leather  binding . .   7  50 

MAYHEW.        "The    lUustrated    Horse    Doctor."      An 

accurate  and  detailed  account  of  the  Various  Diseases 
to  which  the  Equine  Race  is  subject ;  together  with  the 
latest  mode  of  Treatment,  and  all  the  Requisite  Pre- 
scriptions written  in  plain  English.  By  E.  Edward 
Maynew,  M.R.C.V.S.  Illustrated.  Entirely  new 
edition,  Svo,  cloth 2  75 


851-853  Sixth  Avenue  {cor.  iSth  St.),  Ncic  Vork.  15 


McIiJilDi:.         ''Anatomical     OiitUucs     of    the     Horse." 

I'imo,  ololli.     litMlueixi  to 1  5U 

McCOMBIE.  "Cattle  and  Cattle  Breeders."  Cloth 1  00 

W  FA  DYE  AX.       "Anatomy    of    the    Horse."      A     Dis- 
section   Guide.      J?y    J.    M.    M'Fadyyan,    M.lt.C.V.S. 

8vo,  clotii 5  50 

Tiiis  book  is  intended  for  Veterinary  studonts,  and 
offers  to  tliem  in  its  48  full-page  colored  plates  numer- 
ous other  engravings  and  excellent  text,  tiio  most 
valuable  and  practical  aid  in  the  study  of  Veterinary 
Anatomy,  eupecially   in   the  dissecting  room. 

—  **  Comparafiro  Anatomy  of  the   Domesticated  Animals." 

liy  J.  M'Fadyean.     Profusely   illustrated,  and  to  be 
issued  in  two  ()arLs. 

Part  I— Osteology,  ready.     Paper,  2.50;  cloth 2.75 

(Part  II  In  preparation.) 


MILLS.     "Ho^T  to     Keep     a     Dog     in     the     City."     By 

We.sley  Mills,  M.U  ,  V.S.  It  tells  how  to  choose, 
manage,  iiou.se,  feed,  educate  the  pup,  iiow  to  lieep  Idm 
clean  and  teach  him  cleanliness.     Paper 25 


MOSSELMAS-LIEXAUX.  ''  Veterinary  .Miorobio- 
logy."  Hy  Professors  Mosselnian  and  I,i«iiaux, 
Nat.  Vt!t»>rinary  College,  Cureghem,  Belgium.  Trans- 
lated and  p<lite<l  by  R.  It.  Dinwiddle,  Professor  of 
Veterinary  Soionce,  College  of  Agriculture,  Arkansas 
SUte  Univerelty.     12rao,  cloth,  342  pages 2  00 


MORETOS.     "  On  Horso.l)reaking."    12mo,  cl 60 


16  Veterinary  Catalogue  of  William  R.  Jenkins 


MOLLER,  "Operative  Veterinary  Surgery."  By  Trofes- 
sor  Dr.  H,  MoUer,  Berlin.  Translated  and  edited 
from  the  2nd  edition,  enlarged  and  improved,  by 
John    A.  W.  Dollar,  M.K.C.S. 

Prof.  Moller's  work  presents  the  most  recent  and 
complete  exposition  of  the  Principles  and  Practice  of 
Veterinary  Surgery,  and  is  the  standard  text-book  on  the 
subject  throughout  Germany. 

Many  subjects  ignored  in  previous  treatises  on 
Veterinary  Surgery  here  receive  full  consideration, 
while  the  better  known  are  presented  under  new  and 
suggestive  aspects. 

As  Prof.  Moller's  work  represents  not  only  his 
own  opinions  and  practice,  but  those  of  the  best 
^  Veterinary  Surgeons  of  various  countries,  the  trans- 
lation cannot  fail  to  be  of  signal  service  to  American 
and  British  Veterinarians  and  to  Students  of  Veter- 
inary and  Comparative  Surgery. 
1  vol.,  8vo.     722  pages,  142  illustrations 5  25 

NOCAHD.  "  Tlie  Animal  Tuberculoses,  and  their  Relation 
to  Human  Tuberculosis."  By  Ed.  Nocard,  Prof,  of  the 
Alfort  Veterinary  College.  Translated  by  H.  Scurfield, 
M.D.  Ed.,  Ph.  Camb.  ]2mo,  cloth,  143  pages. . .  .1  00 
Perhaps  the  chief  interest  to  doctors  of  human 
medicine  in  Professor  Nocard's  book  lies  in  the 
demonstration  of  the  small  part  played  by  heredity, 
and  the  great  part  played  by  contagion  in  the  propa- 
gation of  bovine  tuberculosis.  It  seems  not  unreason- 
able to  suppose  that  the  same  is  the  case  for  human 
tuberculosis,  and  that,  if  the  children  of  tuberculosis 
parents  were  protected  from  infection  by  cohabitation 
or  ingestion,  the  importance  of  heredity  as  a  cauge  of 
the  disease,  or  even  of  the  predisposition  to  it,  would 
dwindle  away  into  insignificance. 

PEGLEM,  "TUe  Book  of  tUe  Goat,"  12mo,  cloth 1  75 


m\-85'3  SLvth  Avemte  (cor.  i8thSt.),  AVir  York. 


VKLI.EItiy.       "Median    Nciiiotoiiiy     in     llic   Trcutmcnt 
<»r('hr»iiii'  rciiiliiiiti^  und  I'criostosi^  ofllic  Fctititl*." 

By  C.  rolltMlii,  lalo  rcpotitor  of  Clinic  and  Surgery  to 
tlio  Alfort  Vetoriniiry  School.  Translutcil,  wiLli  Addi- 
tional Facts  Ilelutint:  to  It,  l>y  Prof.  A.  Liautard,  M.D., 

V.ll.     8vo,  boards,  ilhistnilt'd 1  CO 

See  also  "  Liuufanl." 


rETERS.  '  A  Tiil):niiIoiis  Htrd-Te^t  wilh  Tuber- 
ciilin."  By  Austin  IVtcrs,  M.  11.  C.  V.  S.,  Ciiief 
Inspi'ctor  of  Cattlo  for  tlie  New  York  Stato  Board  of 
Health  during  the  winter  of  1892-93.     Pamphlet 25 


i')ri'EirrEIt  -  U  ILLIAMS.  "  a  Comx'  of  Siirjrinil 
Operations  for  Voterlnarj  StiHlenls  and  rracli- 
tloMors.*'  By  \V.  I'feilTer,  Assistant  in  the  Surgical 
Clinii-  of  the  Veterinary  High  School  in  Berlin,  and 
W.  L.  Williams,  V.S.,  Professor  of  Surgery  in  the 
New  York  State  Veterinary  College,  Cornell  Univer- 
sity, Ithaca,  N.  Y. 
With  12  illustrations,  12nio,  cloth 1  2.") 

A  concise  description  of  the  more  common  major 
surgical  operations,  designed  as  a  laltoratory  guide  in 
surgical  exercises  for  veterlnarj*  students  and  as  a 
ready  reference  for  practitioners  In  surgical  opera- 
tions. Based  upon  a  translation  of  Dr.  PfeifTor's 
••  Operatlons-Cursus,"  embodying  the  expi-rience  of 
Dr.  Pf-ilffer  and  Prof.  Dr.  Frohner  in  the  Berlin 
Veterinary  School.  Wltli  numerous  annotations  there 
have  been  addc^l  many  of  the  nt'\v.>r,  largely  distinc- 
tively American,  operations. 


REYyOTjD.      "Breeding  and   .Management    of    Draught 
Horses,"    «vo,  cloth 1  iO 


18  Veterinary  Catalogue  of  Williavi  R.  Jenkins 


ROBERGE.  "  The  Foot  of  the  Horse,"  or  Lameness 
and  all  Diseases  of  the  Feet  traced  to  an  Unbalanced 
Foot  Bone,  prevented  or  cured  by  balancing  the  foot. 
By  David  Roberge.    8vo,  cloth 5  00 


{**)SEWELi1j.  "  The  Examination  of  Horses  as  to  Sound- 
ness  and  Selection  as  to  Purchase."  By  Edward 
Sewell,  M.E.C.V.S.L.     8vo,  paper 1  £0 

—  It  Is  a  great  advantage  to  the  business  man  to 
know  something  of  the  elements  of  law,  and  nobody 
ought  either  to  buy  or  own  a  horse  who  does  not  know 
something  about  the  animal.    That  something  this  book 

gives,  and  gives  in  a  thoroughly  excellent  way 

Our  Animal  Friends,  November,  1898. 


SMITH.     "  A   Manual   of  Veterinary   Physiology."     By 

Veterinary  Captain  F.  Smith,  M.R.C.V.S.     Author  of 
"A  Manual  of  Veterinary  Hygiene." 

Throughout  this  manual  the  object  has  been  to  con- 
dense the  information  as  much  as  possible.  The 
broad  facts  of  the  sciences  are  stated  so  as  to  render 
them  of  use  to  the  student  and  practitioner.  In  this 
second  edition — rewritten — the  whole  of  the  Nervous 
System  has  been  revised,  a  new  chapter  dealing  with 
the  Development  of  the  Ovum  has  been  added  together 
with  many  additional  facts  and  illustrations.  About 
one  hundred  additional  pages  are  given.  Second 
edition,  revised  and  enlarged,  with  additional  illus- 
trations   3  75 

—  '^Manual  of  Veterinary  Hygiene."    2nd  edition,  revised. 
Crown,  8vo,  cloth 3  25 


{")  STRANGE  WAT.  "Veterinary  Anatomy."  Edited  by 
I.  Vaughan,  F.L.S.,  MK.C.V.S.  New  edition  revised, 
with  several  hundred  illustrations.   Svo.  cloth. . .  .5  00 


851-833  Sixth  Arcnue  wor.  48//i  St.),  Neil'  York.  19 


(*')SrsSl)OIlI\      "Laryfe  Coloivd  >Viill  Diagrams."     By 

I'lof.  Siissdorf,  M.D.  (of  G«")ltiiiKi'n).  Text  traiislatod 
by  Prof.  W.  Owon  Williams,  of  tho  Now  Veterinary 
C«)lleg«,  Edinburgh.     Size,  44  inches  by  30  inelies. 

1.— llorsj'.  4.— Ox. 

2.— Maro.  5.— Boar  and  .S(»>v. 

;J.-C'»n.  G.— Dog  anil  IJiUh. 

Showing  the  position  of  the  visceni  in  the  large 
cavities  of  tho  body. 

Price,  unmounte<l I  75  each 

"      mounted  on  linen,  with  roller 3  50     •♦ 


DFAN  MATEIi,  "  .V  Text  HcM.k  of  Vetoriiiarv  {)y\\- 
Ihalmoloiry."  By  Georgf  G.  Van  Mater,  M.D., 
I).\  .S.,  l'rof»^9sor  of  Ophthalmology  in  tho  American 
Vrteriiuiry  College;  Oculist  and  Auristto  St.  Martha's 
Sanitarium  and  Dispensary;  Consulling  Eye  and  Ear 
Sur;;eoti  to  the  Twenty-si.xth  Ward  Dispensary;  Eye 
and  Ear  Surgeon,  Brooklyn  Eastern  District  Dispen- 
sary, etc.  Illustrated  by  one  chromo  lilbogruph  plate 
and  seventy-one  engravings, 
bvo  cloth 3  00 


yETKIUSAUl       in  AG  RAMS       in     Tabular      Form. 
Size,  2HJ  in.  x  22  inches.     Piico  per  set  of  live. . .  4  75 

No.  1.  "The  Kxtcrnnl  Form  and  Eleniontarj  Ana- 
tomj  of  the  Horse-'  Eight  colored  illustraiions — 
I.  External  regions;  2.  Skidelon  ;  3.  Muscles  (Superior 
1-ayer);  I  Muscles  (Deep  Layer);  5.  Resplratojy  Ap- 
panilus;  ('•.  Digestive  Apparatus;  7.  Circulatory  Ap- 
panitus ;  8.  Nerve  Apparatus ;  with  letter-press  descrip- 
tion   1  26 


20  Veterinary  Catalogue  of  William  R.  Jenkins 


VE TEBINA RY  DIA GRAMS. —Continued . 

No.  2.  "The  Ag^e  of  Domestic  Animals."  Fortj-two 
figures  illustrating  the  structure  of  the  teeth,  indicat- 
ing the  Age  of  the  Horse,  Ox,  Sheep,  and  Dog,  with 
full  description 75 


No.  3.    "The  Unsoundness  and  Defects  of  the  Horse." 

Fifty  figures  illustrating— 1.  The  Defects  of  Confor- 
mation ;  2.  Defects  of  Position ;  3.  Infirmities  or  Signs 
of  Disease ;  4.  Unsoundnesses ;  5.  Defects  of  the  Foot ; 
with  full  description 75 


No.  4.    "The  Shoeing  of  the  Horse,  Mule  and  Ox," 

Fifty  figures  descriptive  of  the  Anatomy  and  Physio- 
logy of  the  Foot  and  of  Horse-shoeing 75 


No.  5.  "The  Elementary  Anatomy,  Points,  and  But- 
cher's Joints  of  the  Ox."  Ten  colored  illustrations 
—  1.  Skeleton;  2.  Nervous  Sj'stem :  3.  Digestive 
Sj-stem  (Eight  Side) ;  4.  Respiratory  Sj'stem  ;  5.  Points 
of  a  Fat  Ox  ;  6.  Muscular  System  ;  7.  Vascular  System  ; 
8.  Digestive  System  (Left  Side) ;  9.  Butcher's  Sections 
of  a  Calf ;  10.  Butcher's  Sections  of  an  Ox ;  with  full 
description 1  25 


WAliLEY.     "Four  Bovine  Scourges."    (Pleuro-Pneumonla, 
Foot     and     Mouth      Disease,      Cattle    Plague    and 
Tubercle.)      With   an    Appendix    on    the  Inspection 
of  Live  Animals  and  Meat. 
Illustrated,  4to,  cloth 6  40 


851-853  Sixth  Avenue  (cor.  ISth  St.),  New  York  21 


IVALLEr.    "X  Pratlical  Guide  to  Meat  Inspect  ion."    By 

Tlioiuiia  Wiilhy,  M.K.C.V.S.,  foniH-rly  piimipid  of 
the  EiUiibur};h  lloy.il  (Dick)  Voleriiiary  College;  Pro- 
fessor of  Veterinary  Medicine  and  Surgery,  etc.  Third 
Edition,  thorouglily  revised,  with  forty-five  colored 
Illustrations,  12mo,  cloth 3  00 

(llh  edition  in  preparation.) 

An  experience  of  over  30  years  in  liis  profession 
and  a  long  ofTlcial  connection  (sonio  sixteen  years) 
with  Edinburgli  Abattoirs  have  enabled  the  autiior  to 
gatlier  a  large  store  of  information  on  the  subject, 
which  he  has  embodied  in  his  book.  Dr.  Walley'.'^  opi- 
nions are  regarded  as  the  highest  authority  on  Meat 
Inspection. 


ff'ILLTAMS.      "  Principles   and    Practice   of    Veterinary 
Medicine.  "     Now    author's    edition,  entirely  revised 
and    illustrated    witli    numerous    plain    and    colored 
plates.  By  W.  Williams,  M.R.C.V.S. 
Svc,  eloth 6  00 


—  '•Principles  and   Practice   of  Veterinary    Surgery."    New 
author's   e«litlon,      entirely    revised    and     Illustrated 
witli    numerous    plain    and     colored   plates.     Hy  \V. 
Williams,  M.ll.C.V.8. 
8vo,  cloth C  00 


C)friLLIAMS  .  PFKIFFEn.  "A  Course  of  Snruical 
Oprrations  fur  Veterinary  Students  nnd  Pradi- 
tioners."  Wy  W.  I'f.-ilTer  .'md  W.  L.  Wiili:iiiis.  V.S. 
With  42  illustrallons.  12mo,  eloth 1  V!5 

See  n/xo  ^'Pfriff'tr-WillinwH." 


22  Veterinary  Catalogue  of  William  R.  Jenkins 


THE  MOST  COMPLETE,  PROGRESSIVE  AND 
SCIENTIFIC  BOOK  ON  THE  SUBJECT  IN 
THE  ENGLISH  LANGUAGE 

(*)  WINSL O  fV,  "Veterinary  Materia  Medica  and  Tlierapeu- 
tics."  By  Kenelm  Winslow,  B.A.S.,  M.D.V.,  M.D., 
(Harv.);  Assistant  Professor  of  Therapeutics  in  tiie 
Veterinary  Scliool  of  Harvard  University ;  Fellow  of 
tiie  Massachusetts  Medical  Society  ;  Surgeon  to  the 
Newton  Hospital,  etc. 

8vo,  cloth,  750  pages 6  00 

Youi'  letter  received  and  I  am  pleased  to  know  that  we 
are  to  have  an  American  Materia  Medica.— J.  H.  Wattles, 
Sr.,  M.D.,  D.V.S.,  The  Western  Veterinary  College,  Kansas 
City,  Mo.    March  19th,  mn. 

.  .  .  Am  delighted  with  it.  It  is  remarkably  correct, 
complete  and  up  to  date  and  is  bound  to  supersede  an>' 
other  work  on  the  same  subject  heretofore  before  the  pro- 
fession. 

No  practitioner's  library  is  complete  without  it  and  it 
will  be  indispensable  for  students,  as  it  does  away  with  the 
necessity  of  their  having  a  number  of  collateral  books  tm  the 
subject. 

It  will  be  adopted  as  the  text  l)ook  in  the  Chicago  Veter- 
inary College. — Dr.  E.  L.  Quitman,  Chicago  Veterinary 
College.    June  35th,  liWl. 

.  .  .  The  book  is  of  admirable  merit  and  full  of  valuable 
information  from  beginning  to  end,  very  explicit,  rich  and 
interesting,  and  should  be  in  the  hands  of  every  student  as 
well  as  practitioner  of  the  art  of  Veterinary  Medicine.— 
Tlmrxton  Miller,  M.D.,  Professor  of  Materia  Medica,  Thera- 
peutics and  Chemistry,  San  Francisco  Veterinary  College. 
July  Sth,  liWl. 

.  .  .  I  have  found  the  book  very  satisfactory  as  a 
reference  book  to  be  used  in  connection  witli  lectures.  .  . 
—Dr.  ^y.  A.  Lnnthicve.  College  of  Pliarmacy,  Ohio  State 
University.    August  r.th,  litUl. 


851-853  Sixlh  Avnme  (ror  iHth  St.),  Xtw  York  23 


(*•)  irr.)/.l  .V.  "TIic  Clinical  IMasrnosis  oT  liiiinono.ss 
ill  Iho  Ilorso."  ly  W.  E.  A.  Wyman,  V  S  ,  Prof,  of 
Veterinary  l?cionco,  Clomson  A.  &  M  ColU'tiO,  and 
Veterinariiui  to  the  South  Carolina  Experiment  Sta- 
tion.   8vo,  cloth,  iliudtruted 2  50 


(•)  — "Iloviiic  OI)>lc(rics."  By  M.  G.  Do  IJniln,  Inslructor 
of  Obstetrics  at  the  State  Veterinary  School  in 
I'lreciit.  Translated  by  W.  E.  A.  Wyniiin,  ^I.D.V.. 
V.S.,  Professor  of  Veterinary  Science,  Clemsoii 
A.  it  M.  College,  and  Veterinarian  to  the  South 
Carolina  Experiment  Station. 

8vo,  cloth,  382  pages,  77  illustrations 5  dO 

See  aho  "  De  Bruin." 


ZUNDEL.      "The    Horse's    Foot    and    Its    IMscasos."     By 

A.  Ziintlel,  Principal  Veterinarian  of  Alsac«*  Lorraine. 
Translale<l  by  Dr.  A.  Liautard,  V.S.  12mo,  cloth 
Illustrated 2  UO 


ZUILL.  •Typliiiiil  Fever;  »r  Contaprious  Influenza 
in  the  Horse."  By  Prof.  W.  L.  Zuiii,  M.D.,D.V.S. 
Pamphlet 26 


Our  lUmhs  are  for   sale  hjf   all   hooUsellvrs, 
or    trill  hr  srnt   prrimid  for   tin-  ftyirrsi  lirrr  t/iiotttl. 


VVILUAH   R.  JENKINS, 

851  and  853  Sixth  Avenue, 
NEW  YORK. 


THIS  BOOK  IS  DUE  ON  THE  LAST  DATE 
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WILL  INCREASE  TO  50  CENTS  ON  THE  FOURTH 
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BIOLOGY 

LIBRARY 

OCT  1'^  1934 

DEC  6     193B 

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\ 

0c25'59F? 

OCT  6     l^t' 

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OCT    ^-W^' 

3  195.1 

.' 

1 

^..,«,:.««^. 

LD  21-5m-7,'33 

'^^'•9(; 


